title: Role of sexual transmission of HIV among young noninjection and injection opiate users: a respondent-driven sampling study.
abstract: BACKGROUND
  Sexual transmissibility of HIV among young drug users in China has been investigated in few studies. The objective of this study was to examine the role of sexual transmission on HIV infection among injection drug users (IDUs) and noninjection drug users (NIDUs).
  
  
  METHODS
  Respondent-driven sampling (RDS) was used to recruit 426 young heroin/opium drug users in Yunnan, China. Logistic regression modeling was performed to examine interrelationships among risky sexual behaviors, drug-use modes, and drug-use practices.
  
  
  RESULTS
  Substantial proportions of NIDUs and IDUs reported engagement in risky sexual behaviors including: (1) multiple sexual partners (42% of NIDUs vs. 37% of IDUs), (2) concurrent sexual partnerships (48% vs. 46%), (3) commercial sex partners (23% vs. 24%), and sex partners who were NIDUs (14% vs. 17%). Both NIDUs and IDUs reported low levels of condom use with nonregular partners (48% vs. 42%) and regular partner (24% vs. 27%), and having a history of recent methamphetamine use (21% vs. 18%). Compared to IDUs, NIDUs reported having had fewer sex partners who were IDUs, fewer IDU network peers, more NIDU network peers, and having lower levels of HIV knowledge and self-perceived HIV risk.
  
  
  CONCLUSIONS
  Generalization of the HIV epidemic from high-risk groups to the general population may be driven by risky sexual behavior among drug users. Reducing sexual transmission of HIV among both IDUs and NIDUs is the next major challenge for HIV intervention among drug users in China.
authors.affiliation: Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Hongjie
authors.initials: H
authors.lastname: Liu
authors.forename: Jianhua
authors.initials: J
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Luo
authors.forename: Don Des
authors.initials: DD
authors.lastname: Jarlais
authors.forename: Nana
authors.initials: N
authors.lastname: Koram
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000150:complications* / Q000453:epidemiology; D012309:Risk-Taking; D012494:Sampling Studies; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
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