title: High-risk behaviors in women who use crack: knowledge of HIV serostatus and risk behavior.
abstract: OBJECTIVE
  To determine whether crack cocaine-using women who are aware of their HIV serostatus have made modifications in risk behaviors, we compared known HIV-positive (HIV+) and HIV-negative (HIV-) users with respect to sexual risk behaviors, prevalence of sexually transmitted infections (STIs) and vaginitis, and correlates of unprotected sex.
  
  
  METHODS
  We used a cross-sectional design with street outreach, recruitment, and interviews of sexually active crack cocaine using women. Women received testing for HIV, STIs, and vaginitis.
  
  
  RESULTS
  Sixty-one HIV+ and 117 HIV- women were enrolled. HIV+ women were significantly more likely to be African-American. There were no significant differences in drug use, types of sexual partners, number of paying partners, attitudes regarding condoms, or STI diagnoses. HIV+ women were less likely to engage in unprotected sex compared with HIV- women (56% vs. 75%, adjusted odds ratio [AOR], 0.36; 95% confidence interval [CI], 0.13-0.99). Among HIV+ women, unprotected sex was negatively associated with stronger beliefs regarding the protective value of condoms (AOR, 0.07; 95% CI, 0.01-0.67) and concurrent injection-drug use (AOR, 0.19; 95% CI, 0.04-0.99).
  
  
  CONCLUSIONS
  Although the majority of crack using HIV+ crack using women in this sample continued to engage in high-risk sexual activities, they were less likely to do so than HIV- women. Interventions targeting this population are needed.
authors.affiliation: Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Toye H
authors.initials: TH
authors.lastname: Brewer
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
authors.forename: Amanda
authors.initials: A
authors.lastname: Coltes
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zenilman
mesh_terms: D000328:Adult; D000368:Aged; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D017280:Condoms / Q000706:statistics & numerical data; D016578:Crack Cocaine; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006801:Humans; D008875:Middle Aged; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D016578:Crack Cocaine