Drug use patterns and infection with sexually transmissible agents among young adults in a high-risk neighbourhood in New York City.
OBJECTIVE
To determine relationships between drug use "hardness" (defined in increasing order of hardness as no drug use, marijuana use, non-injected heroin or cocaine use, crack smoking and injection drug use) and prevalences of several sexually transmissible infections among young adults in a high-risk neighbourhood. Drug users, particularly injection drug users and crack smokers, may be a core group for some sexually transmitted infections.


METHODS
Cross-sectional survey and assays of young adults from (a) a household probability sample and (b) a targeted sample of youth who have used injected drugs, crack, other cocaine or heroin.


METHODS
Bushwick, an impoverished New York City minority neighbourhood with major drug markets.


METHODS
A total of 363 18-24-year-olds from a household probability sample; 165 Bushwick 18-24-year-olds who have used injected drugs, crack, other cocaine or heroin.


METHODS
Drug use by self-report; serum- and urine-based assays for HIV, hepatitis B and C, syphilis, gonorrhoea, chlamydia and herpes simplex (type 2).


RESULTS
Household-sample prevalences: HIV, hepatitis C and syphilis, 1%; gonorrhoea 3%; chlamydia 5%; past or present hepatitis B infection 8%; herpes simplex (type 2) 18%. In combined household and targeted samples, hepatitis C and HIV were concentrated among drug injectors. Herpes simplex (type 2), syphilis and hepatitis B increased among women with "hardest drug ever used".


CONCLUSIONS
Using "harder" drugs is associated with some but not all of these infections. Prevention efforts should help youth avoid unsafe sex and higher-risk drugs.
Friedman
Samuel R
SR
National Development and Research Institutes, Inc., 71 West 23rd Street, New York, NY 10010, USA. friedman@ndri.org
Flom
Peter L
PL
Kottiri
Benny J
BJ
Zenilman
Jonathan
J
Curtis
Richard
R
Neaigus
Alan
A
Sandoval
Milagros
M
Quinn
Thomas
T
Des Jarlais
Don C
DC
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D017678:Sex Distribution; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*