Men, women and HIV

Injection drug use has been recognized as one of the major routes of HIV transmission. However, in a cohort of injection drug users in Montreal, Julie Bruneau and colleagues determined sex-related differences in risk behaviour could have implications for the development of preventive and clinical interventions.

The authors report that needle-sharing with a person known to be HIV positive (odds ratio [OR] for men 2.44, 95% CI 1.29-7.13) and needle-sharing in the past 6 months (OR for men 0.61, 95% CI 0.44-0.85; OR for women 0.32, 95% CI 0.14-0.73) were independently associated with HIV infection. Among men, sexual orientation, preference for cocaine over heroin, frequency of injection drug use, and obtaining needless at a pharmacy or through a needle exchange program were major risk factors. Among women, other variables were obtaining needles at shooting galleries and failing to participate in a treatment program.

In a related commentary, Patricia Spittal and Martin Schechter tell one woman�s story to illustrate how issues such as physical abuse, commercial sex work, drug use, vulnerability and despair can result in HIV infection.

Sex-specific determinants of HIV
infection among injection drug users in Montreal
� J. Bruneau et al
Injection drug use through the lens of gender
� P.M. Spittal, M.T. Schechter