Wide Range of Factors Contribute to STI, HIV Risk for Women Using Heroin

drugs and drug paraphernalia
drugs and drug paraphernalia
A wide range of factors including sociodemographic factors and male-female power dynamics contribute to sexual risks related to sexually transmitted infections in women using heroin.

For women using heroin and other drugs, a wide range of factors that includes sociodemographic factors and male-female power dynamics contributes to sexual risks related to sexually transmitted infections (STIs), HIV, and other blood-borne viruses, according to results published in AIDS and Behavior.

These results represent important implications for areas of future research and STI preventative strategies.

For this systematic review, the researchers searched PubMed, EMBASE, PsycNET, Web of Science, Scopus, and PsycEXTRA. They screened a total of 12,135 publications and selected 30 peer-reviewed articles with a total of 11,305 participants.

Most of the included publications were cross-sectional (n=25), and most were quantitative (n=23).

The mean age of the participants was 31 years; 25.5% were African American, 22.5% Latinx/Hispanic, 18.6% indigenous Australian, 15.4% white/Caucasian, 11.6% Asian, and 4.9% indigenous (North American), and 1.5% were from nonspecified ethnicities.

Participants reported use of heroin (44.6%), methadone (22.3%), cocaine and/or crack cocaine (21.7%), methamphetamine (16.8%), alcohol (7.6%), speedball (3.2%), cannabis (2.3%), tobacco (1%), liquefied opium/opium (0.2%), inhalants (0.2%), and heroin together with other narcotics (0.2%).

The results of the studies indicated that 6 main outcomes were associated with the risk of contracting STIs, HIV, or other blood-borne viruses: condom use, transactional sex, experiencing sexual violence, sexual activity, type and characteristics of the sexual partner, and drug use with sex partners.

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The researchers then identified factors that were associated with the risk outcomes, which include sociodemographics, gender roles and violence against women, substance use, transactional sex, partner characteristics, partner’s drug use, context of sex, preferences, availability of condoms, HIV status and STIs, number of sexual partners, love and trust, reproductive health and motherhood, and risk awareness and perception of control.

“[This study] has also identified crucial implications for future research that might serve as guidance for the development of health promotion strategies to tackle STIs, HIV and other [blood-borne viruses] among [women using heroin and other drugs],” the researchers wrote.


Medina-Perucha L, Family H, Scott J, et al. Factors associated with sexual risks and risks of STIs, HIV and other blood-borne viruses among women using heroin and other drugs: a systematic literature review [published online August 2, 2018]. AIDS Behav. doi: 10.1007/s10461-018-2238-7