RACIAL-DIFFERENCES IN SEXUAL BEHAVIORS RELATED TO AIDS IN A 19-CITY SAMPLE OF STREET-RECRUITED DRUG INJECTORS

Questionnaire data from almost 12,000 street-recruited drug injectors in 19 cities were analyzed to determine racial differences that may af fect transmission of the human immunodeficiency virus (HIV). Self-repo rted sexual behaviors of drug injectors differ by city-type. White mal e drug injectors reported less unprotected vaginal sex than black or L atino males in multicultural-black/white/Mexican-origin and biracial c ities. Black drug users of both sexes were less likely than white or L atino drug users to report unprotected anal sex in multicultural-black /white/Mexican-origin and multicultural-black/white/Puerto Rican citie s. The reported percentage of sex acts in which a condom was used was similar for black, white, and Puerto Rican men, and for black and whit e women, in all city types, but Puerto Rican women reported more condo m use than black women. Mexican-origin drug injectors of each gender w ere least likely to report using condoms in multicultural-black/white/ Mexican-origin cities. Black drug injectors arc particularly likely to report having sex partners who do not inject drugs, as are Puerto Ric an men and as are whites in multicultural-black/white/Mexican-origin c ities. High-risk sex without condoms is widely reported among all grou ps of drug injectors studied: Each racial/gender group in each city-ty pe averaged 15 or more episodes of unprotected vaginal sex per month, and 10% of most subgroups report having anal sex within the past 6 mon ths. At least 45% of subjects in each city-type reported sex with noni njectors of the opposite gender. Without continued and expanded interv ention, these data are consistent with HIV spreading to drug injectors , their sexual partners, and their future children, in all racial/ethn ic groups.