Factors associated with positive HIV serostatus among women who use drugs: continued evidence for expanding factors of influence.
OBJECTIVE
To identify risk factors associated with positive HIV serostatus among African American women who smoke crack and/or inject drugs and who are not enrolled in drug treatment or another institutional setting.


METHODS
Baseline interviews were conducted from June 1998 to June 2000 with 379 heterosexually active women (ages 18 to 59) who had been recruited for potential enrollment into an HIV intervention trial.


RESULTS
Adjusted for age and drug using status, women who expressed more difficulty saying no to sex with male partners were more likely to be HIV-positive (adjusted odds ratio [aOR]=3.08, 95% confidence interval [CI] 2.02, 4.83). Similarly, those who indicated greater communication with casual sex partner(s) were less likely to test positive (aOR=0.29, 95% CI 0.10, 0.89). Lower HIV internal control and a history of cuts or burns on lips due to crack smoking were also associated with positive serostatus, and were important confounders in the final multivariate model. A higher level of internal control was associated with a decreased likelihood of positive serostatus, while a history of cuts or burns on the lips was associated with an increased likelihood of HIV antibodies, even after controlling for the amount of oral sex.


CONCLUSIONS
A broad array of factors may promote or avert infection with HIV. The degree to which personal attributes and beliefs, and relationship characteristics contribute to the likelihood of infection must continue to be addressed. The importance of oral sex and presence of oral sores and their potential role in transmission was suggested.
Theall
Katherine P
KP
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
Sterk
Claire E
CE
Elifson
Kirk W
KW
Kidder
Daniel
D
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D016578:Crack Cocaine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005845:Georgia / Q000453:epidemiology; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000208:ethnology* / Q000523:psychology / Q000635:transmission; D006801:Humans; D007389:Internal-External Control; D007407:Interviews as Topic; D008046:Lip / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000145:classification / Q000208:ethnology*; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000208:ethnology / Q000523:psychology
D016578:Crack Cocaine