DETERMINANTS OF CONDOM USE AMONG INTRAVENOUS-DRUG-USERS

Objective: To examine the factors associated with condom use among a c ohort of sexually active intravenous drug users (IVDU). Design: Data w ere collected via personal interview at the fourth-month assessment po int of a longitudinal study monitoring HIV infection and risk behavior s among IVDU. Setting: A community-based methadone clinic. Participant s: A total of 158 sexually active heterosexual male and female IVDU, i ncluding both methadone patients and out-of-treatment individuals with a history of opiate abuse. Main outcome measures: We describe a new a pproach to identify the determinants of condom use. Previous studies h ave described subjects as either 'condom users' or 'condom non-users', using an individual's overall behavior as the unit of analysis. By an alyzing condom use during the most recent sexual encounter, we avoided the problem of interpreting inconsistent condom use. Data were analyz ed using forward stepwise logistic regression. Results: Thirty-four pe r cent of the heterosexual subjects (n = 160) reported using a condom during their last sexual encounter. Being HIV-positive and having eith er a casual or commercial partner were each associated with increased probability of using a condom (odds ratio, 10.6, 4.4 and 12.1, respect ively). No interactions with sex were found. Conclusions. Our results suggest that knowing that one is HIV-positive is an important determin ant of condom use; HIV testing may therefore increase the use of condo ms. In addition, interventions to change sexual behaviors may need to focus on the type of sexual partner.