Open Access Open Badges Research article

HIV risk behaviors among female IDUs in developing and transitional countries

Charles M Cleland1*, Don C Des Jarlais12*, Theresa E Perlis12*, Gerry Stimson3, Vladimir Poznyak4 and the WHO Phase II Drug Injection Collaborative Study Group5

Author Affiliations

1 Center for Drug Use and HIV Research, National Development and Research Institutes Inc. 71 West 23rd Street, New York, NY 10010, USA

2 Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 160 Water Street, 24th Floor, New York, NY 10038, USA

3 International Harm Reduction Association; The Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, UK

4 Department of Mental Health and Substance Dependence, World Health Organization, Geneva, Switzerland

5 Professor Moruf Adelekan and Dr Rahim Lawal, University of Ilorin Teaching Hospital, Ilorin – Kwara State, Nigeria; Dr Francisco Inacio Bastos, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Dr Nguyen Tran Hien and Dr Dao Thi Minh An, Hanoi Medical University, Hanoi, Viet Nam; Dr Sylvia Inchaurraga, Universidad Nacional de Rosario, Rosario, Argentina; Dr Don Des Jarlais and Dr Theresa Perlis, National Development and Research Institutes, Inc., New York, USA; Dr Maristela Monteiro, World Health Organization, Geneva, Switzerland; Prof. V. Navaratnam and B. Vicknasingam, Centre for Drug Research, University Sains Malaysia, Malaysia; Dr Augusto Perez Gomez and Dr Ines Elvira Mejia, Programa RUMBOS, Bogotá, Colombia; Dr Fabio Mesquita, Faculdade de Medicina da USP, Santos, Brazil; Dr Sergey Molochko, Minsk City Narcological Dispensary, Minsk, Belarus; Dr Maurice Odek-Ogunde, United States International University, Nairobi, Kenya; Mr Dimitry Ostrovsky, Foundation Vozvrastcheniye, St. Petersburg, Russia; Dr Vladimir Poznyak, World Health Organization, Geneva, Switzerland; Dr Emran Razzaghi and Dr Afarin Rahimi, Iranian Welfare Organization, Teheran, Iran; Professor Gerry Stimson and Mr Chris Fitch, formerly at Imperial College School of Medicine, London, United Kingdom; Dr Olga Balakireva and Dr Marina Varban, Ukrainian Institute for Social Research, Kiev, Ukraine; Prof. Zunyou Wu and Dr Lorraine Yap, Chinese Academy of Preventive Medicine, Beijing, China

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BMC Public Health 2007, 7:271  doi:10.1186/1471-2458-7-271

Published: 1 October 2007



A number of studies suggest females may be more likely to engage in injection and sex risk behavior than males. Most data on gender differences come from industrialized countries, so data are needed in developing countries to determine how well gender differences generalize to these understudied regions.


Between 1999 and 2003, 2512 male and 672 female current injection drug users (IDUs) were surveyed in ten sites in developing countries around the world (Nairobi, Beijing, Hanoi, Kharkiv, Minsk, St. Petersburg, Bogotá, Gran Rosario, Rio, and Santos). The survey included a variety of questions about demographics, injecting practices and sexual behavior.


Females were more likely to engage in risk behaviors in the context of a sexual relationship with a primary partner while males were more likely to engage in risk behaviors in the context of close friendships and casual sexual relationships. After controlling for injection frequency, and years injecting, these gender differences were fairly consistent across sites.


Gender differences in risk depend on the relational contexts in which risk behaviors occur. The fact that female and male risk behavior often occurs in different relational contexts suggests that different kinds of prevention interventions which are sensitive to these contexts may be necessary.