Abstract

This study examines two major domains of HIV transmission including sexual risk behavior and injection drug use among adults of four racial/ethnic groups recruited from places of public congregation in Houston. The results of this study illustrate the complex interactions between HIV sexual risk behavior and injection drug use as well as knowing people with AIDS.

Two separate studies were conducted to address the study objectives. In the first paper we examined the hypothesis that injection drug users will present distinct demographic characteristics and exhibit high risk sexual behavior than other drug users. In the second paper, we examined the association between knowing people with AIDS and demographic characteristics as well as sexual risk behavior of adults.

Data for this study came from a larger community-based anonymous survey designed to determine knowledge, misconception, and sources of information in minority population regarding HIV transmission in January 1997 and June 1998.

The findings from the injection drug use study suggest a relatively high prevalence of injection drug use and health compromising sexual practices among injection drug users in an understudied population. Race/ethnicity was the only demographic characteristic which demonstrated association in multivariate logistic regression analysis. A number of sexual risk behavior characteristics including age at first sexual intercourse, sexual identity and number of sexual partners in last three months were associated with injection drug use in the multivariate logistic regression analysis. The demonstrated association between injection drug use and high risk sexual behavior not only suggest the importance of public health programs designed to address race/ethnicity related factors but also demonstrate the need for much greater attention to injection drug users' sexual risk behavior beyond the scope of their needle sharing behavior. Further research is required to determine the directionality of the association and the effects of commonly used injection drugs on sexual risk behavior, but our findings, together with other reports on the prevalence of injection drug use and the already high-prevalence of HIV among injection drug users in urban communities, hold troubling implications for the future of the HIV epidemic in this population.

In the role of knowing people with AIDS on sexual behavior study, 867 (58.5%) of the 1482 participants knew people with AIDS. The multivariate logistic regression analysis demonstrated association between knowing people with AIDS and two demographic characteristics including race/ethnicity and education, and several sexual risk factors including percentage of partners using condom in sexual contacts, degree of difficulty in condom use during sexual contacts and frequency of sexual intercourse with partners of same sex in past three months. Interestingly, knowing persons with AIDS was not associated with frequency of sexual intercourse with partners of opposite sex in the past three months and sexual identify. These results suggest the importance of public health programs designed to address race/ethnicity-related factors, condom use and men having sex with men (MSM).