Trenz, Rebecca C.Scherer, MichaelDuncan, AlexandraHarrell, PaulMoleko, Anne GloriaLatimer, William W.2014-04-092014-04-092013-10Trenz, RC, Scherer, M, Duncan, A, Harrell, PT, Moleko, AG & Latimer, WW 2013, 'Latent class analysis of polysubstance use, sexual risk behaviors, and infectious disease among South African drug users', Drug and Alcohol Dependence, vol. 132, no. 3, pp. 441-448.0376-8716 (print)1879-0046 (online)10.1016/j.drugalcdep.2013.03.004http://hdl.handle.net/2263/39626BACKGROUND : HIV transmission risk among non-injection drug users is high due to the co-occurrence of drug use and sexual risk behaviors. The purpose of the current study was to identify patterns of drug use among polysubstance users within a high HIV prevalence population. METHODS : The study sample included 409 substance users from the Pretoria region of South Africa. Substances used by 20% or more the sample included: cigarettes, alcohol, marijuana and heroin in combination, marijuana and cigarettes in combination, and crack cocaine. Latent class analysis was used to identify patterns of polysubstance use based on types of drugs used. Multivariate logistic regression analyses compared classes on demographics, sexual risk behavior, and disease status. RESULTS : Four classes of substance use were found: MJ + Cig (40.8%), MJ + Her (30.8%), Crack (24.7%), and Low Use (3.7%). The MJ + Cig class was 6.7 times more likely to use alcohol and 3 times more likely to use drugs before/during sex with steady partners than the Crack class. The MJ + Cig class was 16 times more likely to use alcohol before/during sex with steady partners than the MJ + Her class. The Crack class was 6.1 times more likely to engage in transactional sex and less likely to use drugs before/during steady sex than the MJ + Her class. CONCLUSIONS : Findings illustrate patterns of drug use among a polysubstance using population that differ in sexual risk behavior. Intervention strategies should address substance use, particularly smoking as a route of administration (ROA), and sexual risk behaviors that best fit this high-risk population.en© 2013 Elsevier Ireland Ltd. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Drug and alcohol dependence. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Drug and Alcohol Dependence, vol. 132, no. 3, pp. 441-448, 2013. doi : 10.1016/j.drugalcdep.2013.03.004Polysubstance useSexual risk behaviorInfectious diseaseSteady sex partnersHIV populationSubstance abuse -- South AfricaDrug abuse -- South AfricaSexual behavior -- South AfricaPostprint Article