Gender differences in the perceived self-efficacy of safer HIV practices among polydrug abusers in Taiwan

Studies have documented that the perceived self-efficacy of attempts to engage in safer behavior is critical for the prevention of blood-borne diseases, including hepatitis C and HIV. The aim of this study was to examine gender differences in the perceived self-efficacy of safer HIV-related behavior among heroin and amphetamine abusers. Of the eligible participants from Taiwan prisons, 1622 polydrug users voluntarily agreed to complete a questionnaire regarding HIV risks. Participants had to be polydrug abusers (amphetamines and heroin), 18 years or older, sexually experienced, and literate. The questionnaire addressed background information, drug abuse, sexual behavior, and perceived self-efficacy in drug- and sex-related HIV risk situations. Twenty-four percent of respondents were HIV positive. Compared to men, women started illicit drug use at a younger age and were less likely to share syringes. Women also tended to have their first sexual coitus at an older age and were less likely to use a condom in their last sexual encounter. Men were more likely to have multiple sexual partners in the past 6 months. Results from a multinomial logistic regression indicate that gender, age, their interaction, age of first sexual encounter, HIV knowledge, condom use at last sexual encounter, and multiple sexual partners were associated with perceived self-efficacy of condom use. Results also show that gender, HIV serostatus, HIV knowledge, condom use at last sexual encounter, and sharing needles at last injection were associated with perceived self-efficacy in not sharing needles. The findings provide evidence for gender differences among polydrug abusers in Taiwan regarding perceived self-efficacy in adopting HIV prevention practices. Findings also provide evidence that knowledge about HIV transmission is related to perceived self-efficacy in promoting safe behavior. To raise polydrug abusers' perceived self-efficacy, gender and HIV/AIDS education must be taken into consideration in counseling and/or public health education related to HIV prevention for drug abusers.