HIV risks differ by gender

HIV risk factors among injection drug users differ markedly by gender, according to a 10-year study funded by the National Institute on Drug Abuse. The findings, reported in the Archives of Internal Medicine (vol. 161, no. 10), indicate that while drug-related risk behaviors and homosexual activity are the most important predictors of HIV seroconversion among males, factors consistent with high-risk heterosexual activities are the main predictors among females.

"Early studies of injection drug users suggested that most HIV infections were due primarily to sharing needles," said NIDA Director Alan I. Leshner. "This study adds to the body of evidence that supports the need for gender-specific interventions in the treatment of that group of drug users."

Between 1988 and 1998, a team of researchers led by Steffanie Strathdee at the Johns Hopkins University Bloomberg School of Public Health examined both drug-related and sexual risk factors for HIV transmission in a study of more than 1,800 injecting drug users in Baltimore, MD. Study participants were age 18 or older, did not have an AIDS-defining illness at enrollment, and reported a history of illicit injection drug use within the previous 10 years. Through semi-annual interviews, researchers collected data on drug use history, sociodemographics, and drug use and sexual behavior within the last six months. Blood samples were also obtained at each study visit.

High-risk activities

Dr. Strathdee and her colleagues found that the greatest predictor for HIV seroconversion among both male and female IDUs was high-risk sexual behavior. Study findings revealed that male injection drug users who reported recent homosexual activity were four times more likely to become infected with HIV.

Among females, indicators of high-risk heterosexual activity outweighed needle-sharing behaviors as independent predictors of HIV seroconversion. HIV incidence was more than two times higher among women who reported recently having sex with another injection drug user. PR