Prevalence and correlates of chlamydia trachomatis, neisseria gonorrhoeae, trichomonas vaginalis infections, and bacterial vaginosis among a cohort of young injection drug users in Baltimore, Maryland

Abstract

Objectives: Injection drug users (IDUs) consistently demonstrate high-risk behaviors for sexually transmitted infections (STIs). This study examines STI prevalence and correlates among young IDUs.

Study: This cross-sectional study recruited IDUs aged 18 to 30 years. Participants completed a behavioral risk assessment and were tested for chlamydia, gonorrhea, and trichomoniasis by nucleic acid amplification methods. Women were also tested for bacterial vaginosis (BV). Gender-specific analyses were done comparing infected with noninfected participants using chi-square, Mann-Whitney tests, and logistic regression.

Results: Of the 115 (35.3%) women and 211 (64.7%) men in the study, STI prevalence, respectively, was: chlamydia, 5.3% and 3.3%; gonorrhea, 3.5% and 0%; and trichomoniasis, 8.6% and 1.9%. Most (68.0%) participants had 2 or more sex partners in the past 3 months, of whom fewer than half consistently used condoms. Independent correlates for prevalent STIs included douching (adjusted odds ratio [AOR], 4.9; 95% confidence interval [CI], 1.5-23.6) for women and anal sex with female partners (AOR, 6.3; 95% CI, 1.5-25.8) for men. BV prevalence was 56.3% and was associated with douching (OR, 2.5; 95% CI, 1.1-5.7).

Conclusions: Despite high sexual risk, STI prevalence among young IDUs was similar to that of the general population. BV prevalence was high, suggesting that future STI assessments among female IDUs should include BV.