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  • Title: HIV-related risk behaviors among cocaine users.
    Author: Khalsa HK, Kowalewski MR, Anglin MD, Wang J.
    Journal: AIDS Educ Prev; 1992; 4(1):71-83. PubMed ID: 1311941.
    Abstract:
    Risk behaviors related to human immunodeficiency virus (HIV) infection and transmission were studied in a sample of 167 male cocaine users admitted during a 5-month period to an inpatient drug treatment program. Data obtained included drug history and related behaviors, sexual behaviors, knowledge, and attitudes regarding HIV infection and AIDS. Approximately 20% of the sample had used IV drugs in the year prior to the interview and 94% of these reported sharing needles; 20% of the IV drug users (IVDUs) reported always using bleach to clean needles. With regard to sexual practices, 7% of the total sample reported sex with other males in the year prior to the interview; 86% of the total sample reported having sex with females and 80% of these noted they never or rarely used condoms during vaginal sex. Respondents generally did not believe they themselves were at high risk for HIV infection, yet they continued to engage in acknowledged high-risk behaviors. These findings suggest that IVDUs and non-IV cocaine users are likely to contribute to the spread of HIV in several populations. 167 cocaine-dependent male admissions to an inpatient alcohol and drug treatment program at West Los Angeles Veterans Administration Medical Center in 1988-89 were studied to identify determinants of HIV infection and issues relevant in planning risk-reduction behavior. Criteria for cocaine drug dependent diagnosis was based on the staff physician's determination according to the DSM-III-R. 18% were at least 29 years old, 51% were 30-39 years, 26% were 40-49 years, and 5% were 50 years. 53% were black, 32% white, 7% Hispanic,and 8% other. 38% were unemployed, 33% had full-time employment, and 10% worked part-time. 19% received welfare or disability or had irregular jobs. 16% were homeless at the time of the interview. 76% had a high school education or higher. 57% had an income US $15,000/year. 42% were separated or divorced. 88% had been in jail for at least 1 day. The average score on the knowledge of AIDS 6-point scale was 4.45 with iv drug users (IVDUs) having the highest scores. 25% had been tested previously for HIV infection. 10.6% of the 47 tested were seropositive. Most had prior other drug and alcohol use. 74% perceived themselves to be cocaine dependent. 20% (32) had used iv drugs within 6 months of the interview of which 88% were iv cocaine users (IVCUs). Most heavy IVCUs concentrated use within 1-3 months. 50% reported iv heroin use. IVCU drug use was between 1-10 times a month. Source of needle acquisition is provided. 21% used a needle only once. 46% reused needles 2-6 times, and 33% 10 times. 94% (31) reported sharing needles with 1 other person and 55% in group situations of whom 26% were strangers. 10% in group situations shared in shooting galleries and 13% with strangers. Only 5 of the 33 IVDUs reported using effective needle cleaning methods. 85% had sex with female partners and 7% had male sex partners. 71 % of heterosexuals and 75% of homosexuals had 1-5 partners. 3% (5) of the total sample of 67 had male IVDU sex partners. 21% had sex with female IVDUs. 60% of those having sex with IVDUs had 1-5 partners. 16.2% reported participating in anal sex with 5 partners. 91.7% did use condoms regularly. 50% reported being high during sex. 11% reported being paid for sex. 17% recognized being at greater risk and 41% thought their risk was lower. 72% reported behavior changes to reduce the risk of HIV infection. Subjects report fewer sexual contacts than previous studies. More pay for sex with crack. Female use patterns are different. IVDUs and non-IVCUs are likely to contribute to the spread of HIV in several populations.
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