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78 Revue sexoloSique / Sexolosical Review
female sexual partners in New York City, with a ratio which is stable
over time. They suggest that in this population, 1.5% of sexually
active women between the ages of 15 and 44 will have intercourse
with male IDUs per year (this estimate also takes account of the
proportion of male IDUs who have female IDU partners). A second
avenue of risk involves male prostitutes: Morse, Simon, Osofsky,
Balson and Gaumer (1991) report that 52% of male street prostitutes
interviewed in New Orleans were IDUs. Further, they note that 80%
identified themselves as heterosexual or bisexual, that 42% had a
regular female sexual partner, and that 70% never used condoms with
their regular female partner. Risks for HIV transmission to and from
other populations included the fact that 26% of these men had a
steady partner who was an IDU, 45% reported unsafe needle practices,
and one third of the clients were estimated by the prostitutes to be
bisexual men (men who have sex with both men and women, who
would thus have their own female partners).
Sexual activity has often been assumed to be depressed in opioid
users partly as a consequence of their pharmacological actions, but
Klee, Faugier, Haynes, Boulton and Morris (1990) note that despite
decreased libido, 81% of her sample of IDUs in Northern England had
had sexual intercourse in the past six months, and 32% had done so
with more than one partner (although there was no comparison with
similar non-opioid users). While there are major gender and ethnie
variations in high-risk sexual behaviour among IDUs (Lewis &
Watters, 1991), most studies indicate that the majority of IDUs to be
sexually active: Donoghoe, Stimson and Dolan (1989) reported that
more than three quarters of clients at a London needle and syringe
exchange had been sexually active in the past three months. Darke,
Hall and Carless (1990) found a similar proportion (78%) of Sydney
IDUs studied had had sex in the past month, 30% of the sample had
had more than one partner and 21% reported sex with partners they
described as "casual." Two thirds of their sample reportedly never
used condoms with regular partner(s).
Male IDUs are reportedly less likely to have partners who are IDUs
than female IDUs. Sasse, Salmaso, Conti and Rezza (1991) found in an
Italian study that women were more likely to have only IDU partners
(as opposed to non-using or a combination of using and non-using
partners: 43% versus 17% for males). Salmaso and Sasse (1991)
concluded that IDU women in Italy are more likely to have shared
injecting equipment and had sex with an HIV-seropositive partner.
Sasse et al. have also reported that 90% of women who only have IDU