16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

HIGH RISK SEXUAL AND DRUG USING BEHAVIORS AMONG MALE INJECTION DRUG USERS WHO HAVE SEX WITH MEN IN TWO MEXICO - U. S. BORDER CITIES

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. TuAc0302

R. Deiss¹, K. Brouwer¹, O. Loza¹, R. Ramos², R. Lozada³, M. Firestone¹, T. Patterson⁴, C. Magis-Rodriguez⁵, S. Strathdee^1
1 University of California, San Diego School of Medicine, Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, La Jolla, United States, ² Border Planning and Evaluation Group, El Paso, United States, ³ Patronato COMUSIDA, Tijuana, Mexico, ⁴ University of California, San Diego School of Medicine, Department of Psychiatry, La Jolla, United States, ⁵ Centro Nacional para la Prevencion y Control del VIH/SIDA (CENSIDA), Secretaria de Salud, Mexico City, Mexico

BACKGROUND: The extent to which populations of MSM and injection drug users (IDUs) overlap is understudied. We studied risk behaviors of male MSM-IDUs compared to other male IDUs in two Mexican-U.S border cities.

METHODS: In 2005, IDUs who had injected within one month were recruited using respondent-driven sampling (RDS) in Tijuana and Ciudad Juarez and underwent antibody testing for HIV, HCV and syphilis and interviewer-administered surveys pertaining to behaviors in their lifetime and the prior six months. Men were labeled MSM if they had one or more lifetime male partners. Descriptive statistics were used to compare MSM/IDUs vs. non-MSM/IDUs.

RESULTS: Of 393 male IDUs, 30% [RDS adjustment 28% (95%CI: 21,37)] reported MSM, (47% [RDS adjustment 40% (95%CI 30,54)] in Tijuana versus 13% [RDS adjustment 15% (95%CI: 8, 22)] in Cd. Juarez, Chi-Square p<0.05). Compared to non-MSM/ IDUs, MSM/IDUs were more likely to report shooting galleries as their primary injection location (OR:2.5; 95%CI: 1.6, 3.8), receptive needle sharing (OR:3.5; 95%CI: 1.9, 6.4) and injection of methamphetamine alone (OR:3.1; 95%CI: 2.2, 5.7) or in combination with heroin (OR:3.8; 95%CI: 2.4, 6.1) or cocaine (OR:7.5; 95%CI: 3.4, 16.7), but were less likely to have injected daily or more (OR:0.4; 95%CI: 0.2, 0.6) in the prior six months. In their lifetimes, compared to non-MSM/IDU, MSM/IDU were also more likely to have overdosed (OR:1.6; 95%CI: 1.03, 2.5), received drug abuse treatment (OR:2.4; 95%CI: 1.5, 3.7), been diagnosed with an STD (OR:3.0; 95%CI: 1.3, 7.2), received payment for sex (OR:3.8; 95%CI: 1.7, 8.5), and had a higher number of female sexual partners (mean: 27 vs 18, p<0.05).

CONCLUSIONS: In these Mexican-U.S. border cities, the proportion of male IDUs who reported MSM was high, and these men engaged in behaviors placing them at high risk of acquiring HIV and STDs. Culturally-appropriate interventions targeting MSM/ IDUs in this setting are warranted.

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2006-08-13
TuAc0302

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