Crack use and human immunodeficiency virus infection among San Francisco intravenous drug users

The relationship between crack use, human immunodeficiency virus (HIV) infection, and risk behavior among 1281 intravenous drug users in treatment is analyzed. Of these patients, 23% reported crack use, and blacks and women were more likely to use crack. Of crack users 19% were HIV positive, in comparison to 8% of non-users (OR = 2.9, P = 0.0001). In multivariate analysis, the association was no longer significant (OR = 1.4, P = 0.14). Independent behavioral predictors of HIV seropositivity were number of sexual partners, and intravenous cocaine use among blacks. Crack use was a marker for high-risk sexual and drug use behavior in the study population.