title: Latent class analysis of polysubstance use, sexual risk behaviors, and infectious disease among South African drug users.
abstract: BACKGROUND
  HIV transmission risk among non-injection drug users is high due to the co-occurrence of drug use and sexual risk behaviors. The purpose of the current study was to identify patterns of drug use among polysubstance users within a high HIV prevalence population.
  
  
  METHODS
  The study sample included 409 substance users from the Pretoria region of South Africa. Substances used by 20% or more the sample included: cigarettes, alcohol, marijuana and heroin in combination, marijuana and cigarettes in combination, and crack cocaine. Latent class analysis was used to identify patterns of polysubstance use based on types of drugs used. Multivariate logistic regression analyses compared classes on demographics, sexual risk behavior, and disease status.
  
  
  RESULTS
  Four classes of substance use were found: MJ+Cig (40.8%), MJ+Her (30.8%), Crack (24.7%), and Low Use (3.7%). The MJ+Cig class was 6.7 times more likely to use alcohol and 3 times more likely to use drugs before/during sex with steady partners than the Crack class. The MJ+Cig class was 16 times more likely to use alcohol before/during sex with steady partners than the MJ+Her class. The Crack class was 6.1 times more likely to engage in transactional sex and less likely to use drugs before/during steady sex than the MJ+Her class.
  
  
  CONCLUSIONS
  Findings illustrate patterns of drug use among a polysubstance using population that differ in sexual risk behavior. Intervention strategies should address substance use, particularly smoking as a route of administration (ROA), and sexual risk behaviors that best fit this high-risk population.
authors.affiliation: Mercy College, School of Social and Behavioral Sciences, Mahoney Hall, 555 Broadway, Dobbs Ferry, NY 10522, United States. Electronic address: rtrenz@mercy.edu.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Trenz
authors.forename: Michael
authors.initials: M
authors.lastname: Scherer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Duncan
authors.forename: Paul T
authors.initials: PT
authors.lastname: Harrell
authors.forename: Anne Gloria
authors.initials: AG
authors.lastname: Moleko
authors.forename: William W
authors.initials: WW
authors.lastname: Latimer
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology; D013019:South Africa / Q000208:ethnology; D019966:Substance-Related Disorders / Q000145:classification / Q000208:ethnology* / Q000523:psychology; D013997:Time Factors; D047568:Unsafe Sex / Q000145:classification / Q000208:ethnology* / Q000523:psychology; D055815:Young Adult
keywords: HIV population; Infectious disease; Polysubstance use; ROA; Route of administration; Sexual risk behavior; South Africa; Steady sex partners
references.citation: Psychopharmacology (Berl). 2009 Dec;207(2):225-34
references.pmid: 19727676
references.citation: J Subst Use. 2011 Feb;16(1):57-67
references.pmid: 21603063
references.citation: AIDS Behav. 2006 Mar;10(2):131-7
references.pmid: 16482408
references.citation: AIDS Care. 2010 Jan;22(1):62-70
references.pmid: 20390482
references.citation: Prev Med. 1994 Jan;23(1):61-9
references.pmid: 8016035
references.citation: J Urban Health. 2011 Feb;88(1):54-65
references.pmid: 21234695
references.citation: Drug Alcohol Depend. 2012 May 1;122(3):220-7
references.pmid: 22030276
references.citation: Addict Behav. 2009 Oct;34(10):826-9
references.pmid: 19285810
references.citation: Soc Sci Med. 2006 Apr;62(7):1641-9
references.pmid: 16213078
references.citation: Epidemiology. 1993 Jan;4(1):63-72
references.pmid: 8420583
references.citation: J Subst Abuse Treat. 2010 Jun;38(4):366-74
references.pmid: 20362407
references.citation: Drug Alcohol Depend. 2010 Sep 1;111(1-2):173-6
references.pmid: 20547014
references.citation: J Womens Health Gend Based Med. 2000 Dec;9(10):1101-11
references.pmid: 11153106
references.citation: Drug Alcohol Depend. 2011 Sep 1;117(2-3):139-44
references.pmid: 21316871
references.citation: AIDS Patient Care STDS. 2008 Sep;22(9):745-51
references.pmid: 18754704
references.citation: J Acquir Immune Defic Syndr. 2010 Dec;55 Suppl 2:S84-7
references.pmid: 21406993
references.citation: Psychol Methods. 2002 Jun;7(2):147-77
references.pmid: 12090408
references.citation: J Infect Dis. 2001 Aug 1;184(3):359-63
references.pmid: 11443564
references.citation: Sex Transm Dis. 2012 Jan;39(1):1-7
references.pmid: 22183836
references.citation: JAMA. 1996 Apr 10;275(14):1097-103
references.pmid: 8601929
references.citation: Am J Addict. 2005 Jan-Feb;14(1):43-53
references.pmid: 15804876
references.citation: Am J Drug Alcohol Abuse. 1991;17(1):39-48
references.pmid: 2038982
references.citation: Addiction. 2002 Aug;97(8):969-76
references.pmid: 12144599
references.citation: Subst Use Misuse. 2007;42(11):1629-49
references.pmid: 17934988
references.citation: J Urban Health. 2003 Dec;80(4 Suppl 3):iii7-14
references.pmid: 14713667
references.citation: Subst Abuse Treat Prev Policy. 2007 Nov 08;2:33
references.pmid: 17996066
references.citation: Int J Drug Policy. 2008 Apr;19(2):130-9
references.pmid: 18207723
references.citation: Drug Alcohol Depend. 2007 Apr 17;88(1):1-8
references.pmid: 17049753
references.citation: Addict Behav. 2008 Dec;33(12):1630-3
references.pmid: 18790575
references.citation: SAHARA J. 2008 Sep;5(3):113-9
references.pmid: 18979044
references.citation: AIDS Behav. 2009 Oct;13(5):849-59
references.pmid: 18324470
references.citation: AIDS Care. 2009 Jun;21(6):692-700
references.pmid: 19806485
references.citation: Am J Drug Alcohol Abuse. 2007;33(5):687-98
references.pmid: 17891661
references.citation: AIDS Care. 2002 Dec;14(6):801-13
references.pmid: 12511213
references.citation: Stat Med. 2004 May 15;23(9):1455-97
references.pmid: 15116353
references.citation: Drug Alcohol Depend. 2011 Nov 1;118(2-3):237-43
references.pmid: 21530105
references.citation: Subst Use Misuse. 2010 Nov;45(13):2221-43
references.pmid: 21039113
references.citation: Soc Sci Med. 2008 Nov;67(9):1447-55
references.pmid: 18678437
references.citation: Epidemics. 2010 Sep;2(3):155-164
references.pmid: 21352786
references.citation: J Clin Exp Neuropsychol. 2010 Jul;32(6):599-609
references.pmid: 19937505
references.citation: Neuropsychol Rev. 2004 Mar;14(1):1-41
references.pmid: 15260137
references.citation: BMC Public Health. 2010 Nov 05;10:676
references.pmid: 21054855
references.citation: Am J Addict. 2002 Summer;11(3):209-18
references.pmid: 12202013
references.citation: Psychopharmacology (Berl). 2010 Jun;210(3):377-92
references.pmid: 20386885
references.citation: AIDS Behav. 2009 Apr;13(2):288-96
references.pmid: 18850265
references.citation: AIDS. 2008 Jan 30;22(3):415-20
references.pmid: 18195568
references.citation: Subst Use Misuse. 2010 Oct;45(12):1971-87
references.pmid: 20438343
references.citation: AIDS Behav. 2010 Oct;14(5):1045-54
references.pmid: 20499153
references.citation: AIDS. 1991;5 Suppl 1:S197-208
references.pmid: 1669920
references.citation: Sex Transm Dis. 2007 Nov;34(11):856-63
references.pmid: 18049422
references.citation: Soc Sci Med. 2006 Jan;62(1):217-27
references.pmid: 16054281
references.citation: J Acquir Immune Defic Syndr. 2009 May 1;51(1):72-7
references.pmid: 19282783