Skip to main content
Log in

Drug-Using Women's Sexual Risk: An Event Analysis

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Using event analysis, this study describes the most recent sexual events of drug-using women and their male partners and identifies relationship-specific and event-specific determinants of condom use. Women drug users (n = 320) were recruited from the streets of East Harlem. After validation of drug use, they participated in structured interviews and were offered HIV testing and counseling. Interview topics included the following: (1) demographic characteristics of respondents, (2) relationship factors, including age difference, race/ethnicity concordance, and HIV serostatus of partners, and (3) event-specific factors, including sexual repertoire, communication about condom use, and perception of HIV risk. Univariate and multivariate analyses identified five major variables associated with event-specific condom use: (1) closeness to partner, (2) perceived dyadic serostatus, (3) sexual repertoire, (4) communication about condoms, and (5) perceived control of condom use. Behavioral interventions to reduce sexual risk should target dyads with long-standing sexual relationships and focus on the dynamics of the relationship, especially the issues of dyadic serostatus, intimacy, communication, and control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Auerbach, J. D., Wypijewska, C., and Brodie, H. K. H. (Eds.). (1994). AIDS and behavior: An integrated approach, Washington,DC: National Academy Press.

    Google Scholar 

  • Beardsley, M., Deren, S., Tortu, S., Goldstein, M. F., Ziek, K., and Hamid, R. (in press). Trends in injection risk behaviors in a sample of New York City injection drug users. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology.

  • Booth, R. E. (1995). Gender differences in high-risk sex behaviours among heterosexual drug injectors and crack smokers. American Journal of Drug and Alcohol Abuse, 21, 419–432.

    PubMed  Google Scholar 

  • Booth, R. E., Watters J. K., and Chitwood, D. D. (1993). HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. American Journal of Public Health, 83, 1144–1148.

    PubMed  Google Scholar 

  • Brown, P. L. (1999, April 11). The ‘Leonardo' of condoms. The New York Times, pp. 1, 3.

  • Centers for Disease Control and Prevention. (1994). HIV/AIDS Surveillance Report, No. 5 (1994).

  • Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, No. 8 (1997).

  • Centers for Disease Control and Prevention. (1998). HIV/AIDS Surveillance Report, No. 10 (1998).

  • Chesney, M. A. (1994). Prevention of HIV and STD infections. Preventive Medicine. 23, 655–660.

    PubMed  Google Scholar 

  • Clark, R. A., Kissinger, P., Bedimo, A. L., and Albertin, H. (1997). Determination of factors associated with condom use among women infected with human immunodeficiency virus. International Journal of STD and AIDS, 8, 229–233.

    PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cottler, L. B., Leukefeld, C., Hoffman, J., Desmond, D., Wechsberg, W., Inciardi, J. A., Compton, W. M., Ben Abdallah, A., Cunningham-Williams, R., and Woodson S. J. (1998). Effectiveness of HIV risk reduction initiatives among out-of-treatment non-injection drug users. Psychoactive Drugs, 30, 279–290.

    Google Scholar 

  • Coyle, S. L., Needle, H., and Normand, J. (1998). Outreach-based HIVprevention for injecting drug users:Areview of published outcome data. Public Health Reports, 113, 19–30.

    PubMed  Google Scholar 

  • Crosby, R. A. (1998). Condom use as a dependent variable: Measurement issues relevant to HIV prevention programs. AIDS Education and Prevention, 10, 548–557.

    PubMed  Google Scholar 

  • DeHovitz, J. A., Kelly, P., Feldman, J., Sierra, M. F., Clarke, L., Bromberg, J., Wan, J. Y., Vermund, S. H., and Landesman, S. (1994). Sexually transmitted diseases, sexual behavior, and cocaine use in inner-city women. American Journal of Epidemiology, 140, 1125–1134.

    PubMed  Google Scholar 

  • Elias, C., and Coggins, C. (1996) Female-controlled methods to prevent sexual transmission of HIV. AIDS, 10, S43–S51.

    Google Scholar 

  • Evans, B. A., Kell, P. D., Bond, R. A., and MacRae, K. D. (1995). Heterosexual relationships and condom-use in the spread of sexually transmitted diseases to women. Genitourinary Medicine, 71, 291–294.

    PubMed  Google Scholar 

  • Falck, R. S., Wang, J., Carlson, R. G., and Siegal, H. A. (1997). Factors influencing condom use among heterosexual users of injection drugs and crack cocaine. Sexually Transmitted Diseases, 24, 204–210.

    PubMed  Google Scholar 

  • Fitterling, J. M., Matens, P. B., Scotti, J. R., and Allen, J. S., Jr. (1993). AIDSrisk behaviors and knowledge among heterosexual alcoholics and non-injecting drug users. Addiction, 88, 1257–1265.

    PubMed  Google Scholar 

  • Fortenberry, J. D., Orr, D. P., Katz, B. P., Brizendine, E. J., and Blythe, M. J. (1997). Sex under the influence: A diary selfreport study of substance use and sexual behavior among adolescent women. Sexually Transmitted Diseases, 24, 313–319.

    PubMed  Google Scholar 

  • Friedman, S. R., DesJarlais, D. C., Ward, T. P., Jose, B., Neaigus, A., and Goldstein, M. F. (1994). Drug injectors and heterosexual AIDS. In L. Sherr (Ed.), AIDS and the heterosexual population (pp. 41-65). Chur, Switzerland: Harwood.

    Google Scholar 

  • Gillespie, C. C. (1997). Women's HIV risk reduction efforts and traditional models of health behavior: A review and critique. Women's Health: Research on Gender, Behavior, and Policy, 3, 1–30.

    Google Scholar 

  • Graves, K. L, and Hines, A. M. (1997). Ethnic differences in the association between alcohol and risk sexual behavior with a new partner: An event-based analysis. AIDS Education and Prevention, 9, 219–237.

    PubMed  Google Scholar 

  • Ickovics, J. R., and Yoshikawa, H. (1998). Preventive interventions to reduce heterosexual HIV risk for women: Current perspectives, future directions. AIDS, 12, 197–208.

    PubMed  Google Scholar 

  • Kenen, R. H., and Armstrong, K. (1992). The why, when and whether of condom use among female and male drug users. Journal of Community Health, 17, 303–317.

    PubMed  Google Scholar 

  • Larrat, E. P., Zierler, S., and Mayer, K. (1994). Cocaine use and heterosexual exposure to human immunodeficiency virus. Epidemiology, 5, 398–403.

    PubMed  Google Scholar 

  • Leonard, L., and Ross, M. W. (1997). The last sexual encounter: The contextualization of sexual risk behaviour. International Journal of STD and AIDS, 8, 643–645.

    PubMed  Google Scholar 

  • Logan, T. K., Leukefeld, C., and Farabee, D. (1998). Sexual and drug use behavior among women crack users: Implications for prevention. AIDS Education and Prevention, 10, 327–340.

    PubMed  Google Scholar 

  • Malow, R. M., Corrigan, S. A., Cunningham, S. C., West, J. A., and Pena, J. M. (1993). Psychosocial factors associated with condom use among African-American drug abusers in treatment. AIDS Education and Prevention, 5, 244–253.

    PubMed  Google Scholar 

  • McMahon, J., and Tortu, S. (1998). Sexual risk behavior and condom use among women at high risk for HIV infection. Presented at the American Public Health Association 126th Annual Meeting, November 15-19, 1998, Washington, D.C.

  • Molitor, F., Truax, S. R., Ruiz, J. D., and Sun, R. K. (1998). Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. Western Journal of Medicine, 168, 93–97.

    PubMed  Google Scholar 

  • Montoya, I. D. (1998). Social network ties, self-efficacy, and condom use among women who use crack cocaine: A pilot study. Substance Use and Misuse, 33, 2049–2073.

    PubMed  Google Scholar 

  • Moore, J., Harrison, J. S., Kay, K. L., Deren, S., and Doll, L. S. (1995). Factors associated with Hispanic women's HIV-related communication and condom use with male partners. AIDS Care, 7, 415–427.

    PubMed  Google Scholar 

  • Morrill, A. C., Ickovics, J. R., Golubchikov, V. V., Beren, S. E., and Rodin, J. (1996). Safer sex: Social and psychological predictors of behavioral maintenance and change among heterosexual women. Journal of Consulting Clinical Psychology, 64, 819–828.

    Google Scholar 

  • Nyamathi, A. M., Lewis, C. L., Flaskerud, J., and Bennett, C. (1995). Barriers to condom use and needle cleaning among impoverished minority female injection drug users and partners of injection drug users. Public Health Reports, 110, 166–172.

    PubMed  Google Scholar 

  • Padian, N. S., Shiboski, S. C., Glass, S. O., and Vittinghoff, E. (1997). Heterosexual transmission of human immunodefi-ciency virus (HIV) in Northern California: Results form a tenyear study. American Journal of Epidemiology, 146, 350–357.

    PubMed  Google Scholar 

  • Prince, A., and Bernard, A. L. (1998). Sexual behaviors and safer sex practices of college students on a commuter campus. Journal of the American College of Health, 47, 11–21.

    Google Scholar 

  • Reitmeijer, C. A., and Fichtner, R. R. (1998). Use of condoms at last sexual intercourse: an example of advantages and pitfalls of standardizing questions surveys for HIV and STD risk behavior. In 12th International Conference on AIDS, Geneva (Abstract 43427).

  • Roberts, K. L. (1998). Correlates of condom use and attitudes to condoms and AIDS in a group of Darwin women. Australian Journal of Rural Health, 6, 5–11.

    PubMed  Google Scholar 

  • Siegal, H. A., Falck, R. S., Wang, J., and Carlson, R. G. (1996). History of sexually transmitted diseases infection, drug-sex behaviors, and the use of condoms among midwestern users of injection drugs and crack cocaine. Sexually Transmitted Diseases, 23, 277–282.

    PubMed  Google Scholar 

  • Skurnick, J. H., Abrams, J., Kennedy, C. A., Valentine, S. N., and Cordell, J. R. (1998). Maintenance of safe sex behavior by HIV-serodiscordant heterosexual couples. AIDS Education and Prevention, 10, 493–505.

    PubMed  Google Scholar 

  • Sloboda, Z. (1998). What we have learned from research about the prevention of HIV transmission among drug abusers. Public Health Reports, 113, 194–204.

    Google Scholar 

  • Sly, F., Quandagno, D., Harrison, D. F., Eberstein, I., and Riehman, K. (1997). The association between substance use, condom use and sexual risk among low-income women. Family Planning Perspectives, 29, 132–136.

    PubMed  Google Scholar 

  • St. Lawrence, J. S., Eldridge. G. D., Reitman, D., Little, C. E., Shelby, M. C., and Brasfield, T. L. (1998). Factors influencing condom use among African American women: Implications for risk reduction interventions. American Journal of Community Psychology, 26, 7–28.

    PubMed  Google Scholar 

  • Tortu, S., McMahon, J. M., and Haid, R. (1999, July). The social ecology of exchanging sex for drugs or money in East Harlem, NYC: An event analysis focused on women drug users. In AIDS Impact. Fourth International Conference on the Biopsychosocial Aspects of HIV Infection (p. 207). Canadian PsychologicalAssociation

  • Tortu, S., McMahon, J. M., Hamid, R., and Neaigus, A. (1998). The social ecology of drug using women's sexual risk in East Harlem, NYC: An event analysis. In 12th World International Conference on AIDS, Geneva (Abstract 23493).

  • Wasserheit, J. (1991). Epidemiology synergy: Interrelationships between HIV infections and other STDs. In L. Chen et al. (Eds.), AIDS and women's reproductive health (pp. 47–72). New York: Plenum Press.

    Google Scholar 

  • Watkins, K. E., Metzger, D., Woody, G., and McLellan, A. T. (1993). Determinants of condom use among intravenous drug users. AIDS, 7, 719–723.

    PubMed  Google Scholar 

  • Watters, J., and Biernacki, P. (1989). Targeted sampling: Options for the study of hidden populations. Social Problems, 6, 416–430.

    Google Scholar 

  • Weinstock, H., Lindan, C., Bolan, G., Kegeles, S. M., and Hearst, N. (1993). Factors associated with condom use in a highrisk heterosexual population. Sexually Transmitted Diseases, 20, 14–20.

    PubMed  Google Scholar 

  • White, D., Phillips, K., Mulleady, G., and Cupitt, C. (1993). Sexual issues and condom use among injecting drug users. AIDS Care, 5, 427–437.

    PubMed  Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87, 1016–1018.

    PubMed  Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1998). Partner influences and gender-related factors associated with noncondom use among young adult African American women. American Journal of Community Psychology, 26, 29–51.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tortu, S., McMahon, J., Hamid, R. et al. Drug-Using Women's Sexual Risk: An Event Analysis. AIDS Behav 4, 329–340 (2000). https://doi.org/10.1023/A:1026446305081

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026446305081

Navigation