Predictors of intoxicated sex in injecting drug users

Transmission of HIV by sexual contact as well as through sharing of contaminated injection equipment is a source of viral spread from injecting drug users (IDUs). We report on an analysis of data from 1,245 IDUs interviewed in Sydney, Australia in which half of the respondents reported being intoxicated during sex for more than half of their sexual encounters. The most common drugs on which people were intoxicated during sex were heroin, cannabis and alcohol. Predictors of having sex when intoxicated were a lower likelihood of having been in treatment, higher number of sexual partners, sharing injection equipment with more people and more recently, being intoxicated when injecting, and not being a sex worker. The data indicate that having sex while intoxicated is common in these IDUs and that sex under the influence of drugs is part of a more general lifestyle of spending a greater time intoxicated. Targeting of those IDUs who spend a significant amount of time intoxicated and their recruitment into treatment may thus reduce both risky sexual behaviour and risky injecting behaviour.