Prevalence of HIV and risky sexual behaviors among rural drug users: does age matter?

Objectives: To determine the seroprevalence of HIV among a representative sample of drug-using adults in a rural area. Also, to determine whether young drug-using adults in a rural area engage in greater levels of sexual risk behavior than their older counterparts. Methods: Cross-sectional study of 503 adult drug users. Rapid tests for antibodies to HIV were used, and self-reported data were collected via computer. Results: None of the participants tested positive for antibodies to HIV. In bivariate tests, only 2 differences were observed between young and older participants. Young males were more likely to engage in unprotected vaginal sex (P = .018) and young females were more likely to engage in unprotected sex with persons injecting drugs (P = .016). In controlled multivariate analyses, age had a modest but significant association with an 8-item index of sexual risk behavior (beta = -0.15) and a reduced 6-item index of risk (beta = -0.18). Conclusion: Despite a fairly dense and interactive sexual network and relatively high-levels of sexual risk behaviors, this rural population has not yet been affected by the HIV epidemic. In the event an outbreak of HIV in this population the observed levels of sexual behavior suggest that rapid sexual transmission could occur among drug-using populations and may include persons of all ages. (C) 2012 Elsevier Inc. All rights reserved.