Elsevier

Addictive Behaviors

Volume 35, Issue 5, May 2010, Pages 432-437
Addictive Behaviors

High-risk drug use and sexual behaviors among out-of-treatment drug users: An aging and life course perspective

https://doi.org/10.1016/j.addbeh.2009.12.010Get rights and content

Abstract

High-risk injection drug use and its accompanying sexual behaviors have large social and financial costs. However, little is known about how age and age at first drug use are related to high-risk injection or sex behaviors. The current study draws on life course perspectives and data from the NIDA Cooperative Agreement to examine the relationship between eight high-risk behavior variables and age and age at first drug use. Random effects negative binomial regression models reveal that the frequency of high-risk sexual behaviors in the past month decreases up to 28% with each decade of age, although the frequency of high-risk injection behaviors in the past month increases by up to 62% with each decade of age. Both high-risk injection and high-risk sex behaviors are lower among those who initiated first drug use at later ages. Previous research has indicated the importance of interventions to reduce the high-risk sexual behaviors of older drug users. The current study suggests a refocusing of public health efforts on their high-risk injection habits.

Section snippets

Background

High-risk drug injection habits and the sexual practices that accompany them are estimated to be responsible for more than one-third of AIDS cases in the United States (Centers for Disease Control (CDC), 2002). These behaviors also facilitate the rapid spread of Hepatitis B and C, and can have devastating effects on the skin, veins, muscles, and joints (Burt et al., 2007, Ebright & Pieper, 2002, Estrada, 2002, Pieper et al., 2007). Drug treatment, and outreach interventions to those not in

Data and methods

The National Institute on Drug Abuse's (NIDA) Cooperative Agreement (CA) for AIDS Community-Based Outreach/Intervention Research Program collected data from 1992 to 1998 to evaluate interventions designed to reduce HIV risk behaviors (U.S. Department of Health and Human Services, 2001). Because of the illegal nature of their behavior, out-of-treatment drug users are difficult to recruit into research studies (Anglin, Caulkins, & Hser, 1993). The current dataset, with 31 088 respondents, is the

Description of the sample

Table 3 presents means and standard deviations, or percentages, of the age and high-risk behavior variables. On average, in the past 30 days participants had sex on 7.8 days, had approximately three different sex partners, traded drugs for sex less than one time, and engaged in 16.2 unprotected sex acts. Fifty-five percent of the sample had injected drugs in the past 30 days. Table 3 also compares non-injectors and injectors. Non-injectors were younger than injectors (35 versus 38 years) but began

Discussion

Our first aim examines the relationship between age and high-risk habits of out-of-treatment drug users. Age is negatively associated with high-risk sex behaviors, and positively associated with high-risk injection behaviors. The former finding is in line with previous research that shows that high-risk sexual behavior decreases with age (Kwiatkowski & Booth, 2003). However, Kwiatkowski and Booth (2003) find that older drug users had fewer injections than younger drug users in the past 30 days,

Role of Funding Source

We would like to acknowledge administrative support from the University of Colorado Boulder, Population Program (The Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R21 HD51146).

Contributors

We would like to acknowledge helpful comments on an earlier draft of this paper from Beth Quill. All authors contributed to the development and revisions of the manuscript. William Lopez and Patrick Krueger conducted statistical analyses. The data used herein come from the National Institute on Drug Abuse (NIDA). NIDA is not responsible for our analyses, interpretation, or conclusions.

Conflict of Interest

No conflict of interest to declare.

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