(P70) ASSESSMENT OF GENDER DIFFERENCES IN STI RISK AND PROTECTIVE BEHAVIORS IN A PRIORITY POPULATION OF PEOPLE WHO USE ILLICIT OPIOIDS

Background:
The US is amid an ongoing STI epidemic and concurrently grappling with a drug use epidemic. Considering well-documented mutually reinforcing relationships between sexual risk behavior and drug use, these epidemics are believed to be linked. However, relatively little is known about STI prevention among men and women who use illicit opioids (PWUIO), with most studies focused narrowly on bloodborne infections among those who inject or contraception among women. Research is needed to understand gaps in STI prevention education, screening, and services within the priority population of PWUIO.

Methods:
Within a cohort study among PWUIO in New York City, we conducted a cross-sectional sexual health survey from November 2021-August 2022 (n=108). Participants reported methods they/their partners used to prevent STI, which were categorized as none/ineffective (e.g., oral birth control). We examined the prevalence of no/ineffective STI prevention, prevention by sexual partnership type, and barriers to prevention among cisgender men (n=58) and cisgender women (n=50).

Results:
Among men and women, approximately three-quarters reported no/ineffective STI prevention, including 7% reporting “pulling out” as a form of prevention used. Almost 90% of women’s sex acts with a main partner were condomless compared to 75% of men’s; 100% of women’s sex acts with sex trade partner(s) were condomless compared to 25% of men’s; and 67% of women’s sex acts with casual partner(s) were condomless compared to 18% of men’s. Among women, approximately 20% reported price as a barrier to STI prevention compared to 4% of men, and 9% of women reported partners’ preference as a barrier compared to 2% of men. Few reported receiving condoms from drug-related services like needle exchange or treatment programs.

Conclusion:
Considering overlap of drug and sexual networks, it is vital to reach men and women who use drugs with effective STI prevention education and resources, with particular attention to the needs of women.