Sexual Decision Making and Safer Sex Behavior Among Young Female Injection Drug Users and Female Partners of Idus.

A current public health priority is strengthening women’s ability to protect themselves from HIV and other sexually transmitted diseases (STDs) and to negotiate safer sex behaviors with their heterosexual partners. The number of AIDS cases among women has steadily increased (Centers for Disease Control and Prevention [CDC], 1999), and approximately half of all new cases occur in persons under the age of 25, with disproportionate numbers among young women and ethnic minorities (CDC, 2000). Since 1994, heterosexual transmission has been the most common mode of HIV transmission in women (CDC, 1999) and has accounted for 38% of all female AIDS cases reported in 2000 (CDC, 2000). Through December 2000, at least 57% of all accumulated AIDS cases among women were attributed either to their own injection drug use (IDU; 41%) or to sex with an IDU partner (16%), compared with only 24% due to either of these exposures among men (CDC, 2000). Young women who inject drugs may be at even higher risk than males for a number of reasons. Female injection drug users (IDUs) are more likely than males to also have a sex partner who injects (Booth, 1995; Davies, Dominy, Peters, & Richardson, 1996), with needle sharing and sexual risk taking co-occurring (Baker, Kochan, Dixon, Wodak, & Heather, 1994; Booth, 1995). Female IDUs also have higher overall levels of sexual risk taking including having sex with three or more partners, exchanging sex for money or drugs, or having a partner who injects drugs or has sex with males (Sly, Quadagno, Harrison, Eberstein, & Riehman, 1997). Thus, young IDU women or women who have an IDU sex partner are considered to be at potentially high risk for HIV due to both their sexual and their drug-related risk behaviors.

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