title: High prevalence of substance use among heterosexuals living in communities with high rates of AIDS and poverty in Washington, DC.
abstract: OBJECTIVE
  To assess the prevalence and patterns of substance use, HIV prevalence, and sexual risk behaviors in a community-based sample of heterosexuals recruited from areas at high risk for HIV/AIDS and poverty in Washington, DC.
  
  
  METHODS
  Community-recruited heterosexuals aged 18-50 from areas of high AIDS and poverty rates in DC were analyzed. Based on past 12 months use, participants were hierarchically classified into five groups: (1) ever injection drug use (IDU); (2) non-injection crack; (3) non-injection heroin and cocaine; (4) marijuana; and (5) no drug use. Sexual behaviors and HIV serology were also assessed.
  
  
  RESULTS
  Of 862 participants, 40% were men, most were Black and unemployed, and more than half had ever been incarcerated. Prevalence of past year substance use was high: binge drinking (59%); marijuana (50%); non-injection crack (28%); heroin and/or cocaine injection (28%), non-injection cocaine (13%); and ecstasy (13%). In the hierarchical classification, 25% were ever IDU, 15% non-injection crack users, 2% non-injection heroin and/or cocaine users, 31% marijuana users, and 27% reported no drug use. Overall HIV seroprevalence was 5.7% and differed by drug use group-9.5%, 11.1%, 1.8%, 1.6%, and 3.2%, respectively. Nearly half reported having ≥3 sex partners in the past year; 20% reported exchange partners, and 69% had concurrent sex partners.
  
  
  CONCLUSIONS
  Estimated prevalence of substance use in this heterosexual population was high. HIV prevalence among IDUs and non-injection crack users was higher than the estimated population prevalence in Washington, DC. Sexual behaviors above and beyond drug use are likely to be driving HIV transmission.
authors.affiliation: The George Washington University, School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC 20037, USA. sphirk@gwumc.edu
authors.forename: Irene
authors.initials: I
authors.lastname: Kuo
authors.forename: Alan E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
authors.forename: Gregory
authors.initials: G
authors.lastname: Phillips
authors.forename: Anthony
authors.initials: A
authors.lastname: Rawls
authors.forename: James
authors.initials: J
authors.lastname: Peterson
authors.forename: Flora
authors.initials: F
authors.lastname: Hamilton
authors.forename: Tiffany
authors.initials: T
authors.lastname: West-Ojo
authors.forename: Shannon
authors.initials: S
authors.lastname: Hader
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology*; D015528:HIV Seroprevalence; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data* / Q000639:trends; D012111:Residence Characteristics; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult