Gender differences in HIV risk behavior of intravenous drug users who are not prostitutes

Objective: To determine how female intravenous drug users (IDUs) have react ed to the HIV epidemic in terms of risk practices and other variables assoc iated with HIV infection, during the period 1987-1996 in Valencia, Spain. Method: We included in our study 1064 women and 4237 men attending the AIDS Prevention and Information centers (CIPS) of the Autonomous Region of Vale ncia during the period 1987-1996. Information regarding drug use (needle sh aring and duration of consumption) and sexual relations (use of condoms, st eady partner) over the previous three months was collected at a personal in terview during each patient's first visit to the center. In order to study the association between gender and HIV risk behaviors the adjusted odds rat ios with 95% confidence interval were calculated by means of a logistic reg ression analysis. Results: More women than men said they had a steady partner (70.9% vs. 49.6 %). More women than men had IDU partners (OR = 7.8; 95% CI: 5.6-10.9) and w omen were eight times as likely to have a steady partner who was a carrier of HIV antibodies (OR = 7.73; 95% Cl: 6.0-9.96). Prevalence of HIV infectio n was slightly greater among women. After adjusting for age, marital status , level of education, and year of first visit, no differences were seen bet ween male and female IDUs in the use of condoms and needle sharing. Conclusion: The results of this study demonstrate that differences still ex ist in the way male and female IDUs respond to the HIV epidemic. Both men a nd women show a similar decrease in traditional risky practices, but women have not changed their overall sexual behavior and continue to have more ID Us and/or HIV partners than men. This could partly explain the higher preva lence of HIV infection observed among women in our study. The type of relat ionships they have with their partner implies that women are exposed to a g reater risk of infection, which may, in the long term, have the effect of p rolonging the epidemic through sexual transmission. Preventive strategies s hould be devised specifically with couples and groups of drug users in mind , rather than focusing primarily on individual practices. (C) 2001 by The H aworth Press, Inc. All rights reserved.