• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
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Epi Profile Section 10 - Sex and Substance Use in People at Increased Risk for HIV in Dallas, Texas


The National HIV Behavioral Surveillance Survey (NHBS) project conducts interviews in Dallas with MSM, PWID, and heterosexually active people who are not living with HIV. The data collection is completed in rotating, annual cycles of the three groups. Since the interviews are conducted in Dallas, the results may not reflect other areas of the state. 



MSM


In 2017, 427 MSM who were not living with HIV were interviewed (Table 25). Of this group, 72% had condomless anal sex with a male partner, 54% used injection or non-injection drugs, and 12% had condomless anal sex with a male partner whose HIV status was unknown within the past 12 months. Only 2% reported having condomless anal sex with a partner living with HIV in the past 12 months.  Seven percent reported having syphilis in the past 12 months.

In Texas, young Black MSM experience the highest rates of new HIV diagnoses (see Section 4: New Diagnoses in MSM). However, NHBS data indicates that White MSM and Hispanic MSM in Dallas are more likely to report having condomless anal sex: 80% of White MSM and 70% of Hispanic MSM had condomless anal sex compared to 66% of Black MSM. Furthermore, 5% of White MSM had condomless anal sex with a partner living with HIV compared to 0% of Black MSM and 1% of Hispanic MSM.

In general, risk behavior among MSM decreased with age. A lower proportion of respondents 45 years of age or older had condomless anal sex (56%), had condomless anal sex with a male partner whose HIV status was unknown (16%), or had condomless anal sex with a partner living with HIV (0%) compared to those in the younger age groups.



PWID


Interviews with people who inject drugs (PWID) in Dallas were conducted in 2015 (Table 26). Over 70% of PWID recruited for this survey were over the age of 45 and 77% were Black.

Respondents reported that in the last 12 months they had shared needles (28%) or other injection equipment (54%), exchanged money or drugs for sex (19%), or had condomless sex (67%).

White PWID more frequently reported sharing needles compared to Hispanic (45%) and Black participants (21%). In addition, 65% of Hispanic participants shared drug paraphernalia compared to 59% of White and 52% of Black participants. Slightly more Black participants (20%) exchanged money or drugs for sex compared to all other race/ethnic groups (15% for each).

In general, risk behavior among PWID decreased with age. A lower proportion of respondents 45 years of age or older shared needles (23%) or drug paraphernalia (53%) compared to their 18 to 24-year-old counterparts (50% and 67%). Fewer older respondents exchanged money or drugs for sex (19%) compared to those 18 to 24-years-old (33%). Finally, fewer older respondents had condomless sex (60%) compared to those 18 to 24-years-old (92%).



Persons who Acquired HIV through Heterosexual Contact


Ninety-one percent of heterosexual study participants in Dallas reported having condomless sex with a partner of the opposite sex. Twenty-two percent exchanged money or drugs for sex in the past 12 months. Only 1% reported having condomless sex with a person living with HIV within the last 12 months.

Age appears unrelated to patterns in condomless sex, as it was reported by 93% of those 18-24 years of age and by 91% of those 45 years of age or older. Furthermore, older respondents were more likely to report exchanging sex for money or drugs. More information on this wave of the project can be found in Table 27.

Table 25: Sex and drug use in Dallas MSM who are not living with HIV, 2017 (weighted)

MSM

Average number of male sex partners in past 12 months

Had condomless anal sex with a male partner in the past 12 months

Had condomless anal sex with last male partner whose HIV status was unknown

Had condomless anal sex with last partner living with HIV

Used injection or non-injection drugs in the past 12 months

Self-reported syphilis infection in the past 12 months

Number

Number

Number

%

Number

%

Number

%

Number

%

Number

%

Race/Ethnicity

White

137

13

109

80%

15

11%

7

5%

79

58%

11

8%

Black

68

6

45

66%

8

12%

0

0%

31

46%

5

7%

Hispanic

192

11

134

70%

27

14%

2

1%

102

53%

14

7%

Other

29

14

20

69%

3

10%

0

0%

17

59%

1

3%

Total*

427

11

308

72%

53

12%

9

2%

230

54%

31

7%

Age group (years)

18-24

100

9

70

70%

13

13%

1

1%

58

58%

8

8%

25-34

196

9

152

78%

18

9%

7

4%

112

57%

17

9%

35-44

63

9

48

76%

11

17%

1

2%

28

44%

3

5%

45+

68

22

38

56%

11

16%

0

0%

32

47%

3

4%

Total

427

11

308

72%

53

12%

9

2%

230

54%

31

7%

* One participant whose race/ethnicity was missing was included in the total.


Table 26: Sex and drug use in Dallas PWID who were not living with HIV, 2015 (unweighted)

People who Inject Drugs

Shared needle in past 12 months

Sharing of drug paraphernalia in past 12 months

Exchanged money or drugs for sex in past 12 months

Average number of sex partners in the past 12 months*

Had condomless sex in the past 12 months

Number

Number

%

Number

%

Number

%

Number

Number

%

Race/Ethnicity

 

White

86

46

53%

51

59%

13

15%

4

66

77%

Black

390

81

21%

203

52%

79

20%

3

253

65%

Hispanic

20

9

45%

13

65%

3

15%

3

16

80%

Other

13

6

46%

8

62%

2

15%

3

7

54%

Total

509

142

28%

275

54%

97

19%

3

342

67%

Age group (years)

 

18-24

12

6

50%

8

67%

4

33%

6

11

92%

25-34

60

27

45%

32

53%

8

13%

5

54

90%

35-44

71

24

34%

40

56%

14

20%

7

56

79%

45+

366

85

23%

195

53%

71

19%

2

221

60%

Total

509

142

28%

275

54%

97

19%

3

342

67%

* This analysis excluded female PWID who reported sex exclusively with other females.


Table 27: Sexual behavior in Dallas HIV-negative people at an increased risk for HIV because of their heterosexual status, Dallas, 2016 (unweighted)

Persons Who Engage in Heterosexual Contact

Average number of sex partners of the opposite sex in the past 12 months

Had condomless sex with a partner of the opposite sex in the past 12 months*

Exchanged money or drugs for sex in past 12 months

Had condomless sex with an HIV-positive partner in the past 12 months*

Number

Number

Number

%

Number

%

Number

%

Race/Ethnicity

White

9

5

9

100%

2

22%

0

0%

Black

364

5

331

91%

86

24%

6

2%

Hispanic

34

2

32

94%

2

6%

0

0%

Other

20

7

17

85%

4

20%

0

0%

Total

427

5

389

91%

94

22%

6

1%

Age group (years)

18-24

73

4

68

93%

7

10%

1

1%

25-34

123

6

111

90%

29

24%

0

0%

35-44

89

6

81

91%

22

25%

3

3%

45+

142

5

129

91%

36

25%

2

1%

Total

427

5

389

91%

94

22%

6

1%

* This item is referring to condomless sex with either a main or casual partner.



Epi Profile

Table of Contents | 1. Executive Summary | 2. Texans Living with HIV in 2018 | 3. Texans with New HIV Diagnoses | 4. New Diagnoses in MSM | 5. Texans with Newly Acquired HIV | 6. Deaths in Texans Living with HIV | 7. Comorbidities in Texans Living with HIV | 8. HIV Testing in Programs Funded by DSHS | 9. Sex and Substance Use in PLWH | 10. Sex and Substance Use in People at Increased Risk for HIV in Dallas, Texas | 11. Texas Treatment Cascade for 2018 | Data Sources and Notes


Last updated June 18, 2020