FACTORS INFLUENCING CONDOM USE AMONG HETEROSEXUAL USERS OF INJECTION-DRUGS AND CRACK COCAINE

Objectives: To study factors that influence the self-reported use of c ondoms among injection drug users and crack smokers. Study Design: A c ross-sectional design was used to collect data from drug-using heteros exual men (n = 247) and women (n = 107). Results: Participants were la rgely African American (79.4%), male (69.8%), and unmarried (90.1%), T he mean age for men was 39.9 years, 35.5 years for women, Drug user gr oups consisted of individuals who used both crack cocaine and injectio n drugs (40.1%), noninjecting crack smokers (33.1%), and noncrack-smok ing injection drug users (26.8%), Daily injection drug or crack use wa s reported by 62.9% of the sample. One third of the sample reported re cent vaginal sex with more than one partner More than 70% of the parti cipants frequently used drugs when having sex, Logistic regression sho wed that individuals who were high when having vaginal sex were less l ikely to use condoms than people who were not high (odds ratio [OR] 0. 82; 95% confidence interval [CI], 0.68-0.99); individuals whose partne rs got high when having sex were more likely to report condom use (OR 1.20; 95% CI, 1.01-1.42); individuals were less likely to use condoms when having sex with a main partner (OR 0.40; 95% CI, 0.20-0.80); indi viduals who believed it was important to use condoms were more likely to use condoms (p = 0.57, P < 0.00); and people who believed condoms r educed sexual pleasure were less likely to use condoms (P = -0.53, P < 0.00). Conclusions: In addition to being sensitive to partner charact eristics, sex risk-reduction interventions targeting users of injectio n drugs or crack must address the widespread use of psychoactive drugs that occurs immediately before and during sex because such use presen ts a significant impediment to the employment of safer-sex techniques that rely on condoms. Until such interventions are in place, access to drug abuse treatment is a critical dimension of human immunodeficienc y virus and other sexually transmitted disease prevention.