Women inmates' risky sex and drug behaviors: Are they related?

The large concentration of female illicit drug users in state correctional facilities prompted an examination of the associations among different type s of drug use and sexual risk factors related to human immunodeficiency vir us (HIV) among women inmates. A consecutive sampie of 805 women felons admi tted to the North Carolina Correctional Institution for Women between July 1991 and November 1992 was interviewed. Of these inmates, 651 had complete information on relevant characteristics. Of the women inmates, 73% had used drugs prior to incarceration; most women were crack smokers only (33%), fo llowed by non-drug users (27%), other drug users (19%), crack-smoking injec ting drug users (15%), and injecting drug users only (6%). Inconsistent con dom use with multiple sex partners, a history of a diagnosed sexually trans mitted disease (STD), a drug-injecting sex partner, or exchanging sex for m oney or drugs prior to incarceration were reported by 55% of the women. Sex ual risk factors differed across different types of drug users, with crack- smoking injectors being placed at greatest potential risk for exposure to h eterosexually transmitted HIV, followed by injecting drug users, crack smok ers, and then other drug users. Given the differential associations between sexual risk factors and types of drug use, prison-based sexual-risk reduct ion strategies should be tailored to specific types of drug users. In times of limited resources, special attention should be given to crack smokers a nd/or drug injectors.