Crack Cocaine Use and Sexual Behavior Among People With AIDS

To the Editor. —Crack cocaine use, because of its association with risky sexual behaviors, 1-3 may play an important role in the acquisition and transmission of human immunodeficiency virus (HIV) infection. 4,5 Because of their addiction, crack users may not discontinue high-risk sexual behaviors, eg, prostitution, even if they are aware of their HIV status. To examine this possibility, we analyzed data collected from interviews of 3927 persons at least 18 years of age reported to health departments with acquired immunodeficiency syndrome (AIDS) or HIV infection between June 1, 1990, and January 31, 1993. This special surveillance project is currently being conducted by the Centers for Disease Control and Prevention in collaboration with 11 state and local health departments. We elicited detailed information on drug use and sexual activities within the past 5 years. Among men, those who used crack but did not inject drugs were more likely to have