Injection and sexual HIV/HCV risk behaviors associated with nonmedical use of prescription opioids among young adults in New York City

J Subst Abuse Treat. 2015 Jan;48(1):13-20. doi: 10.1016/j.jsat.2014.07.002. Epub 2014 Jul 11.


Prevalence of nonmedical prescription opioid (PO) use has increased markedly in the U.S. This qualitative study explores the drug-use and sexual experiences of nonmedical PO users as they relate to risk for HIV and HCV transmission. Forty-six New York City young adult nonmedical PO users (ages 18-32) completed in-depth, semi-structured interviews. Despite initial perceptions of POs as less addictive and safer than illegal drugs, PO misuse often led to long-term opioid dependence and transition to heroin use and drug injection. Injectors in the sample reported sporadic syringe-sharing, frequent sharing of non-syringe injection paraphernalia and selective sharing with fellow injectors who are presumed "clean" (uninfected). Participants reported little knowledge of HCV injection-related risks and safer injection practices. They also reported engaging in unprotected sex with casual partners, exchange sex and group sex, and that PO misuse increases the risk of sexual violence. Prevention efforts addressing HIV/HCV risk should be targeted to young nonmedical PO users.

Keywords: HIV/HCV risk; Injection risk behavior; Prescription opioid misuse; Sexual risk behavior.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Female
  • HIV Infections / psychology*
  • Health Knowledge, Attitudes, Practice*
  • Hepatitis C / psychology*
  • Heroin Dependence / psychology
  • Humans
  • Male
  • Needle Sharing / adverse effects
  • Needle Sharing / psychology
  • New York City
  • Opioid-Related Disorders / psychology
  • Prescription Drug Misuse / psychology*
  • Risk-Taking*
  • Substance Abuse, Intravenous / psychology
  • Substance-Related Disorders / psychology*
  • Unsafe Sex / psychology*
  • Young Adult


  • Analgesics, Opioid