High prevalence of substance use among heterosexuals living in communities with high rates of AIDS and poverty in Washington, DC

Drug Alcohol Depend. 2011 Sep 1;117(2-3):139-44. doi: 10.1016/j.drugalcdep.2011.01.006. Epub 2011 Feb 12.

Abstract

Objectives: To assess the prevalence and patterns of substance use, HIV prevalence, and sexual risk behaviors in a community-based sample of heterosexuals recruited from areas at high risk for HIV/AIDS and poverty in Washington, DC.

Methods: Community-recruited heterosexuals aged 18-50 from areas of high AIDS and poverty rates in DC were analyzed. Based on past 12 months use, participants were hierarchically classified into five groups: (1) ever injection drug use (IDU); (2) non-injection crack; (3) non-injection heroin and cocaine; (4) marijuana; and (5) no drug use. Sexual behaviors and HIV serology were also assessed.

Results: Of 862 participants, 40% were men, most were Black and unemployed, and more than half had ever been incarcerated. Prevalence of past year substance use was high: binge drinking (59%); marijuana (50%); non-injection crack (28%); heroin and/or cocaine injection (28%), non-injection cocaine (13%); and ecstasy (13%). In the hierarchical classification, 25% were ever IDU, 15% non-injection crack users, 2% non-injection heroin and/or cocaine users, 31% marijuana users, and 27% reported no drug use. Overall HIV seroprevalence was 5.7% and differed by drug use group-9.5%, 11.1%, 1.8%, 1.6%, and 3.2%, respectively. Nearly half reported having ≥3 sex partners in the past year; 20% reported exchange partners, and 69% had concurrent sex partners.

Conclusion: Estimated prevalence of substance use in this heterosexual population was high. HIV prevalence among IDUs and non-injection crack users was higher than the estimated population prevalence in Washington, DC. Sexual behaviors above and beyond drug use are likely to be driving HIV transmission.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology*
  • Acquired Immunodeficiency Syndrome / psychology
  • Adolescent
  • Adult
  • Black or African American
  • District of Columbia / epidemiology
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • HIV Seropositivity / epidemiology*
  • HIV Seroprevalence
  • Heterosexuality / psychology*
  • Humans
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Poverty / trends
  • Residence Characteristics
  • Risk-Taking
  • Sexual Behavior / psychology
  • Sexual Behavior / statistics & numerical data
  • Substance-Related Disorders / epidemiology*
  • Young Adult