Sexually transmitted infections and sexual behaviours of young drug users in Baltimore, Maryland

Introduction. Young drug users are thought to be at high risk for sexually transmitted infections (STIs) however there is little prevalence data on non-bloodborne STIs for such populations. This dissertation has aimed to examine sexual behaviours and the prevalence and correlates of non-ulcerative and ulcerative STIs of young drug users in Baltimore, Maryland.;Methods. Two separate cohorts of drug users aged 18 to 30 years were examined. The prevalence of chlamydia, gonorrhea, trichomonas and bacterial vaginosis (BV) was determined among young injection drug users (IDUs) from the Collaborative Injection Drug User Study III (CIDUS-III) cohort. Baseline serum samples from the Risk Evaluation and Assessment of Community Health III (REACH-III) cohort were tested for serological markers of herpes simplex virus type-2 (HSV-2), syphilis and three sub-types of human papillomavirus (HPV; sub-types 16, 18 and 53). Baseline questionnaires for both cohorts gathered information on socio-demographics, drug use and sexual behaviours. The sexual behaviours were described for both cohorts and correlates of each infection were identified. In addition, the sexual behaviours and seroprevalence of STIs were compared between young IDUs and non-IDUs (NIDUs) of the REACH-III cohort.;Results. These populations demonstrated a high frequency of unprotected sex, number of sex partners, and sex trade involvement. In both cohorts, the prevalence of STIs were moderate to high. The chlamydia, gonorrhea, and trichomonas prevalence data were similar to those of the general population, however the female prevalence of HSV-2, HPV, syphilis and BV were higher. Female sex and black race were strongly associated with STIs throughout this research. NIDUs and IDUs had extremely similar STI seroprevalence and sexual risk profiles. IDUs had a significantly higher number of lifetime sex partners (for females only) and were more likely to have an IDU as a sex partner than NIDUs.;Conclusion. The prevalence of high-risk sexual behaviours and certain STIs were high among young drug users. In order to reduce STI sequelae and HIV transmission, STI education and safe-sex messages should be included in public health programs and interventions aimed at young IDUs and NIDUs.