Gender differences in drug use and sexual risk behaviors among noninjecting heroin users in Puerto Rico

Irmaly Sosa-Zapata, Héctor M. Colón, Rafaela R. Robles, Myrna Cabassa


Introduction: During the 1990s non-injected heroin use (NIHU) increased notably in several countries. However, very few studies have examined the drug-using practices and other problem behaviors of NIHUs. In this study, we compared male and female NIHUs from Puerto Rico across a number of domains. Methods: Recruitment proceeded through visits to drug-copping areas and the local hangouts in their vicinity. Subjects were eligible if they were 18 to 25 years old, had never injected any drugs, and had recently used heroin or cocaine. Study participants were administered a computer-assisted personal interview. Results: Of the 412 NIHUs recruited at the time of this study, 74 (18.0%) were females. Female NIHUs were more likely to report sexual assaults and more likely to manifest severe symptomatology of post-traumatic stress disorder than male NIHUs (35.1% vs. 3.6%, p < .01, and 40.5% vs. 25.7%, p=.01, respectively). Females were less likely to report a source of emotional support than males (86.5% vs. 95.3%, p < .01). Close to one in four of the females (23.0%) reported a history of sexually transmitted infections, compared to three percent of the males (p < .01). HIV seroprevalence among females was 4.3% compared to 0.6% among males (p=.01). Discussion: Female heroin users seem to present a host of different needs compared to male heroin users. Given the scarcity of existing programs for female drug users in Puerto Rico, designing supportive systems that effectively address the specific needs of drug-using women should become a high-priority public health issue.

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