Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey

Studies in drug use settings rarely use sex under the influence of drugs as an indicator of sexual risk behaviors. This study explored the prevalence of sex under the influence of drugs and its correlates among people who use drugs (PWUD) in Cambodia. We included 1147 PWUD from 12 provinces in this study. A multiple logistic regression analysis was conducted to identify factors associated with sex under the influence of drugs. Of the total, 39.7% reported having had sex under the influence of drugs in the past three months. After adjustment, sex under the influence of drugs was significantly associated with living in urban areas (AOR 2.97, 95% CI 1.68–5.27), having two to three (AOR 2.48, 95% CI 1.76–3.49) and four or more sexual partners (AOR 6.46, 95% CI 4.24–9.85), engaging in transactional sex (AOR 1.69, 95% CI 1.19–2.39), using methamphetamine (AOR 2.97, 95% CI 2.06–4.31), using drugs for three years or longer (AOR 1.67, 95% CI 1.15–2.41), having been to a drug rehabilitation center (AOR 1.77, 95% CI 1.18–2.41), having a network of ten or more PWUD (AOR 1.82, 95% CI 1.25–2.66), and having high psychological distress (AOR 1.66, 95% CI 1.25–2.22). This study documents the high prevalence of sex under the influence of drugs and its risk factors among male and female PWUD in Cambodia. These findings point to the need for integrating HIV and harm-reduction programs using innovative approaches to address the overlapping risks in this key population.