The Context of HIV Risk Among Drug Users and Their Sexual Partners

Most of these were unprotected sexual encounters; 48 percent of males
and 64 percent of females never or rarely used condoms (Boyer et al.
1993).
In addition, some teenagers engage in other sexual risk behaviors that
also increase their risk of negative health outcomes, especially HIV
transmission. For example, some adolescent males engage in anal
intercourse without the use of barrier methods to protect against disease
transmission (Remafedi 1990). Clinical surveys of adolescent females
attending family planning clinics found that 12 to 26 percent engaged in
anal intercourse (either as a form of birth control or as a means of sexual
experimentation), which also may increase their risk for certain STDs
(Catania et al. 1990; Moscicki et al. 1988).
Contraceptive Use Behavior
The concurrent epidemics of STDs and unintended pregnancies among
adolescents suggest that most teens, like many adults, do not use
contraceptives effectively. The role oral contraceptives play in the
acquisition of STDs and their sequelae of PID is unclear. It appears that
while the use of oral contraceptives provides some protection against
gonococcus-related PID, it may increase the risk of chlamydia-related
PID (Shafer and Sweet 1990).
Use of the latex condom is effective in reducing the risk of STDs,
including HIV. However, the extent to which teens use them is unclear;
differences in samples and in questions asked of adolescents make it
difficult to compare results of the studies.
National epidemiologic data from high school students reveal that, among
students who engaged in sexual activity within the 3 months prior to the
survey, 78 percent of females and 79 percent of males reported use of
some form of contraception (birth control pills, condoms, withdrawal, or
another method) during their last sexual encounter. However, when
queried specifically about the use of condoms, the number decreased;
only 40 percent of the females and 49 percent of the males reported use
of this form of protection (CDC 1992). In addition, ethnic/racial
differences in the use of contraceptives have been found. A large survey
of adolescent and adult women ages 15 to 44 indicates that, compared to
their white counterparts, African-American women are significantly more
likely to use oral contraceptives and are less likely to use condoms or
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