Unprotected casual sex and perceived risk of contracting HIV among drug users in Baltimore, Maryland: evaluating the influence of non-injection versus injection drug user status.

The purpose of this study was to assess the relative importance and interactive effects of drug use status (i.e. injection or non-injection drug user) and condom use with casual partners in predicting perceived risk of contracting HIV among drug users in Baltimore, Maryland. Baseline data was used from the longitudinal NEURO-HIV Epidemiological Study. This battery of questionnaires assessed a variety of demographic, drug use and sex risk variables. The current study examined these variables in association with perceived risk of contracting HIV. Significant covariates included having at least some college education (AOR=.42, 95%CI=.20, .89), knowing someone who is HIV-positive (AOR = 1.82, 95%CI = 1.15, 2.89), using drugs twice (AOR = 2.02, 95%CI = 1.02, 3.99) or more (AOR = 2.22, 95%CI = 1.22, 4.04) per day and having unprotected casual sex (AOR = 2.51, 95%CI = 1.42, 4.41). These covariates explained 15% of the variance in perceived HIV risk. A significant interaction between type of drug user and having unprotected casual sex revealed that the greatest likelihood of perceived HIV risk associated with unprotected casual sex occurred among non-injection drug users. The results suggest that non-injection drug users are aware of their risk for contracting HIV if they engage in unprotected casual sex. Future HIV-prevention programs should build on this awareness by targeting this subgroup of drug users for condom-use interventions with casual partners. Additional programs should target injection drug users to increase their perceived risk of contracting HIV through unprotected casual sex.