Sexual contacts of intravenous drug abusers: implications for the next spread of the AIDS epidemic

A scarcity of knowledge exists regarding the sexual behavior of intravenous drug abusers (IVDAs) despite their potential role in the heterosexual transmission of acquired immunodeficiency syndrome (AIDS). Using a standardized questionnaire of drug and sexual practices, 96 patients enrolled in methadone maintenance treatment in New York City were interviewed anonymously.Over one half of the 767 sexual contacts reported by this sample were non-IVDAs. Male IVDAs, compared with female IVDAs, reported a significantly greater percentage of heterosexual non-IVDA contacts (P < .001). Participating in needle-sharing behavior or being younger than 35 years of age was also associated with a significant probability (P < .001) of having a non-drug-using sex partner. Female IVDAs, as compared with male IVDAs, were at greater risk for human immunodeficiency virus (HIV) infection from sexual contacts with male IVDAs and their own parenteral drug use. Black and Hispanic IVDAs, in contrast to white IVDAs, reported a statistically insignificant greater percentage of non-IVDA sex partners.These findings suggest that aggressive health education campaigns targeted for IVDAs and sexually active female non-IVDAs are sorely needed to reduce HIV-exposing sexual behaviors, especially in communities where intravenous drug use is prevalent.