Recent condom use by arrested injection drug users in King County, Washington, USA

Abstract

Background Sexual transmission is a significant HIV infection route among injection drug users (IDU) in the United States and condom use is a primary means of HIV prevention. To help guide and evaluate public health measures to reduce HIV infection, we examined HIV prevalence among IDU and evaluated condom use levels, time trends and associations with sociodemographic, sexual and drug-related variables. Methods Interviews and HIV screening were conducted among 1765 arrested IDU recruited from two jails (in Seattle and Kent) in King County, Washington, from 1998 through 2002. Results HIV prevalence was 2.5%. Prevalence was higher for participants reporting a history of sex work and for men reporting male-to-male, which together accounted for 26 of the 44 HIV-positive participants. In the previous 6 months, among sexually active participants, 13% reported using condoms always, 22% sometimes and 65% never. There was a significant rise in condom use over time, with 14% reporting any condom use in 1998 and 44% in 2002. In both males and females, condom use rose as a function of the number of sexual partners; in females the rise was especially steep. Condom use was more likely to be reported by men reporting a recent male sex partner and less likely to be reported by amphetamine injectors. Condom use was less frequently reported by older participants than younger among those recruited at the Kent Jail but not the Seattle jail. Conclusions The trend towards increasing likelihood of condom use over time and the tendency of Seattle-area IDU at highest risk to be more likely to report condom use suggest measurable, if modest, progress in reducing risk of sexual transmission of HIV among Seattle IDU.