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Differences in HIV Risk Behaviors by Gender in a Sample of Tanzanian Injection Drug Users

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Abstract

This study investigated differences in drug use and sexual behaviors among from 237 male and 123 female heroin users in Dar es Salaam, Tanzania. Multivariate models of risk of needle sharing were estimated using multivariate logistic regression. Men were significantly older, more likely to inject only white heroin, share needles, and give or lend used needles to other injectors. Women were more likely to be living on the streets, have injected brown heroin, have had sex, have had a higher number of sex partners, and have used a condom with the most recent sex partner. Being male and earning less than US $46 in the past month were significant predictors of increased risk of needle sharing. Despite differences in sociodemographic, drug use, and sexual behaviors by gender, both male and female injectors in Dar es Salaam exhibit elevated risk of HIV infection associated with drug use.

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References

  • Adimora, A., & Schoenbach, V. (2005). Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. Journal of Infectious Diseases, 191, S115–S122.

    Article  PubMed  Google Scholar 

  • Allen, S., Meinzen-Derr, J., Kautzman, M., Zulu, I., Trask, S., Fideli, U., et al. (2003). Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS, 17, 733–740.

    Article  PubMed  Google Scholar 

  • Appleby, P., Miller, L., & Rothspan, S. (1999). The paradox of trust for male couples: When risking is a part of loving. Personal Relationships, 6, 81–93.

    Article  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • Blattner, W., O’Brien, T., & Mueller, N. (1997). Retroviruses–Human immunodeficiency virus. In A. Evansand R. Kaslow (Eds.), Viral infections of humans: Epidemiology and control (pp. 713–783). New York: Plenum Medical Book Company.

    Google Scholar 

  • Boerma, J., Gregson, S., Nyamukapa, C., & Urassa, M. (2003). Understanding the uneven spread of HIV within Africa: Comparative study of biologic, behavioral, and contextual factors in rural populations in Tanzania and Zimbabwe. Sexually Transmitted Diseases, 30, 779–787.

    Article  PubMed  Google Scholar 

  • Booth, R., Watters, J., & Chitwood, 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.

    Article  PubMed  CAS  Google Scholar 

  • Bowen, A., Williams, M., McCoy, H., & McCoy, C. (2001). An investigation of the psychosocial determinants of condom use among sexually active heterosexual drug users. AIDS Care, 13, 579–594.

    Article  PubMed  CAS  Google Scholar 

  • Carneiro, M., Fuller, C., Doherty, M., & Vlahov, D. (1999). HIV prevalence and risk behaviors among new initiated into injection drug use over 40 years old. Drug and Alcohol Dependence, 54, 83–86.

    Article  PubMed  CAS  Google Scholar 

  • Catania, J., Gibson, D., Chitwood, D., & Coates, T. (1990). Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychological Bulletin, 108, 339–362.

    Article  PubMed  CAS  Google Scholar 

  • Chaisson, R., Bacchetti, P., Osmond, D., Brodie, B., & Sande, M. (1989). Cocaine use and HIV infection in intravenous drug users in San Francisco. Journal of the American Medical Association, 261, 561–565.

    Article  PubMed  CAS  Google Scholar 

  • Colfax, G., Mansergh, G., Gusman, R., Vittinghoff, E., Mark, G., Rader, M., et al. (2001). Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: A venue-based comparison. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 28, 373–379.

    CAS  Google Scholar 

  • Corby, N., Jamner, M., & Wolitski, R. (1996). Using the theory of planned behavior to predict intention to use condoms among male and female injecting drug users. Journal of Applied Psychology, 26, 52–75.

    Article  Google Scholar 

  • Darke, S. (1998). Self-report among injecting drug users: A review. Drug and Alcohol Dependence, 51, 253–263.

    Article  PubMed  CAS  Google Scholar 

  • Davies, A., Dominy, N., Peters, A., & Richardson, A. (1996). Gender differences in HIV risk behaviour of injecting drug users in Edinburgh. AIDS Care, 8, 517–527.

    Article  PubMed  CAS  Google Scholar 

  • Des Jarlais, D. (1992). The first and second decades of AIDS among injecting drug users. British Journal of Addictions, 87, 347–353.

    Article  CAS  Google Scholar 

  • 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.

    PubMed  CAS  Google Scholar 

  • Dowling-Guyer, S., Johnson, M., Fisher, D., Needle, R., Watters, J., Andersen, M., et al. (1994). Reliability of drug users’ self-reported HIV risk behaviors and validity of self-reported recent drug use. Assessment, 1, 383–392.

    Google Scholar 

  • Friedman, S., Jose, B., Deren, S., Des Jarlais, D., & Neaigus, A. (1995). Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. American Journal of Epidemiology, 42, 864–874.

    Google Scholar 

  • Grosskurth, H., Gray, R., Hayes, R., Mabey, D., & Wawer, M. (2000). Control of sexually transmitted diseases for HIV-1 prevention: Understanding the implications of Mwanza and Rakai trials. Lancet, 355, WA8–WA14.

    Article  Google Scholar 

  • Grosskurth, H., Mosha, F., Todd, J., Senkoro, K., Newell, J., Klokke, A., et al. (1995). A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS, 9, 927–934.

    Article  PubMed  CAS  Google Scholar 

  • Hayes, R., Mosha, F., Nicoll, A., Grosskurth, H., Newell, J., Todd, J., et al. (1995). A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 1. Design. AIDS, 9, 919–926.

    Article  PubMed  CAS  Google Scholar 

  • Kalichman, S., & Simbayi, L. (2003). HIV testing attitudes, AIDS stigma, and voluntary HIV counseling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections, 79, 442–447.

    Article  PubMed  CAS  Google Scholar 

  • McCurdy, S. (2001). Urban threats: Manyema women, low fertility and venereal diseases in British colonial Tanganyika. In D. Hodgsonand S. McCurdy (Eds.), “Wicked” women and the reconfiguration of gender in Africa (pp. 212–233). Portsmouth, NH: Heinemann.

    Google Scholar 

  • McCurdy, S., Williams, M., Kilonzo, G., Ross, M., & Leshabari, M. (2005). Heroin and HIV risk in Dar es Salaam, Tanzania: Youth hangouts, mageto, and injecting practices. AIDS Care, S65–S76.

  • Murphy, S., & Waldorf, D. (1991). Kickin’ down to the street doc: Shooting galleries in San Francisco Bay Area. Contemporary Drug Problems, 1991, 9–29.

    Google Scholar 

  • Mwaluko, G., Urassa, M., Isingo, R., Zaba, B., & Boerma, J. (2003). Trends in HIV sexual and behaviour in a longitudinal study in a rural population in Tanzania, 1994–2000. AIDS, 17, 2645–2651.

    Article  PubMed  Google Scholar 

  • Needle, R., Fisher, D., Weatherby, N., Brown, B., Cesari, H., Chitwood, D., et al. (1995). The reliability of self-reported HIV risk behaviors of drug users. Psychology of Addictive Behaviors, 9, 242–250.

    Article  Google Scholar 

  • Orroth, K., Korenromp, E., White, R., Gavyole, A., Gray, R., Muhangi, L., et al. (2003). Higher risk behavior and rates of sexual transmitted disease in Mwanza compared to Uganda may help explain HIV prevention trial outcomes. AIDS, 17, 2653–2660.

    Article  PubMed  Google Scholar 

  • Parry, C., Bhana, A., Pluddemann, A., Myers, B., Siegfried, N., Morojele, N., et al. (2002). The South African Community Epidemiology Network of Drug Use (SACENDU): Description, findings (1997–1999), and policy implications. Addiction, 97, 969–976.

    Article  PubMed  Google Scholar 

  • Patrick, D., Strathdee, S., Archibald, C., Ofner, M., Craib, K., Cornelisse, P., et al. (1997). Determinants of HIV seroconversion in injection drug users during a period of rising prevalence in Vancouver. International Journal of STD and AIDS, 8, 837–445.

    Google Scholar 

  • Rothenberg, R. (2001). How a net works: Implications of network structure for the persistence and control of sexually transmitted diseases and HIV. Sexually Transmitted Diseases, 28, 63–68.

    PubMed  CAS  Google Scholar 

  • Rothenberg, R., Potterat, J., & Woodhouse, D. (1996). Personal risk taking and the spread of disease: Beyond core groups. Journal of Infectious Diseases, 174, S144–S149.

    PubMed  Google Scholar 

  • Rusch, M., Lampinen, T., Schilder, A., & Hogg, R. (2004). Unprotected anal intercourse associated with recreational drug use among young men who have sex with men depends on partner type and intercourse role. Sexually Transmitted Diseases, 31, 492–498.

    Article  PubMed  Google Scholar 

  • Schmid, G., Buve, A., Mugyenyi, P., Garnett, G., Hayes, R., Williams, B., et al. (2004). Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections. Lancet, 363, 482–488.

    Article  PubMed  Google Scholar 

  • Singer, M., Jia, Z., Schensul, J., Weeks, M., & Bryan, J. (1992). AIDS and the IV drug user: The local context in prevention efforts. In R. Boltonand M. Singer (Eds.), Rethinking AIDS prevention: Cultural approaches (pp. 147–168). Yverdon, Switzerland: Gordon and Breach Science Publishers.

    Google Scholar 

  • Vanichseni, S., Choopanya, K., Des Jarlais, D., Plangsringarm, K., Sonchai, W., Carballo, M., et al. (1992). HIV testing and sexual behavior among intravenous drug users in Bangkok, Thailand. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 5, 1119–1123.

    CAS  Google Scholar 

  • Vanichseni, S., Des Jarlais, D., Choopanya, K., Friedmann, P., Wenston, J., Sonchai, W., et al. (1993). Condom use with primary partners among injecting drug users in Bangkok, Thailand, and New York City, United States. AIDS, 7, 887–891.

    Article  PubMed  CAS  Google Scholar 

  • Watters, J., & Biernacki, P. (1989). Targeted sampling: Options for the study of hidden populations. Social Problems, 36, 416–430.

    Article  Google Scholar 

  • Williams, M., Bowen, A., Elwood, W., McCoy, C., McCoy, H., 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.

    Article  Google Scholar 

  • Williams, M., Timpson, S., Klovdahl, A., Bowen, A., Ross, M., & Keel, K. (2003). HIV risk among a sample of male sex workers. AIDS, 17, 1402–1404.

    Article  PubMed  Google Scholar 

  • Wodak, A., Sarkar, S., & Mesquita, F. (2004). The globalization of drug injecting. Addiction, 99, 799–801.

    Article  PubMed  CAS  Google Scholar 

  • Wodak, A., Stowe, A., Ross, M., Gold, J., & Miller, M. (1995). HIV risk exposure of injecting drug users in Sydney. Drug and Alcohol Review, 14, 213–222.

    Article  PubMed  CAS  Google Scholar 

  • Zule, W. (1992). Risk and reciprocity: HIV and the injection drug user. Journal of Psychoactive Drugs, 24, 243–249.

    PubMed  CAS  Google Scholar 

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Acknowledgments

This research is based on an ongoing collaboration between researchers at the University of Texas-Health Science Center at Houston and Muhimbili University College of Health Sciences and is supported by a grant from the National Institute on Drug Abuse, National Institutes of Health, USA. The opinions expressed in the manuscript are solely those of the authors.

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Correspondence to Mark L. Williams.

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Williams, M.L., McCurdy, S.A., Atkinson, J.S. et al. Differences in HIV Risk Behaviors by Gender in a Sample of Tanzanian Injection Drug Users. AIDS Behav 11, 137–144 (2007). https://doi.org/10.1007/s10461-006-9102-x

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