HIV risk behaviors among female IDUs in developing and transitional countries

Charles M Cleland,Vladimir Poznyak,Theresa E Perlis,Gerry Stimson,Don C Des Jarlais

doi:10.1186/1471-2458-7-271

Abstract

BackgroundA number of studies suggest females may be more likely to engage in injection and sex risk behavior than males. Most data on gender differences come from industrialized countries, so data are needed in developing countries to determine how well gender differences generalize to these understudied regions.MethodsBetween 1999 and 2003, 2512 male and 672 female current injection drug users (IDUs) were surveyed in ten sites in developing countries around the world (Nairobi, Beijing, Hanoi, Kharkiv, Minsk, St. Petersburg, Bogotá, Gran Rosario, Rio, and Santos). The survey included a variety of questions about demographics, injecting practices and sexual behavior.ResultsFemales were more likely to engage in risk behaviors in the context of a sexual relationship with a primary partner while males were more likely to engage in risk behaviors in the context of close friendships and casual sexual relationships. After controlling for injection frequency, and years injecting, these gender differences were fairly consistent across sites.ConclusionGender differences in risk depend on the relational contexts in which risk behaviors occur. The fact that female and male risk behavior often occurs in different relational contexts suggests that different kinds of prevention interventions which are sensitive to these contexts may be necessary.

Highlights

A number of studies suggest females may be more likely to engage in injection and sex risk behavior than males
Johnson and colleagues found more needle sharing among female injection drug users (IDUs), and suggested this might have been due to higher depression among females, since females were more depressed and depression was related to needle sharing [6]
Data collected as part of the NIDA Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research showed that needle sharing was more frequent among female than male IDUs, and this effect was consistent across the 18 sites studied [7]

Summary

Introduction

A number of studies suggest females may be more likely to engage in injection and sex risk behavior than males. Female injection drug users (IDUs) frequently have been found to engage in more risk behavior than males. In a general sample of drug users in Denver, Colorado, Booth [1] found that needle sharing was more common among females than males. Among IDUs not in treatment in Paterson, New Jersey, recent injecting with a sex partner was more common among females [3], and this was often an injection given to the female by the male after the male had already injected. Women may avoid using syringe exchanges out of fear that they will be recognized within their community as an injection drug user, leading to eviction or loss of child custody [8]

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Conclusion