Modulators of "activated motivation": event-specific condom use by drug injectors who have used condoms to prevent HIV / AIDS.

Since sexual transmission of HIV among and from drug injectors is a frequent source of infection, condom use by them is important for prevention. This paper focuses on predictors of condom use at last sex by drug injectors with “activated motivation,” that is, by those who already are trying to use condoms to reduce HIV risk. Principal subjects are 1,240 drug injectors who report activated motivation to use condoms to prevent HIV and who had had sex within 6 months before the interview. Many used condoms at last sexual event with primary partners (65%) and with casual partners (80%). Condom use with primary partners increased over time, and was higher among those who knew they were HIV-positive or who talked about AIDS with sexual partners, but was lower among those who knew they were HIV-negative, who were Black, Hispanic, women, younger, or high school graduates, or who used crack with their partners at the sexual event. Condom use with casual partners was lower among women, older drug injectors, and those who were high on alcohol along with their partners, and tended to be more likely among those who know they are infected. Condom use with both primary and casual partners was greater with partners who did not themselves inject drugs. Programs should urge drug injectors who are trying to use condoms to avoid HIV transmission that having sex while using psychoactive substances may be a barrier to their doing so even if they want to use condoms and have done so in the past. Finally, research should be conducted to determine if persons with activated motivation should receive HIV prevention assistance that is different from that offered those who lack risk-reduction motivation or those who want to reduce their risk behaviors, but have been unable to implement the desired changes.