Clustered drug and sexual HIV risk among a sample of middle-aged injection drug users, Houston, Texas

• Published in: AIDS care Vol. 25; no. 7; pp. 895 - 903
• Main Authors: Noor, Syed W.B., Ross, Michael W., Lai, Dejian, Risser, Jan M.
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 08.05.2013; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Acquired immune deficiency syndrome; Adult; Age Factors; Aged; AIDS/HIV; Biological and medical sciences; clustered HIV risk; Cocaine; Drug addiction; dual HIV exposure; Female; High risk; HIV; HIV Infections - epidemiology; HIV Infections - etiology; HIV Infections - psychology; homeless; Homeless people; Homelessness; Houston; Human immunodeficiency virus; Human viral diseases; Humans; Hypodermic needles; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; injection drug user; Intravenous drug addicts; Logistic Models; Male; Medical sciences; Middle Aged; Middle aged people; Needle Sharing - statistics & numerical data; Public health; Risk; Risk exposure; Risk Factors; Safe sexual practices; Sexual behaviour; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - etiology; Substance Abuse, Intravenous - psychology; Texas; Texas - epidemiology; U.S.A; Unsafe Sex - statistics & numerical data; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States; North America; Texas; America; United States > US; Houston Texas; USA, Texas; Social environment; Intravenous administration; dual HIV exposure; Mental health; clustered HIV risk; Ester; Adult; Drug of abuse; Public health; Human; Immunopathology; Illicit drug; Retroviridae; AIDS; Exposure; Immune deficiency; Lentivirus; Infection; Virus; Homeless; Viral disease; Texas; injection drug user; Cocaine; Human immunodeficiency virus; Houston
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2012.733333

Recent studies have reported a clustered pattern of high-risk drug using and sexual behaviors among younger injection drug users (IDUs), however, no studies have looked at this clustering pattern in relatively older IDUs. This analysis examines the interplay and overlap of drug and sexual HIV risk among a sample of middle-aged, long-term IDUs in Houston, Texas. Our study includes 452 eligible IDUs, recruited into the 2009 National HIV Behavioral Surveillance project. Four separate multiple logistic regression models were built to examine the odds of reporting a given risk behavior. We constructed the most parsimonious multiple logistic regression model using a manual backward stepwise process. Participants were mostly male, older (mean age: 49.5±6.63), and nonHispanic Black. Prevalence of receptive needle sharing as well as having multiple sex partners and having unprotected sex with a partner in exchange for money, drugs, or other things at last sex were high. Unsafe injecting practices were associated with high-risk sexual behaviors. IDUs, who used a needle after someone else had injected with it had higher odds of having more than three sex partners (odds ratio (OR) = 2.10, 95% confidence interval (CI): 1.40-3.12) in last year and who shared drug preparation equipment had higher odds of having unprotected sex with an exchange partner (OR = 3.89, 95% CI: 1.66-9.09) at last sex. Additionally, homelessness was associated with unsafe injecting practices but not with high-risk sexual behaviors. Our results show that a majority of the sample IDUs are practicing sexual as well as drug-using HIV risk behaviors. The observed clustering pattern of drug and sexual risk behavior among this middle-aged population is alarming and deserve attention of HIV policy-makers and planners.