Gender, cocaine and during-treatment HIV risk reduction among injection opioid users in methadone maintenance

HIV risk behavior was examined in relation to gender and cocaine use among a sample of 327 daily opioid users in methadone maintenance treatment. Women and cocaine users tended to be at higher risk than men and non-users prior to treatment entry. Significant reductions in both injection and sex-related risks occurred from intake to months 3 and 6 of treatment; HIV risks were also reduced among the subsample of clients who continued to inject drugs during treatment. The rate of HIV risk reduction was similar for both cocaine and non-cocaine users, but women had lower rates of risk reduction than men in terms of injecting with used equipment and number of sex partners. Measures of risk behavior at month 6 of treatment showed that women used 'dirty works' more often than men, and cocaine users injected more frequently and had more sex partners than non-cocaine users. Study outcomes highlight the need for specialized interventions targeting women and cocaine-using opioid addicts.