Abstract
Cocaine use, marijuana use, alcohol use, and polysubstance use (e.g., alcohol and cocaine, alcohol and marifuana) are associated with high-risk sexual behavior and higher rates of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). The purpose of this study was to examine readiness for using condoms among three groups (cocaine users, noncocaine drug users, and non-drug users) of African Americans living in low-income urban settings. African Americans in this sample differed in sex risk behaviors according to their drug use status. Noncocaine drug users reported higher levels of sex risk behaviors than non-drug users, and cocaine users reported the highest levels of risk. Cocaine users also reported lower levels of condom use with their main and nonmain sexual partners than both other groups. Results of multivariate analyses indicate that, compared to the other two groups, cocaine users are at earlier stages of readiness for condom use with main partners. Cocaine users have accurate perceptions of their HIV risk, but are more likely to factor into their decisions for using condoms cost and the trouble that it takes to get condoms. Different approaches to sexually transmitted disease and human immunodeficiency virus prevention will be necessary to meet the needs of these three different subgroups.
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References
Alabama Department of Public Health. HIV/AIDS in African Americans: a growing crisis in Alabama.Alabama HIV/AIDS Update Newsletter. 1999;10:1–9.
Baseman J, Ross M, Williams M. Sale of sex for drugs and drugs for sex: an economic context of sexual risk behavior for STDs.Sex Transm Dis. 1999;26:444–449.
Beltrami JF, Vermund SH, Fawal HJ, Moon TD, Von Bargen JC, Holmberg, SD. HIV/AIDS in nonurban Alabama: risk activities and access to services among HIV-infected persons.South Med J. 1999;92:677–683.
Word CO, Bowser B. Background to crack cocaine addiction and HIV high-risk behavior: the next epidemic.Am J Drug Alcohol Abuse. 1997;23:67–77.
Castilla J, Barrio G, Belza MJ, de la Fuente L. Drug and alcohol consumption and sexual risk behaviour among young adults: results from a national survey.Drug Alcohol Depend. 1999;56:47–53.
Boscarino JA, Avins AL, Woods WJ, Lindan CP, Hudes ES, Clark W. Alcohol-related risk factors associated with HIV infection among patients entering alcoholism treatment: implications for prevention.J Stud Alcohol. 1995;56:642–653.
Shillington AM, Cottler LB, Compton WM, III, Spitznagel EL. Is there a relationship between “heavy drinking” and HIV high risk sexual behaviors among general population subjects?Int J Addict. 1995;30:1453–1478.
Booth RE, Watters JK, Chitwood DD. HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack.American J Public Health. 1993;83:1144–1148.
Rasch RF, Weisen CA, MacDonald B, Wechsberg WM, Perritt R, Dennis ML. Patterns of HIV risk and alcohol use among African-American crack abusers.Drug Alcohol Depend. 2000;58:259–266.
Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change.J Consult Clin Psychol. 1983;51:390–395.
Grimley DM, Riley GE, Bellis JM, Prochaska JO. Assessing the stages of change and decision-making for contraceptive use for the prevention of pregnancy, sexually transmitted diseases, and acquired immunodeficiency syndrome.Health Educ. Q. 1993;20:455–470.
Stark MJ, Tesselaar HM, O'Connell AA, et al. Psychosocial factors associated with the stages of change for condom use among women at risk for HIV and STDs: implications for intervention development.J Consult Clin Psychol. 1998;66:967–978.
Schnell DJ, Galavotti C, Fishbein M, Chan DK. Measuring the adoption of consistent use of condoms using the stages of change model. AIDS Community Demonstration Projects.Public Health Rep. 1996;111(suppl 1):59–68.
Grimley DM, Riley GE, Prochaska JO, et al. Application of the transtheoretical model to contraceptive and condom use in high-risk women. Unpublished technical report, 1993.
Prochaska JO, Velicer WF, Rossi JS, et al. Stages of change and decisional balance for 12 problem behaviors.Health Psychol. 1994;13:39–46.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change.Am J Health Promotion. 1997;12:38–48.
Bowen AM, Trotter R. HIV risk in intravenous drug users and crack cocaine smokers: predicting stage of change for condom use.J Consult Clin Psychol. 1995;63:238–248.
Galavotti C, Cabral RJ, Lansky A, Grimley DM, Riley GE, Prochaska JO, Validation of measures of condom and other contraceptive use among women at high risk for HIV infection and unintended pregnancy.Health Psychol. 1995;14:570–578.
O'Campo P, Fogarty L, Gielen AC, et al. Distribution along a stages-of-behavioralchange continuum for condom and contraceptive use among women accessed in different settings. Prevention of HIV in Women and Infants Demonstration Projects.J Community Health. 1999;24:61–72.
Anderson JE, Cheney R, Clatts M et al. HIV risk behavior, street outreach, and condom use in eight high-risk populations.AIDS Educ Prev. 1996;8(3):191–204.
US Department of Health and Human Services.National Household Survey on Drug Abuse: Population Estimates for 1995. Rockville, MD: National Institute on Drug Abuse. SMA Publication No. 96-3095, 1996.
Wang MQ, Fitzhugh E, Westerfield RC. Determining sample size for simple-random surveys.Health Values. 1995;19:53–56.
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Ross, L., Kohler, C.L., Grimley, D.M. et al. Intention to use condoms among three low-income, urban african American subgroups: Cocaine users, noncocaine drug users, and non-drug users. J Urban Health 80, 147–160 (2003). https://doi.org/10.1093/jurban/jtg147
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DOI: https://doi.org/10.1093/jurban/jtg147