Archives of Sexual Behavior

, Volume 39, Issue 6, pp 1353–1358 | Cite as

Sexual Activity in HIV-Positive African American Crack Cocaine Smokers

  • Sandra C. Timpson
  • Mark L. Williams
  • Anne M. Bowen
  • John S. Atkinson
  • Michael W. Ross
Original Paper


The AIDS epidemic in the United States continues to disproportionately affect minorities of color, especially African Americans. The purpose of this study was to explore the sexual behaviors of a sample of African American HIV positive crack smokers aware of their serostatus. Participants (100 men, 37 women) were included in this study based on the following criteria: a minimum age of 18 years, HIV positive serostatus, treatment with HIV antiretroviral medications for a minimum of 3 months prior to interview, crack cocaine use at least once in the 7 days prior to being interviewed, willingness to provide a urine sample to confirm recent drug use, and vaginal or anal sex at least once in the past 7 days. The questionnaire was a compilation of other reliable surveys and was designed to collect sociodemographic data, drug use, sexual behavior, condom use intentions and motivators, STD and HIV infection history, HIV medications, and adherence requirements. Participants reported having 1,266 different partners in the 30 days prior to the interview and had traded sex for money or drugs with 68%. A total of 79 participants had multiple partners and accounted for 1,247 partnerships. Rates of consistent condom use across partnerships were low, indicating that more interventions in this at-risk population are needed.


African-American Crack cocaine HIV+ Sexual activity 



Support for this research was provided by a grant from the National Institute on Drug Abuse, RO3 DA12328, Dr. Mark Williams, Principal Investigator.


  1. Avants, S., Warburton, L., Hawkins, K., & Margolin, A. (2000). Continuation of high-risk behavior by HIV-positive drug users: Treatment implications. Journal of Substance Abuse Treatment, 19, 15–22.CrossRefPubMedGoogle Scholar
  2. Centers for Disease Control and Prevention. (2009). HIV/AIDS surveillance report, 2007 (Vol. 19). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
  3. Cottler, L., Compton, W., Ben Abdallah, A., Cunningham-Williams, R., Abram, F., Fichtenbaum, C., et al. (1998). Peer-delivered interventions to reduce HIV risk behaviors among out-of-treatment drug abusers. Public Health Reports, 113, 31–41.PubMedGoogle Scholar
  4. Des Jarlais, D., Friedman, S., Perlis, T., Chapman, T., Sotheran, J., Paone, D., et al. (1999). Risk behavior and HIV infection among drug injectors in the era of AIDS in New York City. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 20, 67–72.PubMedGoogle Scholar
  5. Des Jarlais, D., Marmor, M., Friedmann, P., Titus, S., Aviles, E., Deren, S., et al. (2000). HIV incidence among injection drug users in New York City, 1992–1997: Evidence for a declining epidemic. American Journal of Public Health, 90, 352–359.CrossRefPubMedGoogle Scholar
  6. Friedman, S., Chapman, T., Perlis, T., Rockwell, R., Paone, D., Sotheran, J., et al. (1999). Similarities and differences by race/ethnicity in changes of HIV seroprevalence and related behaviors among drug injectors in New York City, 1991–1996. Journal of Acquired Immune Deficiency Syndromes, 22, 83–91.PubMedGoogle Scholar
  7. Friedman, S., Jose, B., Neaigus, A., Goldstein, M., Curtis, R., Ildefonso, G., et al. (1994). Consistent condom use in relationships between seropositive injecting drug users and sex partners who do not inject drugs. AIDS, 8, 357–361.CrossRefPubMedGoogle Scholar
  8. Hershberger, S., Wood, M., & Fisher, D. (2003). A cognitive-behavioral intervention to reduce HIV risk behaviors in crack and injection drug users. AIDS and Behavior, 7, 229–243.CrossRefPubMedGoogle Scholar
  9. Higgenbotham, S., Holmes, R., Stone, H., Beil, J., Datu, G., Costa, S., et al. (2000). Adoption of protective behaviors among persons with recent HIV infection and diagnosis—Alabama, New Jersey, and Tennessee, 1997–1998. MMWR Morbidity and Mortality Weekly Report, 49, 512–515.Google Scholar
  10. Kotranski, L., Semaan, S., Collier, K., Lauby, J., Halbert, J., & Feighan, K. (1998). Effectiveness of an HIV risk reduction counseling intervention for out-of-treatment drug users. AIDS Education and Prevention, 10, 19–33.PubMedGoogle Scholar
  11. Kwiatkowski, C., & Booth, R. (1998). HIV-seropositive drug users and unprotected sex. AIDS and Behavior, 2, 151–159.CrossRefGoogle Scholar
  12. Kwiatkowski, D., Stober, D., Booth, R., & Zhang, Y. (1999). Predictors of increased condom use following HIV intervention with heterosexually active drug users. Drug and Alcohol Dependence, 54, 57–62.CrossRefPubMedGoogle Scholar
  13. McCoy, C., & Inciardi, J. (1995). Sex, drugs, and the continuing spread of AIDS. Los Angeles: Roxbury Publishing Company.Google Scholar
  14. Nilsson Schonnesson, L., Atkinson, J., Williams, M., Bowen, A., Ross, M., & Timpson, S. (2008). A cluster analysis of drug use and sexual HIV risks and their correlates in a sample of African American crack cocaine smokers with HIV infection. Drug and Alcohol Dependence, 97, 44–53.CrossRefGoogle Scholar
  15. Riehman, F., Wechsberg, W., Zule, W., Lam, W., & Levine, B. (2008). Gender differences in the impact of social support on crack use among African Americans. Substance Use and Misuse, 43, 85–104.CrossRefPubMedGoogle Scholar
  16. Risser, J., Timpson, S., McCurdy, S., Ross, M., & Williams, M. (2006). Psychological correlates of trading sex for money among African American crack cocaine smokers. American Journal of Drug and Alcohol Abuse, 32, 645–653.CrossRefPubMedGoogle Scholar
  17. Ross, M. W., Risser, J., Peters, R. J., & Johnson, R. J. (2006). Cocaine use and syphilis trends: Findings from the Arrestee Drug Abuse Monitoring (ADAM) program and syphilis epidemiology in Houston. American Journal on Addictions, 15, 473–477.CrossRefPubMedGoogle Scholar
  18. Ross, M., Timpson, S., Williams, M., & Bowen, A. (2003). Situational correlates of condom use in a sample of African-American drug users who are primarily crack cocaine users. AIDS and Behavior, 7, 55–60.CrossRefPubMedGoogle Scholar
  19. Ross, M., Timpson, S., Williams, M., & Bowen, A. (2007). The impact of HIV-related interventions on HIV risk behavior in a community sample of African American crack cocaine users. AIDS Care, 19, 608–616.CrossRefPubMedGoogle Scholar
  20. Simpson, D., Camacho, L., Vogtsberger, K., Williams, M., Stephens, R., Jones, A., et al. (1994). Reducing AIDS risks through community outreach for drug injectors. Psychology of Addictive Behavior, 8, 86–101.CrossRefGoogle Scholar
  21. Simpson, D., Knight, K., & Ray, S. (1993). Psychosocial correlates of AIDS-risk drug use and sexual behaviors. AIDS Education and Prevention, 5, 121–130.PubMedGoogle Scholar
  22. Smith, D., Gwinn, M., Selik, R., Miller, K., Dean-Gaitor, H., Ma’at, P., et al. (2000). HIV/AIDS among African Americans: Progress or progression. AIDS, 14, 1237–1248.CrossRefPubMedGoogle Scholar
  23. Sterk, C., Theall, K., & Elifson, K. (2003). Effectiveness of a risk reduction intervention among African American women who use crack cocaine. AIDS Education and Prevention, 15, 15–32.CrossRefPubMedGoogle Scholar
  24. Timpson, S., Williams, M., Bowen, A., & Keel, B. (2003). Condom use behaviors in HIV-infected African Americans crack cocaine users. Substance Abuse, 24, 211–220.PubMedGoogle Scholar
  25. Timpson, S., Williams, M., Ross, M., & Keel, B. (2005). African-American crack users’ attitudes and beliefs about male and female condoms. Journal of Substance Use, 10, 207–213.CrossRefGoogle Scholar
  26. Watters, J., Needle, R., Brown, B., Weatherby, N., Booth, R., & Williams, M. (1992). The self-reporting of cocaine use. Journal of the American Medical Association, 268, 2374–2377.CrossRefPubMedGoogle Scholar
  27. Weatherby, N., Needle, R., Cesari, H., Booth, R., McCoy, C., Watters, J., et al. (1994). Validity of self-reported drug use among injection drug users and crack cocaine users recruited through street outreach. Evaluation and Program Planning, 17, 347–355.CrossRefGoogle Scholar
  28. Williams, M., Bowen, A., Elwood, W., McCoy, C., McCoy, V., Freeman, R., et al. (2000). An elicitation of the determinants of condom use among African Americans who smoke crack cocaine. Culture, Health, & Sexuality, 2, 15–32.CrossRefGoogle Scholar
  29. Williams, C., & Latkin, C. (2004). The role of depressive symptoms in predicting sex with multiple and high-risk partners. Journal of Acquired Immune Deficiency Syndrome, 38, 69–73.CrossRefGoogle Scholar
  30. Williams, M., Ross, M., Bowen, A., Timpson, S., McCoy, H., Keel, K., et al. (2001). An investigation of condom use by frequency of sex. Sexually Transmitted Infections, 77, 433–435.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sandra C. Timpson
    • 1
  • Mark L. Williams
    • 1
  • Anne M. Bowen
    • 2
  • John S. Atkinson
    • 1
  • Michael W. Ross
    • 1
  1. 1.Center for Health Promotion and Prevention ResearchUniversity of Texas School of Public HealthHoustonUSA
  2. 2.Department of PsychologyUniversity of WyomingLaramieUSA

Personalised recommendations