Sex-specific differences in circumstances of initiation into injecting-drug use among young adult Latinos in Harlem, New York City

Background: Data are limited that examine circumstances of initiation and risk for HIV infection among Latino injecting-drug users (IDUs) in the United States. Methods: Baseline data were obtained from a cohort study of young (aged 18-29 years) IDUs residing in Harlem, New York City, conducted during 1997-1999. Participants were administered standardized face-to-face interviews. Data collected included demographics, age and circumstances surrounding initiation of injecting-drug use, and lifetime and recent risk behaviors. Results: Of the 156 participants who self-identified as Latino, 145 (94%) were Puerto Rican, 112 (72%) were male, and 44 (28%) were female. The median number of years of injecting drug use was 3 for women and 5 for men (Wilcoxon ranks sums test p = .007). Significantly (p < .05) more women than men reported that at the first injection episode, they were injected by a sexual partner (26% versus 4%), were provided the syringe by their sexual partner (24% versus 4%), had sex with the initiator after being injected the first time (23% versus 5%), and were injected by a person ≥5 years older than themselves (50% versus 32%). Women were more likely than men to report having ever had unprotected sex with a person known to be HIV-positive (18% versus 4%, respectively; p = .006); however, women were just as likely as men to report having ever injected drugs with a person known to be HIV-positive (11% versus 10%). Conclusions: Latinas were more likely than their male counterparts to be initiated either directly (being injected) or indirectly (being provided a syringe) into injecting-drug use by their sexual partner. HIV and drug use prevention programs for Latinas in Harlem must address the interrelationship between drug use and sexual relations.