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

Co-Occurrence of Risk Behaviors and Negative Health
Outcomes
Although alcohol consumption and use of noninjecting drugs are not
directly linked to acquisition of STDs/HIV, youths who use one or more
of these substances also tend to engage in sexual risk behaviors, including
earlier initiation of sexual intercourse and inconsistent use of barriermethod
contraceptives, when compared to youth who abstain from using
these substances (Bagnall et al. 1990; Ensminger 1990; Keller et al. 1991;
Mott and Haurin 1988; Rosenbaum and Kandel 1990). Moreover, a
recent study found a significant association between abuse of alcohol and
drugs and failure to use condoms (Hingson et al. 1990). Specifically, the
authors reported that adolescents who consumed five or more drinks daily
or used marijuana within the month prior to the survey were significantly
less likely to use condoms. In addition, of the teens who reported sexual
activity after drinking alcohol, 16 percent indicated that they were less
likely to use condoms, and 25 percent reported using condoms less often
after using drugs.
While the co-occurrence of adolescent substance use behavior and sexual
activity is well established, the role of this relationship to transmission of
STD/HIV infection has recently received attention. Use of crack cocaine
has been linked to increased rates of syphilis and gonorrhea in some
urban adolescent populations; this increase is postulated to be due to
drug-related sexual disinhibition and the exchange of sex for drugs
(Fullilove et al. 1990; Goldsmith 1988; Schwarcz et al. 1992; Zweig et al.
1991).
Summary of Adolescents’ Risk for STDs/HIV
From the data reported thus far, one can conclude that:
risk-taking behavior among adolescents is prevalent and interrelated;
adolescents commence sexual intercourse at earlier ages than ever
before, and many of them do not use effective measures to protect
themselves from diseases;
STD and pregnancy rates among adolescents are high;
use of substances, especially alcohol, is common in teens and thought
to be associated with increased risk of STDs/HIV;
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