| Methods. This study examined prevalence and correlates of safer sex by IDUs at the most recent non-commercial heterosexual encounter. 107 Toronto injection drug users not in drug treatment were surveyed using a standardized, face-to-face, anonymous interview.; Results. 35% reported safer sex. Condoms were less likely to be used in closer relationships. Controlling for relationship type, and IDU partner (OR = 0.2), prostitution in the past 6 months (OR = 0.1), and intoxication during sex (OR = 0.2) were negatively associated with condom use; drug use per se was not. Discussing safer sex (OR = 4.0) was positively associated with safer sex. Behaviour at the most recent sexual encounter was highly consistent with behaviour over the previous six months.; Conclusions. There is considerable potential for sexual HIV transmission among/from Toronto IDUs. Female IDUs are at particularly high risk. IDUs often experience day-to-day risks of withdrawal, overdose, criminal activity to procure drug money, legal sanction, and social marginalization. In this context the longer term risks of HIV infection may be perceived as low priority, particularly when risk reduction would involve changing complex, deeply rooted behaviours and may threaten important relationships. HIV prevention efforts must address relationship and drug use factors; qualitative research is also needed to clarify the social meanings and barriers associated with condom use in this population. |
