Sex partner support, drug use and sex risk among HIV-negative non-injecting heroin users

HIV prevention efforts among drug users have incorporated social support to reinforce risk reduction. We examine the extent to which sex partner characteristics, including partner support, influence HIV sex risk practices among a little studied population of non-injecting heroin users, 257 of whom were recruited in New York City between 1996 and 2001. The sample was racially/ethnically diverse (26% African American, 43% Latino, 31% white or other ethnicity) and 65% male. Three-quarters reported having unprotected intercourse within 30 days; 27% had sex with partners at known risk of being HIV infected. There were no gender differences in terms of sex or drug use practices; however, gender differences in sex partner characteristics were apparent. Men were significantly less likely than women to have partners who used drugs (OR = 0.5, 95% CI = 0.3, 0.9), receive support from their partners (OR = 0.5, 95% CI = 0.3, 0.8), use heroin with their partners (OR = 0.5, 95% CI = 0.3, 0.8) and have partners at known risk of being HIV infected (OR = 0.4, 95% CI = 0.2, 0.7). For men, increased sex risk was independently associated with sex partner support, and for women, increased sex risk was independently associated with having used heroin with sex partners. Social support may have detrimental, as well as beneficial, consequences on HIV risk.