Emerging linkages between substance abuse and HIV infection in St. Croix, US Virgin Islands

H. L. Surratt, J. A. Inciardi, J. C. Weaver, V. M. Falú

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


In the US Virgin Islands 575 cases of AIDS had been reported to the Centers for Disease Control and Prevention through mid-2003. Although males continue to be most affected by HIV/AIDS, the feminization of the epidemic is evidenced by recent data showing rates of infection increasing rapidly among women. This paper focuses on the role of substance abuse and the socially and culturally based gender issues that influence risk and vulnerability to HIV in this setting. 254 chronically drug- or alcohol-involved men and women were recruited and interviewed using targeted sampling strategies. Crack use was overwhelmingly reported by females when compared to males (84.7% vs. 48.8%). Women also reported a significantly higher number of sexual partners in the past month (5.6 vs. 2.3) and significantly more occasions of unprotected vaginal sexual contact (11.2 vs. 6.5). Rates of self-reported HIV infection were elevated among women as well (8.8% vs. 1.4%). Women's precarious economic position and lack of access to legitimate income-generating activities tended to drive them into 'survival sex' to support their subsistence and drug needs. As such, it would appear that substance abuse has an emerging role in the spread of the epidemic in St. Croix, particularly among women.

Original languageEnglish
Pages (from-to)S26-S35
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue numberSUPPL. 1
StatePublished - 2005

Bibliographical note

Funding Information:
Within the context of these remarks, this paper examines the effects of gender on drug use patterns and sexual risk behaviours for HIV in St. Croix, U.S. Virgin Islands, and explores the potential linkage between substance abuse and the spread of HIV in this Caribbean territory. The data were collected from a sample of chronically drug-or alcohol-involved men and women under the auspices of a developmental research grant awarded by the US National Institutes of Health to develop a culturally specific HIV/AIDS prevention programme for substance abusers.

Funding Information:
This research was supported by Grant Number 1 R21 DA15017, from the U.S. National Institute on Drug Abuse.

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health


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