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Risk behaviors for HIV in sexual partnerships of San Francisco injection drug users

机译：旧金山注射吸毒者性伴侣中艾滋病毒的危险行为

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While injection drug users (IDU) in the USA are known to form sexual partnerships with IDU as well as non-IDU, scientific research is lacking regarding risk behaviors for HIV transmission within these partnerships. Such information could aid HIV-prevention efforts among IDU and could also explain the relatively low prevalence of HIV among non-IDU heterosexuals in US cities such as San Francisco. Using data from a cross-sectional sample of San Francisco IDU we estimated (1) the prevalence of IDU-IDU and IDU-non-IDU sexual partnerships, (2) the frequency of serodiscordant unprotected intercourse in IDU-IDU and IDU-non-IDU sexual partnerships, and (3) the frequency of concurrence of sexual risk and injection-related risk within IDU-IDU sexual partnerships. An estimated 68% of sexually active San Francisco IDU is in IDU-IDU partnerships. Our analysis suggests that compared to IDU-non-IDU partnerships, IDU-IDU partnerships include a greater rate of episodes of serodiscordant unprotected intercourse (incidence rate ratio: 10.2; 95% confidence interval: 2.1-50.7). In fact, our data suggest that 92% of serodiscordant sexual episodes involving IDU are attributable to IDU-IDU pairings. Unprotected intercourse and needle sharing occur concurrently in an estimated 29% of IDU-IDU partnerships. Our data suggest that HIV-transmission risk is higher within IDU-IDU partnerships than it is within IDU-non-IDU partnerships. This disparity could explain the relatively low prevalence of HIV among non-IDU heterosexuals in San Francisco. We recommend that HIV-prevention efforts among IDU continue to address sexual risk behaviors for HIV transmission in addition to injection-related risk behaviors, with emphasis on IDU-IDU partnerships.
机译：尽管众所周知，美国的注射吸毒者（IDU）与IDU和非IDU建立了性伙伴关系，但在这些伙伴关系中缺乏有关HIV传播风险行为的科学研究。这些信息可以帮助IDU中的HIV预防工作，也可以解释旧金山等美国城市中非IDU异性恋者中HIV的患病率较低。根据旧金山IDU横断面样本的数据，我们估算了（1）IDU-IDU和IDU-非IDU性伴侣的患病率，（2）在IDU-IDU和IDU-non- IDU性伙伴关系，以及（3）IDU-IDU性伙伴关系中性风险和注射相关风险并发的频率。旧金山有约68％从事性活动的IDU与IDU-IDU合作。我们的分析表明，与IDU-非IDU伙伴关系相比，IDU-IDU伙伴关系包括血清环素类无保护性交事件的发生率更高（发生率比：10.2; 95％置信区间：2.1-50.7）。实际上，我们的数据表明涉及IDU的血清恶性性病的92％可归因于IDU-IDU配对。大约29％的IDU-IDU合作伙伴同时进行无保护的性交和共用针头。我们的数据表明，IDU-IDU伙伴关系中的HIV传播风险高于IDU-非IDU伙伴关系中的HIV传播风险。这种差异可以解释旧金山非注射吸毒者异性恋者中艾滋病毒相对较低的流行。我们建议IDU之间的艾滋病毒预防工作，除了注射相关的危险行为，应继续解决艾滋病毒传播的性危险行为，重点是IDU-IDU的伙伴关系。

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