| 418
A. R. WOHL ET AL. TABLE 4. Injection drug use behavior in women with HIV and
AIDS
interviewed in Los Angeles County, 1990-1997
Race/ethnicity
of women
Behavior |
(n = 168) |
(n = 87) |
(n = 357) |
(n = 12) |
ORa |
95% |
Cl |
| Ever injected a drug with a needle? |
| Yes |
38 |
23 |
28 |
32 |
45 |
13 |
3 |
25 |
1.5 |
0.9 |
2.3 |
| No |
130 |
77 |
59 |
68 |
312 |
87 |
9 |
75 |
| Age first injected drugsb |
| <19 y |
18 |
47 |
15 |
54 |
17 |
38 |
1 |
33 |
|
|
|
| 20-29 y |
14 |
37 |
10 |
36 |
23 |
51 |
2 |
67 |
|
|
|
| 30 39y |
5 |
13 |
3 |
11 |
4 |
9 |
0 |
— |
|
|
|
| >=40 y |
1 |
3 |
0 |
— |
1 |
2 |
0 |
— |
|
|
|
| t-Test on difference in mean
age = 0.2; p = 0.8 |
| Heroin |
21 |
55 |
9 |
32 |
29 |
64 |
0 |
— |
1.2 |
0.6 |
2.7 |
| Cocaine |
6 |
16 |
8 |
29 |
5 |
11 |
1 |
33 |
0.8 |
0.3 |
2.4 |
| Ever shared a needle or syringesb |
| Yes |
36 |
95 |
24 |
86 |
39 |
87 |
0 |
— |
3.7 |
0.9 |
16.1 |
| No |
2 |
5 |
4 |
14 |
6 |
13 |
3 |
100 |
|
|
|
| How often did YOU share needles or
syringesc |
| Sometimes |
23 |
64 |
10 |
42 |
23 |
59 |
0 |
— |
|
|
|
| Usually |
7 |
19 |
8 |
33 |
10 |
26 |
0 |
— |
|
|
|
| Every time |
5 |
14 |
6 |
25 |
6 |
15 |
0 |
— |
|
|
|
| Unknown |
1 |
3 |
0 |
— |
0 |
— |
0 |
— |
|
|
|
| ORa for comparing every
time with usually and sometimes = 0.7; 95% CIs = 0.2, 2.2 |
OR, odds ratio; CI, confidence interval.
a OR and 95% CIs were calculated comparing African-American women with
women of all other races.
b The totals for these analyses include only those women who have ever
injected drugs with a needle.
c The totals for these analyses include only those women who have ever
shared a needle or syringe.
| (50%) compared
with women of other races (15%). Similar findings were not observed in populations at
high-risk for HIV studied on the East Coast, among whom a history of ever using crack was
reported to be 18% in two high-risk African-American female study groups (5,7). Excessive
crack use among African American women in this sample of LAC women with HIV and AIDS is
consistent with patterns of crack use in high-risk women in Los Angeles (4,8). It has been
purported that crack, a smokable form of cocaine, reduces sexual inhibition and judgment,
placing someone at greater risk for unprotected sex and other high-risk sexual behaviors
(20). In addition, the culture of crack use promotes the exchange of sex for drugs and
evidence suggests that crack use is a risk factor for high levels of sexual activity and
STDs among African-American teenagers in Northern California (21). Other evidence also
suggests that crack use may result in oral sores that may promote the transmission of HIV
orally (22). These data infer that crack use is likely to play a larger role in HIV risk
in African-American women in LAC than elsewhere. There is still more, however, that we
need to learn about crack use in African-American women, such as the extent to which the
economic livelihood of AfricanAmerican women depends on the sale |
!!!of crack, the
degree to which sex is exchanged for crack, more detailed information on the high-risk
sexual behaviors that may result from crack use, and the role of oral sores from crack use
in the transmission of HIV.
Certain limitations in this analysis should be considered. First, the lack of
a control group of AfricanAmerican women uninfected with HIV limited our ability to assess
more fully the risk factors for HIV in African-American women. Second, that the study
group was composed of a population-based sample of AfricanAmerican women with AIDS and an
additional group of HIV-infected African-American women seen at a single large
county clinic may have limited the generalizability of our findings. However, the
demographic and behavioral characteristics of each group did not differ appreciably,
suggesting that the combined analyses are valid and are likely to be generalizable to
African-American women with AIDS in LAC.
The findings from this analysis can be used to direct HIV prevention
interventions in African-American women in LAC and underscore the barriers to conducting
effective prevention in a socially and economically disenfranchised population. Previous
education efforts in African-American women who were methadonedependent injection drug
users and non-injection drug |
Journal of Acquired Immune
Deficiency Syndromes and Human Retroviro/ogy, VoL 19, No 4, December 1, 1998
|