Receptive Syringe Sharing Behaviors and High-Risk Sexual Behaviors in Dual Risk Relationship among Persons Who Inject Drugs in 20 Cities in the United States, 2015 Open Access

Abstract

Background: Persons who inject drugs (PWID) engaging in both high-risk injecting behaviors and high-risk sexual behaviors with the same partner (“dual risk relationship”) may face a higher risk of infection with HIV. Current research efforts mostly focus on estimating the risk for HIV infection among PWID who engage in high-risk injection and/or sexual behaviors with different partners in the past 12 months (1). The risk of infection with HIV among PWID and their partners engaging in dual risk relationship has not been fully understood. 

Objective: Investigate the characteristics of last sharing injecting partners and assess the association between dual risk relationship with both high risk injecting and sexual behaviors. 

Methods: PWID aged ≥ 18 years in 20 US cities were recruited by using respondent-driving sampling in the National HIV Behavioral Surveillance in 2015. Descriptive analyses were conducted to investigate last sharing injecting partner’s characteristic and bivariate analyses were conducted to examine the associations between demographic, behavioral, and last sharing injecting partner variables and status as dual risk relationship. 

Results: Condomless sex at last sex, number of sex partners in the past 12 months, and number of injecting partners at last sharing event showed significant associations with dual risk relationship. PWID who had condomless sex at last sex were more likely to report engaging in dual risk relationship (aPR = 2.39, 95% CI 2.06 – 2.77). PWID with more sex partners in the past 12 months (aPR = 0.72, 95% CI 0.66 – 0.78) or more injecting partners at the last sharing event (aPR = 0.73, 95% CI 0.67 – 0.80) were less likely to reported having dual risk relationship. Last sharing partner who were female, white, and young age (18-29 yrs) were more likely to report engaging in dual risk relationship. 

Conclusion: Condomless sex at last sex is positively associated with dual risk relationship. Number of sex partners in the past 12 months and number of injecting partners at last sharing event are negatively associated with dual risk relationship. Prevention strategies should be designed to target PWID engaging in dual risk relationship.

Table of Contents

Introduction 1 - 2 

Methods 3 - 6 

Results 7 - 10 

Discussion 11 - 14 

Limitations 15 

Conclusion 16 

Tables 17 - 22 

References 23 - 25 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Receptive Syringe Sharing Last Sharing Partner High-Risk Sexual and Injecting Behaviors
Committee Chair / Thesis Advisor	Patrick Sullivan, Emory University
Committee Members	Senad Handanagic, Centers for Disease Control and Prevention

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