Background The United States (US) is experiencing record rates of sexually transmitted infections (STI) and opioid misuse, and has in excess of 1.1 million individuals living with HIV. Risk reduction interventions can vary greatly by drug of choice and sexual orientation. This pilot study sought to examine STI risk as a factor of drug misuse and HIV status.

Methods From 1 Jul to 21 Dec 2018 we recruited individuals from a sexual minority support organization also providing syringe exchange services (Springfield, IL). Participants completed surveys of risk and behavior and were screened (genital and oral) for chlamydia (CT) and gonorrhea (GC). Drug use was categorized as: none; opioids only (e.g. heroin, hydrocodone); stimulants only (e.g. methamphetamine, cocaine); and combined.

Results The 54 participants were: 94% male; had a mean age of 41 years; and were 76% white race. Stratified by opioid use (yes/no)/HIV status (pos/neg), participants for each category were: yes/pos=6; yes/neg=27; no/pos=6; and no/neg=15. The 2 identified infections were one oral GC and one genital CT. Among the 50 who identify as male, reported orientation was: 26 heterosexual, 20 homosexual, 3 bisexual (1 missing); and reported drug use was: 14 none, 4 opioids, 7 stimulants, and 25 combined. Drug category was strongly associated with sexual orientation (60.0% of homosexuals reported none vs 72.0% of heterosexuals reporting combined; p=0.003) and employment (64.5% of unemployed reported combined vs 22.2% employed; p=0.008). Drug type use was not significantly associated with: race; ever being diagnosed with a STI; giving or receiving sex for money or drugs; engaging in anonymous hookups; or group sex (though reported by 26% of participants).

Conclusion Given the reported risky behaviors of study participants, actual STI prevalence was surprisingly low. The data show drug use differences by sexual orientation and employment status, indicating areas for further intervention research.

Disclosure No significant relationships.