Providing sex in exchange for money often supports drug use. In sex work, it is often difficult
to negotiate safe sex practices and this is often neglected.
One-third of female drug users interviewed in Osh, Kyrgyzstan, report that they are periodically
or constantly engaged in prostitution to earn their living or to purchase drugs. An estimated
90 per cent of these commercial sex contacts take place without the use of condoms.
In Tashkent, Uzbekistan, more than half of drug users’ sex partners do not use drugs
themselves, but practice unprotected sex with their IDU partners [10].
A study in Brazil among crack users found that 60 per cent of the females worked as
prostitutes to buy drugs. The sex workers did not use condoms to protect themselves or
their customers [7].
While substantial behaviour changes occur in relation to injection drug use after interventions
among IDUs, influencing sexual behaviour is more difficult. The majority of drug injectors are
sexually active, partner change rates are relatively high and there is also a high degree of
sexual mixing between injectors and non-injectors. Condom use is especially uncommon with
regular sexual partners.
Negotiating condom use can be a difficult matter for many girls.
“It’s really a delicate matter; a few [women] do ask. Very few boys don’t need to be asked
before using it . . . but there are many who would get angry and feel you don’t love them
or you don’t trust them.
For some boys, you don’t dare offer them a condom. They will immediately feel you play
around and that you are cheap [18].”
HIV/AIDS (and other STDs)
HIV infection is the most important and the most serious blood borne pathogen acquired by
young injectors. HIV enters the body, attacks, and over time destroys the body’s immune
system. The immunity to diseases and viruses gets considerably weakened. HIV infection
represents the presence of the virus inside the human body. Sometimes, this can go without
any symptoms or signs.
AIDS is the Acquired Immuno Deficiency Syndrome. When AIDS has developed, the body
losses its immunity ability and many symptoms appear (infections and cancer can develop).
The evolution is progressive, and opportunistic infections eventually lead to death, as there
is currently no known cure. However, the increasing availability of Anti Retroviral Therapy
(ART) is providing hope that HIV positive people can hope to lead fairly normal lives.
It is also worth mentioning that other injection related health consequences exist and often
have more immediate effects. Some of these are listed below, however will not be explained in
more detail here.