Needle Exchange and Sexual Risk Behaviors Among a Cohort of Injection Drug Users in Chicago, Illinois

Objective: To examine the impact of a needle exchange program (NEP) on sexual risk behaviors of injecting drug users (IDUs). Methods: Between 1997 and 2000. 889 IDUs in Chicago were recruited from NEPs and an area with no NEP into a cohort study. They, were interviewed and tested for HIV at baseline and 3 annual follow-up visits. Random-effect logistic models were used to compare NEP users and nonusers regarding the number of sex partners, number of unprotected sex acts. and frequency, of condom use. Results: Compared to NEP nonusers, NEP users had a similar number of sex partners over time, but had 49% higher odds of using condoms with their main partners (P = 0.047). At baseline, there was no difference between NEP users and nonusers in episodes of vaginal intercourse. but over time the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26% per year for NEP users but only 10% per year for nonusers (P = 0.02). Conclusion: This study. suggests that NEP participation may help, reduce the absolute risk of HIV sexual transmission.