Factors associated with changes in sex behaviour among drug users in Puerto Rico

Area of Science:

• Public Health
• Epidemiology
• Behavioral Science

Background:

• Heterosexual HIV transmission is increasing in Puerto Rico, particularly among women and children.
• Despite existing prevention strategies, heterosexual contact is the fastest-growing HIV risk category since 1990.

Purpose of the Study:

• To assess changes in sexual risk behaviors among drug users in Puerto Rico.
• To identify factors associated with changes in sexual risk behaviors, including abstinence and condom use.

Main Methods:

• A stratified cluster design recruited 911 drug injectors and 359 crack smokers in the San Juan metropolitan area.
• A total of 1,004 participants (79.1%) completed follow-up assessments.
• Multivariate analysis was used to identify predictors of abstinence and condom use.

Main Results:

• Sexual abstinence increased from 54.6% to 61.1% (p < 0.01).
• Condom use during vaginal sex increased from 26.4% to 36.9% (p < 0.01).
• Predictors of abstinence included gender, injection drug use, HIV seropositivity, and lack of a steady partner. Predictors of condom use included HIV seropositivity, STD diagnosis, and program participation.

Conclusions:

• HIV prevention programs have led to increased abstinence and condom use among drug users.
• Additional targeted HIV prevention efforts are crucial for drug users with steady partners and HIV-negative individuals to reduce ongoing heterosexual transmission.