Inconsistent use of condoms in non-injecting illicit drug users.

Dear Editor,

Non-injecting illicit drug users (NIDU) are a highly vulnerable group for the acquisition of the human immunodeficiency virus (HIV). The majority of these individuals present multiple risk behaviors, such as multiple sexual partners, exchange of sex for money or drugs, and inconsistent use of condoms. In addition, this group consists of individuals with low levels of income and education, which enhances the risk of viral acquisition. Studies have shown high rates of inconsistent use of condoms in NIDU, which increases the risk in this population for the acquisition and transmission of HIV.2, 3 In this context, the objectives of this study were to estimate the prevalence of inconsistent condom use in NIDU and to identify the factors associated with unprotected sex with casual partners.

A cross-sectional study was conducted with 323 NIDU hospitalized in two chemical dependency treatment clinics located in the southwest of Goiás, central west region of Brazil. The study included individuals aged 18 years or over who had used non-injection drugs in the month before the admission date (marijuana, intranasal cocaine, crack, intranasal heroin, inhalants, LSD, and ecstasy). Data collection was carried out between December 2014 and June 2015, through face to face interviews, covering sociodemographic characteristics, drug use pattern, and condom use with casual partners in the previous year.

Inconsistent condom use was defined as irregular use (occasionally or never) by type of sexual intercourse (oral, anal, or vaginal). Univariate analysis was performed to verify the association between the variables and inconsistent use of condoms by sexual practice, using the STATA, version 12.0 program. The study was approved by the Research Ethics Committee of the Federal University of Goiás, authorization No. 926.819/2014. Informed consent was obtained from all participants.

The mean age of the participants was 32.4 years (standard deviation: 11.3) and the majority were male (83.0%). Inconsistent use of condoms in oral, vaginal, and anal sex was reported by 72.2% (95% CI: 66.7–76.7%), 83.5% (95% CI: 79.3–87.4%) and 37.5% (95% CI: 32.3–43.1%) of the participants, respectively. A higher prevalence of inconsistent condom use during vaginal and anal sex was verified in females (Prevalence Ratio: 1.40; 95% CI: 1.16–1.69) and in those with a diagnosis of cannabis dependence (Prevalence Ratio: 1.24; 95% CI: 1.01–1.53).

A high frequency of inconsistent condom use was observed in this study, confirming the vulnerability of NIDU for the acquisition of HIV. In this context, it is necessary to expand health promotion and prevention of sexually transmitted infections in these individuals, with the availability of condoms, encouraging safe sex practices, and health education of this population.

Financial support

This study was supported by Fundação de Amparo à Pesquisa do Estado de Goiás (Brazil), process no. 201200661660420.

Conflicts of interest

The authors declare no conflicts of interest.