OBJECTIVE: To review the relation between drug use, sexual risk behaviour, and STDs including HIV in two marginalised populations--drug users and street youth. METHODS: A review of recent medical and behavioural literature focusing on illustrative examples from industrialised countries. FINDINGS: Injecting and other illicit drug users and street youth are both sexually active populations with a high rate of partner turnover and frequently exchange sex for money or drugs. Both STDs and HIV are prevalent among injecting and crack using individuals. Drug use may lead drug users to be less aware of or concerned about STD symptoms than others with STDs and thus increase the threshold for attending clinical services. CONCLUSIONS: Given that STDs facilitate the transmission of HIV and that standard STD control programmes in general do not reach these populations, it is argued that drug users and street youth require targeted special outreach STD control programmes.
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