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

may be passed down from generation to generation. Corby and
colleagues state that these women were concerned as well as
knowledgeable about HIV transmission, and they were fully aware of
being at risk. From a contextual perspective, these investigators obtained
information that showed the effects of socioeconomic and lifestyle status
of these subjects on behavior.
Des Jarlais and colleagues (1991) examined crack use among 87 females
who had been admitted to a municipal New York City hospital during
1988 with a diagnosis of pelvic inflammatory disease (PID). Face-to-face
interviews were conducted covering the areas of AIDS risk behaviors and
HIV counseling and testing. The subjects were 86 percent African
American, 9 percent Hispanic, 3 percent white, and 1 percent other. The
investigators found that crack use was reported by 49 (56 percent) of the
sample and was strongly associated with unsafe sexual behavior. All
21 subjects who reported recently exchanging sex for money or drugs had
smoked crack, and 21 (84 percent) of the 25 females who had recently
had casual sex partners had also smoked crack. Twelve of the 87 subjects
were HIV positive, and 10 of these were among the 49 who were crack
users.
This study shows a strong connection between female crack cocaine users
and increased risk for HIV transmission. The investigators have raised
awareness to the fact that the very addictive nature of a particular drug is
associated with the increase in HIV among females.
Lewis and Watters (1991) examined the relationship of ethnicity and
gender to high-risk sexual behavior among 457 heterosexual IVDUs,
37 percent of whom were female. The subjects were interviewed on the
street and in clinic settings in San Francisco as part of a larger ongoing
study of risk factors for HIV transmission in IVDUs. Respondents were
given a 45-minute structured interview.
Results showed that 14 percent of African-American women and
30 percent of white women had 10 or more partners over the past year.
Among the subjects who were sexually active during the study, white
women had a median of three sexual partners, and African-American
women had a median of two partners. Fifty percent of the women
reported participating in sex-for-money exchanges. More African-
American women reported prostitution than white women, and, of the
83 women who exchanged sex for money, 54 used condoms.
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