Adults with Prescription-Opioid Dependence Engage in High Rates of HIV Risk Behaviors

Heroin users, particularly those who engage in injection drug use (IDU), are well known to be at increased risk for HIV infection. Less is known about the risk behaviors of those who abuse prescription opioids. Researchers compared data on HIV risk behaviors obtained via interview from persons seeking detoxification treatment for heroin (n=27) or oxycodone (n=23) dependence at an inpatient psychiatric hospital. Demographic characteristics were similar between groups.

• Patients who used oxycodone reported more days of use in the past 30 days than patients who used heroin and were more likely to report marijuana use (13% versus 2%).

• None of the patients using oxycodone engaged in IDU, while 89% of the patients using heroin did.

• Past-month rates of sexual activity (68%), unprotected intercourse (47%), sex while intoxicated (51%), and sex with strangers (18%) were similar between groups; however, patients who used oxycodone were more likely to report having multiple partners (30% versus 4%).

• Patients who used oxycodone were also less likely to report having an HIV test in the past year (33% versus 71%).

Comments:

Although this study looked at a small number of subjects at a single institution, the findings suggest that prescription-opioid–dependent adults engage in risky sexual behaviors at rates comparable to, if not higher than, their heroin-dependent counterparts. It also suggests that more needs to be done to screen these individuals for HIV infection and counsel them regarding their risk.

Darius A. Rastegar, MD

Reference:

Meade CS, McDonald LJ, Weiss RD. HIV risk behavior in opioid dependent adults seeking detoxification treatment: an exploratory comparison of heroin and oxycodone users. Am J Addict. 2009;18(4):289–293.