Preventing AIDS In Women Crack Users

October 23, 1998

LEXINGTON, KY - (Oct. 23, 1998) - A University of Kentucky researcher has published a study that may help develop strategies to prevent HIV in at-risk women.

"It's estimated that approximately 50 percent of crack users engage in sex exchange behavior," said T.K. Logan, Ph.D., assistant professor of psychiatry, UK College of Medicine, and researcher at the UK Center on Drug and Alcohol Research. "There's limited knowledge about the differences between women who do and women who don't exchange sex for drugs or money."

Logan's study, published in AIDS Prevention and Education, provides profiles of female crack users that may help facilitate the effectiveness of HIV prevention measures in the future.

More than 1,200 women from Louisville and Lexington, Ky., were recruited into a National Institute on Drug Abuse-funded HIV prevention intervention study. Women were interviewed using a risk behavior assessment to determine characteristics of sexual behavior and demographics, and were divided into two groups: exchangers, those who exchanged sex for drugs, and non-exchangers, those who reported only using crack.

Past studies have shown that female crack smokers are
15 times more likely to sell themselves for sex than nonusers, and that a link exists between crack use and risk of contracting HIV and other sexually transmitted diseases.

Women in both groups had fairly similar backgrounds - the majority were African American and had incomes of less than $500 a month. About half of the women had at least a high school education.

Women who exchanged sex for drugs or money were four times more likely to have been in substance abuse treatment in the past, twice as likely to have been charged with a criminal offense, and twice as likely to indicate they were currently homeless.

Sexual behavior questions provided some striking differences between the groups. Women who exchanged sex reported an average of five partners in the 30 days prior to the interview, compared with an average of one partner for women who had not exchanged sex. Exchangers reported having, on average, one sexual partner in the previous month who was an intravenous drug user vs. no intravenous drug users for the non-exchangers. Exchangers also had a higher incidence of sexually transmitted diseases and had initiated drug use earlier than those who did not exchange sex.

"Treatment programs and the criminal justice system may be missing important opportunities for targeting HIV risk behaviors," Logan said. "A strategy that may be more cost efficient and effective for HIV prevention may be to focus on those at risk for exchanging sex, but who have not yet begun to do so."

AIDS is the fourth leading cause of death for women ages 25 to 44 in the United States, and infection rates are climbing at an alarming pace, according to the Centers for Disease Control. The study was supported by a grant from the National Institute on Drug Abuse.

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University of Kentucky Medical Center

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