• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of pubhealthrepLink to Publisher's site
Public Health Rep. 2003 Sep-Oct; 118(5): 415–424.
PMCID: PMC1497583

Factors associated with positive HIV serostatus among women who use drugs: continued evidence for expanding factors of influence.

Abstract

OBJECTIVE: To identify risk factors associated with positive HIV serostatus among African American women who smoke crack and/or inject drugs and who are not enrolled in drug treatment or another institutional setting. METHODS: Baseline interviews were conducted from June 1998 to June 2000 with 379 heterosexually active women (ages 18 to 59) who had been recruited for potential enrollment into an HIV intervention trial. RESULTS: Adjusted for age and drug using status, women who expressed more difficulty saying no to sex with male partners were more likely to be HIV-positive (adjusted odds ratio [aOR]=3.08, 95% confidence interval [CI] 2.02, 4.83). Similarly, those who indicated greater communication with casual sex partner(s) were less likely to test positive (aOR=0.29, 95% CI 0.10, 0.89). Lower HIV internal control and a history of cuts or burns on lips due to crack smoking were also associated with positive serostatus, and were important confounders in the final multivariate model. A higher level of internal control was associated with a decreased likelihood of positive serostatus, while a history of cuts or burns on the lips was associated with an increased likelihood of HIV antibodies, even after controlling for the amount of oral sex. CONCLUSIONS: A broad array of factors may promote or avert infection with HIV. The degree to which personal attributes and beliefs, and relationship characteristics contribute to the likelihood of infection must continue to be addressed. The importance of oral sex and presence of oral sores and their potential role in transmission was suggested.

Full Text

The Full Text of this article is available as a PDF (94K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Miller M, Neaigus A. Networks, resources and risk among women who use drugs. Soc Sci Med. 2001 Mar;52(6):967–978. [PubMed]
  • Des Jarlais DC, Friedman SR, Perlis T, Chapman TF, Sotheran JL, Paone D, Monterroso E, Neaigus A. Risk behavior and HIV infection among new drug injectors in the era of AIDS in New York City. J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Jan 1;20(1):67–72. [PubMed]
  • Ickovics JR, Yoshikawa H. Preventive interventions to reduce heterosexual HIV risk for women: current perspectives, future directions. AIDS. 1998;12 (Suppl A):S197–S208. [PubMed]
  • Padian NS. Prostitute women and AIDS: epidemiology. AIDS. 1988 Dec;2(6):413–419. [PubMed]
  • Coyle SL. Women's drug use and HIV risk: findings from NIDA's Cooperative Agreement for Community-Based Outreach/Intervention Research Program. Women Health. 1998;27(1-2):1–18. [PubMed]
  • Neaigus A, Miller M, Friedman SR, Hagen DL, Sifaneck SJ, Ildefonso G, des Jarlais DC. Potential risk factors for the transition to injecting among non-injecting heroin users: a comparison of former injectors and never injectors. Addiction. 2001 Jun;96(6):847–860. [PubMed]
  • Ehrhardt AA, Exner TM. Prevention of sexual risk behavior for HIV infection with women. AIDS. 2000 Sep;14 (Suppl 2):S53–S58. [PubMed]
  • Rothenberg RB, Scarlett M, del Rio C, Reznik D, O'Daniels C. Oral transmission of HIV. AIDS. 1998 Nov 12;12(16):2095–2105. [PubMed]
  • Faruque S, Edlin BR, McCoy CB, Word CO, Larsen SA, Schmid DS, Von Bargen JC, Serrano Y. Crack cocaine smoking and oral sores in three inner-city neighborhoods. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Sep;13(1):87–92. [PubMed]
  • Stacy AW, Newcomb MD, Ames SL. Implicit cognition and HIV risk behavior. J Behav Med. 2000 Oct;23(5):475–499. [PubMed]
  • Morrill AC, Kasten L, Urato M, Larson MJ. Abuse, addiction, and depression as pathways to sexual risk in women and men with a history of substance abuse. J Subst Abuse. 2001;13(1-2):169–184. [PubMed]
  • Compton WM, Cottler LB, Ben-Abdallah A, Cunningham-Williams R, Spitznagel EL. The effects of psychiatric comorbidity on response to an HIV prevention intervention. Drug Alcohol Depend. 2000 Mar 1;58(3):247–257. [PubMed]
  • St Lawrence JS, Eldridge GD, Brasfield TL. Behavioral and psychosocial consequences of HIV antibody counseling and testing with African American women. Womens Health. 1998 Summer;4(2):135–153. [PubMed]
  • Wingood GM, DiClemente RJ. Cultural, gender, and psychosocial influences on HIV-related behavior of African-American female adolescents: implications for the development of tailored prevention programs. Ethn Dis. 1992 Fall;2(4):381–388. [PubMed]
  • Sterk Claire E, Theall Katherine P, Elifson Kirk W. Effectiveness of a risk reduction intervention among African American women who use crack cocaine. AIDS Educ Prev. 2003 Feb;15(1):15–32. [PubMed]
  • Sterk Claire E, Theall Katherine P, Elifson Kirk W, Kidder Daniel. HIV risk reduction among African-American women who inject drugs: a randomized controlled trial. AIDS Behav. 2003 Mar;7(1):73–86. [PubMed]
  • Sterk CE, Dolan K, Hatch S. Epidemiological indicators and ethnographic realities of female cocaine use. Subst Use Misuse. 1999 Dec;34(14):2057–2072. [PubMed]
  • Gallo D, George JR, Fitchen JH, Goldstein AS, Hindahl MS. Evaluation of a system using oral mucosal transudate for HIV-1 antibody screening and confirmatory testing. OraSure HIV Clinical Trials Group. JAMA. 1997 Jan 15;277(3):254–258. [PubMed]
  • Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 1966;80(1):1–28. [PubMed]
  • Brafford LJ, Beck KH. Development and validation of a condom self-efficacy scale for college students. J Am Coll Health. 1991 Mar;39(5):219–225. [PubMed]
  • Brown EJ. Female injecting drug users: human immunodeficiency virus risk behavior and intervention needs. J Prof Nurs. 1998 Nov-Dec;14(6):361–369. [PubMed]
  • Lane HC, Holmberg SD, Jaffe HW. HIV seroconversion and oral intercourse. Am J Public Health. 1991 May;81(5):658–658. [PMC free article] [PubMed]
  • Rozenbaum W, Gharakhanian S, Cardon B, Duval E, Coulaud JP. HIV transmission by oral sex. Lancet. 1988 Jun 18;1(8599):1395–1395. [PubMed]
  • Weinhardt LS, Carey KB, Carey MP. HIV risk sensitization following a detailed sexual behavior interview: a preliminary investigation. J Behav Med. 2000 Aug;23(4):393–398. [PubMed]
  • Vernazza PL, Eron JJ, Cohen MS, van der Horst CM, Troiani L, Fiscus SA. Detection and biologic characterization of infectious HIV-1 in semen of seropositive men. AIDS. 1994 Sep;8(9):1325–1329. [PubMed]
  • Ilaria G, Jacobs JL, Polsky B, Koll B, Baron P, MacLow C, Armstrong D, Schlegel PN. Detection of HIV-1 DNA sequences in pre-ejaculatory fluid. Lancet. 1992 Dec 12;340(8833):1469–1469. [PubMed]
  • Levy JA. Human immunodeficiency viruses and the pathogenesis of AIDS. JAMA. 1989 May 26;261(20):2997–3006. [PubMed]
  • Wallace JI, Porter J, Weiner A, Steinberg A. Oral sex, crack smoking, and HIV infection among female sex workers who do not inject drugs. Am J Public Health. 1997 Mar;87(3):470–470. [PMC free article] [PubMed]
  • Porter J, Bonilla L. Crack users' cracked lips: an additional HIV risk factor. Am J Public Health. 1993 Oct;83(10):1490–1491. [PMC free article] [PubMed]
  • Inciardi JA, Chitwood DD, McCoy CB. Special risks for the acquisition and transmission of HIV infection during sex in crack houses. J Acquir Immune Defic Syndr. 1992;5(9):951–952. [PubMed]
  • Mitchell-Lewis DA, Phelan JA, Kelly RB, Bradley JJ, Lamster IB. Identifying oral lesions associated with crack cocaine use. J Am Dent Assoc. 1994 Aug;125(8):1104–1110. [PubMed]
  • Magura S, Goldsmith D, Casriel C, Goldstein PJ, Lipton DS. The validity of methadone clients' self-reported drug use. Int J Addict. 1987 Aug;22(8):727–749. [PubMed]
  • McElrath K, Chitwood DD, Griffin DK, Comerford M. The consistency of self-reported HIV risk behavior among injection drug users. Am J Public Health. 1994 Dec;84(12):1965–1970. [PMC free article] [PubMed]

Articles from Public Health Reports are provided here courtesy of Association of Schools of Public Health

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Compound
    Compound
    PubChem Compound links
  • PubMed
    PubMed
    PubMed citations for these articles
  • Substance
    Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...