HIV RISK-RELATED SEX BEHAVIORS AMONG INJECTION-DRUG USERS, CRACK SMOKERS, AND INJECTION-DRUG USERS WHO SMOKE CRACK

Objectives. This study was designed to assess and compare sex risk beh aviors for human immunodeficiency virus (HIV) transmission of three dr ug user groups: injectors who do not smoke crack, crack smokers who do not inject, and injectors who also smoke crack. Methods. Sexual risk behaviors for HIV were assessed among 246 drug users from Denver, Miam i, and San Francisco. Respondents were classified into the three drug groups based on self-report and verified through urinalysis and physic al inspection. Results. An increased risk for HIV through sexual trans mission was associated with crack cocaine use, particularly among thos e who also injected. Crack smoking injectors were more likely to repor t sex with an injector, exchanging sex for drugs and/or money, drug us e before or during sex, and unprotected sexual intercourse. They also injected more than injector only, smoked crack as often as smokers onl y, and reported higher overall frequencies of drug use. Conclusions. T hese findings, together with the higher rates of gonorrhea and syphili s reported by smokers and injectors/smokers, are indicators of the ris k crack poses for the heterosexual transmission of HIV.