Needle Exchange and Sexual Risk Behaviors Among a Cohort of Injection Drug Users in Chicago, Illinois

The researchers undertook the current study to examine the impact of a needle-exchange program (NEP) on the sexual risk behaviors of injecting drug users (IDUs).

Between 1997 and 2000, 889 IDUs in Chicago were recruited into a cohort study from NEPs and from an area with no NEP. At baseline and at three annual follow-up visits, participants were interviewed and tested for HIV. Random-effect logistic models were employed to compare users of the NEP with nonusers with regard to the number of sex partners, the number of unprotected sex acts, and the frequency of condom use.

Over time, NEP users and nonusers had a similar number of sex partners. However, NEP users had 49 percent higher odds of using condoms with main partners (P=0.047). There was no difference at baseline between NEP users and nonusers in episodes of vaginal intercourse. Over time, however, the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26 percent per year for NEP users but only by 10 percent per year for nonusers (P=0.02).

"This study suggests that NEP participation may help reduce the absolute risk of HIV sexual transmission," the authors concluded.

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