RISK BEHAVIORS OF INTRAVENOUS-DRUG-USERS - ARE FEMALES TAKING MORE RISKS OF HIV AND HCV TRANSMISSION

Background : This work was aimed at identifying differences in HIV and HCV risk behaviors among intravenous drug users (IDUs) according to t he gender and their determinants. Methods : IDUs over 18 years, having had sexual intercourse and able to answer the questionnaire were inte rviewed in 10 drug abuse treatment centers or social institutions usin g a questionnaire adapted from the one used in the survey of sexual li festyle in France. Results : Over 612 eligible IDUs, 595 completed the questionnaire (women : 29%); 37% had multiple partners with no differ ence according to the gender; 14% of the women and 7% of the men repor ted trading sex. More women reported inconsistent condom use (46% vs. 55%) and inconsistent clean equipment use (65% vs. 73%). A younger age , independently associated to sharing equipment (men. OR = 0.94; 95% C I = 0.90-0.99; women : OR = 0.92; 95% CI = 0.85-0.99) and inconsistent HIV serology testing, independently associated to inconsistent condom use (men : OR = 3.36; 95% CI = 2.02-5.60; women : OR = 10.72; 95% CI = 3.18-36.18), were the only risk markers common to both genders. For women, being HIV negative increased the risk of inconsistent condom ri se. Low educational level increased the risk of inconsistent clean equ ipment use. No risk marker among those analyzed was associated to havi ng had multiple partners. For men, low socioeconomic status markers, a steady sexual partner or nor living in couple and educational level w ere associated with sexual risk behaviors (inconsistent condom use and having multiple partners); low socioeconomic status markers were asso ciated with injecting risk behaviors (inconsistent clean equipment use and sharing). Conclusions : Women were more likely to have both sexua l and injecting risk behaviors; their significant risk markers are les s numerous thus harm reduction could be more difficult than for men.