title: Differences in HIV risk behaviors among people who inject drugs by gender and sexual orientation, San Francisco, 2012.
abstract: BACKGROUND
  Sharing of drug injection equipment is a well-established risk factor for the transmission of viral infections, such as human immunodeficiency virus (HIV). However, there are multiple mechanisms through which people who inject drugs (PWID) can acquire and transmit HIV. Differences in drug using and sexual behaviors among heterosexual males, males who have sex with males (MSM), and females who inject drugs may explain health disparities.
  
  
  METHODS
  Data were collected in San Francisco by the National HIV Behavioral Surveillance (NHBS) System of PWID in 2012, and were analyzed to compare the sexual behaviors, drug use behaviors, and prevalence of viral infections among heterosexual males, MSM, and females.
  
  
  RESULTS
  Using a weighted analysis for the RDS sampling design, we estimate that 3.7% of heterosexual males who inject drugs, 24.0% of MSM, and 13.0% of females who inject drugs are living with HIV. Females and heterosexual males primarily injected heroin, while MSM primarily injected methamphetamine. MSM were most likely to have received goods or money for sex and have unprotected intercourse.
  
  
  CONCLUSIONS
  These data demonstrate differences in risk behaviors and prevalence of viral infections among heterosexual males, MSM, and females. The results also suggest that public health programs prioritizing the different populations of PWID are necessary.
authors.affiliation: San Francisco Department of Public Health, United States.
authors.forename: Harry
authors.initials: H
authors.lastname: Jin
authors.affiliation: San Francisco Department of Public Health, United States.
authors.forename: Emalie
authors.initials: E
authors.lastname: Huriaux
authors.affiliation: San Francisco Department of Public Health, United States.
authors.forename: Eileen
authors.initials: E
authors.lastname: Loughran
authors.affiliation: San Francisco Department of Public Health, United States.
authors.forename: Tracey
authors.initials: T
authors.lastname: Packer
authors.affiliation: San Francisco Department of Public Health, United States. Electronic address: hfisher.raymond@sfdph.org.
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D020010:Heterosexuality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012727:Sex Characteristics; D012725:Sexual Behavior / Q000523:psychology*; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: Gender; HIV; People who inject drugs; Sexual orientation