title: Stimulant use and sexual risk behaviors for HIV in rural North Carolina.
abstract: BACKGROUND
  While literature exists on sexual risks for HIV among rural populations, the specific role of stimulants in increasing these risks has primarily been studied in the context of a single drug and/or racial group.
  
  
  OBJECTIVE
  This study explores the use of multiple stimulants and sexual risk behaviors among individuals of different races and sexual identities in rural North Carolina.
  
  
  METHODS
  In-depth interviews were conducted with 41 individuals in 3 rural North Carolina counties between June 2004 and December 2005. Interviews were audiotaped, transcribed and reviewed for accuracy. Edited interviews were imported into Atlas.ti and askSam for analysis.
  
  
  RESULTS
  Along with marijuana, stimulants-including powder cocaine, crack, and methamphetamine-were the most frequently used illicit drugs in these counties. Powder cocaine use was more closely associated with white participants, crack with African Americans, and both were more commonly used by female participants. Participants reported 3 overlapping behaviors involving stimulant use that may be associated with increased risk of HIV infection: engaging in sex while using drugs, sex trading and group sex. Nearly half of participants reported engaging in group sex activity.
  
  
  CONCLUSIONS
  HIV risk through injection appears to be low in these rural counties. However, nearly all study participants reported some form of sexual risk behavior that may increase transmission of HIV and other sexually transmitted infections. Further research is warranted focusing on the nexus between substance abuse and risky sexual behaviors.
authors.affiliation: Substance Abuse Treatment, Evaluations and Interventions (SATEI), RTI International, Research Triangle Park, NC 27709-2194, USA. zule@rti.org
authors.forename: William A
authors.initials: WA
authors.lastname: Zule
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Costenbader
authors.forename: Curtis M
authors.initials: CM
authors.lastname: Coomes
authors.forename: William J
authors.initials: WJ
authors.lastname: Meyer
authors.forename: Kara
authors.initials: K
authors.lastname: Riehman
authors.forename: Jon
authors.initials: J
authors.lastname: Poehlman
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000697:Central Nervous System Stimulants; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D012424:Rural Population; D019966:Substance-Related Disorders / Q000453:epidemiology*; D047568:Unsafe Sex
chemical_list: D000697:Central Nervous System Stimulants