Skip to main content

Advertisement

Log in

Binge Use of Crack Cocaine and Sexual Risk Behaviors Among African-American, HIV-Positive Users

AIDS and Behavior Aims and scope Submit manuscript

Abstract

This study describes binge use of crack cocaine, binge users, and their sexual risk behaviors in a sample of 303 African-American, HIV-positive users. Recent binge use was defined as, “using as much crack cocaine as you can, until you run out of crack or are unable to use any more” in the last 30 days. Fifty-one percent reported a recent crack binge. The typical crack binge lasted 3.7 days and involved smoking 40 rocks on average. Nearly two-thirds reported their last binge was in their own or another’s home. Seventy-two percent had sex during the last binge, with an average of 3.1 partners. In multivariable logistic regression analyses, recent bingers were more likely than non-bingers to consider themselves homeless, to have any income source, to have used crack longer, and to score higher on risk-taking and need for help with their drug problem. In multivariable ordinal and logistic regression analyses, recent bingers had more sex partners in the last six months and 30 days and were more likely to have never used a condom in the last 30 days. Among male users, recent bingers were more likely to report lifetime and recent exchange of money for sex and drugs for sex. Among both male and female users, recent bingers were more likely to report lifetime trading of sex for drugs. African-American, HIV-positive binge users of crack cocaine appear to be at increased risk for HIV transmission. Further investigations of binge crack use and sexual risk behaviors and interventions targeting and tailored to this group should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bagasra, O., & Pomerantz, R. (1993). Human immunodeficiency virus type 1 replication in peripheral blood mononuclear cells in the presence of cocaine. The Journal of Infectious Diseases, 168(5), 1157–1164.

    CAS  PubMed  Google Scholar 

  • Booth, C. L., & Gerretti, A. M. (2007). Prevalence and determinants of transmitted antiretroviral drug resistance in HIV-1 infection. The Journal of Antimicrobial Chemotherapy, 59(6), 1047–1056. doi:10.1093/jac/dkm082.

    Article  CAS  PubMed  Google Scholar 

  • Campsmith, M. L., Nakashima, A. K., & Jones, J. L. (2000). Association between crack cocaine use and high-risk sexual behaviors after HIV diagnosis. Journal of Acquired Immune Deficiency Syndromes, 25(2), 192–198. doi:10.1097/00126334-200010010-00015.

    Article  CAS  PubMed  Google Scholar 

  • Cottler, L. B., Leukefeld, C., Hoffman, J., Desmond, D., Wechsberg, W., Inciardi, J. A., et al. (1998). Effectiveness of HIV risk reduction initiatives among out-of-treatment non-injection drug users. Journal of Psychoactive Drugs, 30(3), 279–290.

    CAS  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention Research. (2007a). HIV/AIDS Surveillance Report, 2005 (Vol. 17, pp. 1–46). Atlanta, GA: US Department of Health and Human Services, CDC.

  • Centers for Disease Control and Prevention Research. (2007b). Update to racial/ethnic disparities in diagnoses of HIV/AIDS–33 states, 2001–2005. Morbidity and Mortality Weekly Report, 56(9), 189–193.

    Google Scholar 

  • Cunningham, C. O., Sohler, N. L., Berg, K. M., Shapiro, S., & Heller, D. (2006). Types of substance use and access to HIV-related healthcare. AIDS Patient Care and STDs, 20(6), 399–407. doi:10.1089/apc.2006.20.399.

    Article  PubMed  Google Scholar 

  • Daniulaityte, R., Carlson, R. G., & Siegal, H. A. (2007). “Heavy users”, “Controlled users”, and “Quitters”: Understanding patterns of crack use among women in a mid-western city. Substance Use and Misuse, 42(1), 129–152. doi:10.1080/10826080601174678.

    Article  PubMed  Google Scholar 

  • Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75(1), 3–17.

    Article  CAS  PubMed  Google Scholar 

  • German, D., & Sterk, C. E. (2002). Looking beyond stereotypes: Exploring variations among crack smokers. Journal of Psychoactive Drugs, 34(4), 383–392.

    PubMed  Google Scholar 

  • Harzke, A. J., Williams, M. L., Nilsson-Schonnesson, L., Ross, M. W., Timpson, S., & Keel, K. B. (2004). Psychosocial factors associated with adherence to antiretroviral medications in a sample of HIV-positive African American drug users. AIDS Care, 16(4), 458–470. doi:10.1080/09540120410001683394.

    Article  CAS  PubMed  Google Scholar 

  • Hinkin, C. H., Barclay, T. R., Castellon, S. A., Levine, A. J., Durvasula, R. S., Marion, S. D., et al. (2007). Drug use and medication adherence among HIV-1 infected individuals. AIDS and Behavior, 11(2), 185–194. doi:10.1007/s10461-006-9152-0.

    Article  PubMed  Google Scholar 

  • Hershberger, S. L., Wood, M. M., & Fisher, D. G. (2003). A cognitive-behavioral intervention to reduce HIV risk behaviors in crack and injection drug users. AIDS and Behavior, 7(3), 229–243. doi:10.1023/A:1025487501743.

    Article  PubMed  Google Scholar 

  • Hoffman, J. A., Klein, H., Eber, M., & Crosby, H. (2000). Frequency and intensity of crack use as predictors of women’s involvement in HIV-related sexual risk behaviors. Drug and Alcohol Dependence, 58(3), 227–236. doi:10.1016/S0376-8716(99)00095-2.

    Article  CAS  PubMed  Google Scholar 

  • Inciardi, J., Lockwood, D., & Pottieger, A. (1993). Women and crack-cocaine. New York: Macmillan Publishing Company.

    Google Scholar 

  • Kalichman, S. C. (2000). HIV transmission risk behaviors of men and women living HIV-AIDS: Prevalence, predictors, and emerging clinical interventions. Clinical Psychology: Science and Practice, 7(1), 32–47. doi:10.1093/clipsy/7.1.32.

    Article  Google Scholar 

  • Kang, S. Y., Goldstein, M. F., & Deren, S. (2006). Health care utilization and risk behaviors among HIV-positive minority drug users. Journal of Health Care for the Poor and Underserved, 17(2), 265–275. doi:10.1353/hpu.2006.0063.

    Article  PubMed  Google Scholar 

  • Knight, K., Holcom, M., & Simpson, D. (1994). TCU psychosocial functioning and motivation scales: Manual on psychometric properties. Fort Worth, TX: Texas Christian University, Institute of Behavioral Research.

    Google Scholar 

  • McCoy, C., & Inciardi, J. (1995). Sex, drugs, and the continuing spread of AIDS. Los Angeles, CA: Roxbury Publishing Company.

    Google Scholar 

  • McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol involved gay and bisexual men. Journal of Substance Abuse, 13(1–2), 137–154. doi:10.1016/S0899-3289(01)00063-3.

    Article  CAS  PubMed  Google Scholar 

  • Miller, C. L., Kerr, T., Frankish, J. C., Spittal, P. M., Li, K., Schechter, M. T., et al. (2006). Binge drug use independently predicts seroconversion among injection drug users: Implications for public health strategies. Substance Use and Misuse, 41(6–7), 841–843. doi:10.1080/10826080600669595.

    Google Scholar 

  • Moore, J., Hamburger, M. E., Vlahov, D., Schoenbaum, E. E., Schuman, P., & Mayer, K. (2001). Longitudinal study of condom use patterns among women with or at risk for HIV. AIDS and Behavior, 5(3), 263–273. doi:10.1023/A:1011344727416.

    Article  Google Scholar 

  • Moss, A. R., Hahn, J. A., Perry, S., Charlebois, E. D., Guzman, D., Clark, R. A., et al. (2004). Adherence to highly active antiretroviral therapy in the homeless population and in San Francisco: A prospective study. Clinical Infectious Diseases, 39(8), 1190–1198. doi:10.1086/424008.

    Article  PubMed  Google Scholar 

  • Ostrow, D. G. (2000). The role of drugs in the sexual lives of men who have sex with men: Continuing barriers to researching this question. AIDS and Behavior, 4(2), 205–219. doi:10.1023/A:1009520809581.

    Article  Google Scholar 

  • Needle, R., Fisher, D. G., Weatherby, N., Chitwood, D., Brown, B., Cesari, H., et al. (1995). The reliability of self-reported HIV risk behaviors of drug users. Psychology of Addictive Behaviors, 9(4), 242–250. doi:10.1037/0893-164X.9.4.242.

    Article  Google Scholar 

  • Roth, M. D., Tashkin, D. P., Choi, R., Jamieson, B. D., Zack, J. A., & Baldwin, G. C. (2002). Cocaine enhances human immunodeficiency virus replication in a model of severe combined immunodeficient mice implanted with human peripheral leukocytes. The Journal of Infectious Diseases, 185(5), 701–705. doi:10.1086/339012.

    Article  CAS  PubMed  Google Scholar 

  • Rotheram-Borus, M. J., Gwadz, M., Fernandez, M. I., & Srinivasan, S. (1998). Timing of HIV interventions on reductions in sexual risk among adolescents. American Journal of Community Psychology, 26(1), 73–96. doi:10.1023/A:1021834224454.

    Article  CAS  PubMed  Google Scholar 

  • Schiltz, M. A., & Sandfort, T. G. M. (2000). HIV-positive people, risk, and sexual behavior. Social Science and Medicine, 50(11), 1571–1588. doi:10.1016/S0277-9536(99)00466-9.

    Article  CAS  PubMed  Google Scholar 

  • Seage, G. R., Mayer, K. H., Wold, C., Lenderking, W. R., Goldstein, R., Cai, B., et al. (1998). The social context of drinking, drug use, and unsafe sex in the Boston Young Men Study. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 17(4), 368–375.

    PubMed  Google Scholar 

  • Simpson, D. D., Camacho, L. M., Vogtsberger, K. N., Williams, M. L., Stephens, R. C., Adelbert, J., et al. (1994). Reducing AIDS risks through community outreach for drug injectors. Psychology of Addictive Behaviors, 8(2), 86–101. doi:10.1037/0893-164X.8.2.86.

    Article  Google Scholar 

  • Simpson, D. D., Knight, K., & Ray, S. (1993). Psychosocial correlates of AIDS-risk drug use and sexual behaviors. AIDS Education and Prevention, 5(2), 121–130.

    CAS  PubMed  Google Scholar 

  • Sobel, L. C., & Sobel, M. B. (1992). Timeline follow-back a technique for assessing self-reported alcohol consumption. In R. Litten & J. Allen (Eds.), Measuring alcohol consumption. Totawa, NH: Humana Press.

    Google Scholar 

  • Sterk, C. E., Theall, K. P., & Elifson, K. W. (2003). Effectiveness of a risk reduction intervention among African American women who use crack cocaine. AIDS Education and Prevention, 15(1), 15–32. doi:10.1521/aeap.15.1.15.23843.

    Article  PubMed  Google Scholar 

  • Timpson, S. C., Williams, M. L., Bowen, A. M., & Keel, K. B. (2003). Condom use behaviors in HIV-infected African American crack cocaine users. Substance Abuse, 24(4), 211–220. doi:10.1023/A:1026043529583.

    Article  PubMed  Google Scholar 

  • Weatherby, N., Needle, R., Cesari, H., Booth, R., McCoy, C. B., Watters, J. K., et al. (1994). Validity of self-reported drug use among injection drug users and crack cocaine users recruited through street outreach. Evaluation and Program Planning, 17(4), 347–355. doi:10.1016/0149-7189(94)90035-3.

    Article  Google Scholar 

  • Weinhardt, L. S., Care, M. P., Johnson, B. T., & Bickman, N. L. (1999). Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985–1997. American Journal of Public Health, 89(9), 1397–1405.

    Article  CAS  PubMed  Google Scholar 

  • Weschberg, W. M., Lam, W. K., Zule, W. A., & Bobashev, G. (2004). Efficacy of a woman-focused intervention to reduce HIV risk and increase self-sufficiency among African American crack abusers. American Journal of Public Health, 94(7), 1165–1173.

    Article  Google Scholar 

  • Williams, T. (1992). Crack house: Notes from the end of the line. Reading, MA: Addison-Wesley Publishing Company, Inc.

    Google Scholar 

  • Williams, M. L., Freeman, R. C., Bowen, A. M., Zhao, Z., Elwood, W. N., Gordon, C., et al. (2000). A comparison of the reliability of self-reported drug use and sexual behaviors using computer assisted versus face-to-face interviewing. AIDS Education and Prevention, 12(3), 199–213.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported from a grant from the National Institute for Drug Abuse (R01, DAO14485) awarded to Dr. Williams.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amy Jo Harzke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harzke, A.J., Williams, M.L. & Bowen, A.M. Binge Use of Crack Cocaine and Sexual Risk Behaviors Among African-American, HIV-Positive Users. AIDS Behav 13, 1106–1118 (2009). https://doi.org/10.1007/s10461-008-9450-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-008-9450-9

Keywords

Navigation