{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T23:33:07Z","timestamp":1772753587659,"version":"3.50.1"},"reference-count":48,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,5,21]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the differences in sexual practices among individuals with various drug administration patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A detoxification centre in Southwest China, a part of the Chinese national sentential surveillance network for hepatitis C virus (HCV), HIV and syphilis infections, was recruited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 610 newly enrolled injection drug users (IDUs) from detoxification centre were included during 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Self-reported sexual activities, drug-related practices and laboratory-confirmed HCV, HIV and syphilis infection status were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 610 IDU, 295 (48.4%) used heroin only, 277 (45.4%) poly-drug users reported the mixed use of synthetic drugs (SDs) with heroin and 38 (6.2%) used SDs only. The average daily drug injection frequency for poly-drug users (3.3\u00b11.2 times) was the highest, followed by heroin-only (2.2\u00b10.8 times) and SD-only users (1.2\u00b10.4\u2009time). SD-only drug users reported the highest proportion (86.8%) of engaging in sexual activities in the previous month, with more than half (54.5%) reporting any condomless sex. A higher frequency of daily injecting in heroin-only users was significantly correlated with the less likelihood of sex, condomless sex in the past month, having sex with fixed partners, condomless commercial sex in the previous 12 months (all p&lt;0.01). In poly-drug users, who injected drugs two times per day was associated with the highest proportion of people who engaged in sex and commercial sex (p&lt;0.05). For SD-only users, increased drug use was not associated with reducing sexual risk (p&gt;0.05). Different patterns of HCV, HIV and syphilis infections prevalence rates were shown among the IDU depending on the roles and length of exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The daily drug injecting frequency of heroin-only and poly-drug users was negatively associated with sexual activities, but SD-only users kept a high frequent engagement in sex. The interventions for relevant diseases should adapt to characteristics of IDU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019730","type":"journal-article","created":{"date-parts":[[2018,6,30]],"date-time":"2018-06-30T05:25:25Z","timestamp":1530336325000},"page":"e019730","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"given":"Shu","family":"Su","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"},{"name":"Research Center for Public Health, Tsinghua University, Beijing, China"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Research Center for Public Health, Tsinghua University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunxiang","family":"Li","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shifu","family":"Li","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Jing","sequence":"additional","affiliation":[{"name":"Research Center for Public Health, Tsinghua University, Beijing, China"},{"name":"Division of HIV\/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher Kincaid","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinxian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Mao","sequence":"additional","affiliation":[{"name":"Center for Social Research in Health, Faculty of Arts and Social Science, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,30]]},"reference":[{"key":"2025121407433864000_8.6.e019730.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2012-001465","article-title":"HIV among people who inject drugs in Central and Eastern Europe and Central Asia: a systematic review with implications for policy","volume":"2","author":"Jolley","year":"2012","journal-title":"BMJ Open"},{"key":"2025121407433864000_8.6.e019730.2","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.drugpo.2015.07.016","article-title":"Access to hepatitis C treatment for people who inject drugs in low and middle income settings: Evidence from 5 countries in Eastern Europe and Asia","volume":"26","author":"Luhmann","year":"2015","journal-title":"Int J Drug Policy"},{"key":"2025121407433864000_8.6.e019730.3","unstructured":"UNODC. World Drug Report 2015: UNODC, 2015."},{"issue":"Suppl 1","key":"2025121407433864000_8.6.e019730.4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/add.12769","article-title":"Tracking the evolution of drug abuse in China, 2003-10: a retrospective, self-controlled study","volume":"110","author":"Jia","year":"2015","journal-title":"Addiction"},{"key":"2025121407433864000_8.6.e019730.5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.drugalcdep.2014.05.007","article-title":"Use of synthetic cathinones and cannabimimetics among injection drug users in San Diego, California","volume":"141","author":"Wagner","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"2025121407433864000_8.6.e019730.6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.drugpo.2016.10.007","article-title":"Social norms related to combining drugs and sex (\"chemsex\") among gay men in South London","volume":"38","author":"Ahmed","year":"2016","journal-title":"Int J Drug Policy"},{"key":"2025121407433864000_8.6.e019730.7","doi-asserted-by":"crossref","first-page":"762-770","DOI":"10.2174\/1570159X15666161117151148","article-title":"When \"Chems\" Meet Sex: A Rising Phenomenon Called \"ChemSex\"","volume":"15","author":"Giorgetti","year":"2017","journal-title":"Curr Neuropharmacol"},{"issue":"Suppl 1","key":"2025121407433864000_8.6.e019730.8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/add.12770","article-title":"Club drug use and associated high-risk sexual behaviour in six provinces in China","volume":"110","author":"Bao","year":"2015","journal-title":"Addiction"},{"key":"2025121407433864000_8.6.e019730.9","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.3109\/10826084.2015.1013132","article-title":"Polydrug Use and HIV Risk Among People Who Inject Heroin in Tijuana, Mexico: A Latent Class Analysis","volume":"50","author":"Meacham","year":"2015","journal-title":"Subst Use Misuse"},{"key":"2025121407433864000_8.6.e019730.10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.drugpo.2014.09.002","article-title":"How do drug market changes affect characteristics of injecting initiation and subsequent patterns of drug use? Findings from a cohort of regular heroin and methamphetamine injectors in Melbourne, Australia","volume":"26","author":"Horyniak","year":"2015","journal-title":"Int J Drug Policy"},{"key":"2025121407433864000_8.6.e019730.11","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.puhe.2015.07.020","article-title":"Disassortative mixing patterns of drug-using and sex networks on HIV risk behaviour among young drug users in Yunnan, China","volume":"129","author":"Li","year":"2015","journal-title":"Public Health"},{"key":"2025121407433864000_8.6.e019730.12","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jth110"},{"key":"2025121407433864000_8.6.e019730.13","doi-asserted-by":"publisher","DOI":"10.1080\/09595230801919486"},{"key":"2025121407433864000_8.6.e019730.14","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/YCO.0000000000000073","article-title":"The new pattern of drug abuse in China","volume":"27","author":"Sun","year":"2014","journal-title":"Curr Opin Psychiatry"},{"key":"2025121407433864000_8.6.e019730.15","doi-asserted-by":"publisher","DOI":"10.1016\/0376-8716(96)01262-8"},{"key":"2025121407433864000_8.6.e019730.16","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00236.x"},{"key":"2025121407433864000_8.6.e019730.17","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1111\/add.13516","article-title":"Heroin overdose","volume":"111","author":"Darke","year":"2016","journal-title":"Addiction"},{"key":"2025121407433864000_8.6.e019730.18","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/S2352-3018(14)70001-3","article-title":"Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study","volume":"1","author":"Daskalopoulou","year":"2014","journal-title":"Lancet HIV"},{"key":"2025121407433864000_8.6.e019730.19","first-page":"1","article-title":"Gaps in the continuum of HIV care: long pretreatment waiting time between hiv diagnosis and antiretroviral therapy initiation leads to poor treatment adherence and outcomes","volume":"2016","author":"Su","year":"2016","journal-title":"Biomed Res Int"},{"key":"2025121407433864000_8.6.e019730.20","unstructured":"Centers for disease control and prevention, Yuxi. The epidemic characteristics and tendency analysis of syphilis in Yuxi: 2005-2016. Yuxi, 2017."},{"key":"2025121407433864000_8.6.e019730.21","unstructured":"Centers for disease control and prevention, Yuxi. Annual report of HIV, STI and HCV infections in Yuxi: Yuxi, 2017."},{"key":"2025121407433864000_8.6.e019730.22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050234"},{"key":"2025121407433864000_8.6.e019730.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001874","article-title":"Simplified HIV testing and treatment in China: analysis of mortality rates before and after a structural intervention","volume":"12","author":"Wu","year":"2015","journal-title":"PLoS Med"},{"key":"2025121407433864000_8.6.e019730.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2007.04883.x"},{"key":"2025121407433864000_8.6.e019730.25","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1080\/10550887.2010.509279","article-title":"Erectile dysfunction in opioid users: lack of association with serum testosterone","volume":"29","author":"Cioe","year":"2010","journal-title":"J Addict Dis"},{"key":"2025121407433864000_8.6.e019730.26","doi-asserted-by":"crossref","first-page":"355","DOI":"10.4103\/0253-7176.140699","article-title":"Sexual dysfunction in patients with alcohol and opioid dependence","volume":"36","author":"Grover","year":"2014","journal-title":"Indian J Psychol Med"},{"key":"2025121407433864000_8.6.e019730.27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0147852","article-title":"Sexual dysfunction in heroin dependents: a comparison between methadone and buprenorphine maintenance treatment","volume":"11","author":"Yee","year":"2016","journal-title":"PLoS One"},{"key":"2025121407433864000_8.6.e019730.28","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(12)60520-0","article-title":"Erectile dysfunction","volume":"381","author":"Shamloul","year":"2013","journal-title":"The Lancet"},{"key":"2025121407433864000_8.6.e019730.29","doi-asserted-by":"crossref","first-page":"e29640","DOI":"10.5812\/ijhrba.29640","article-title":"A qualitative study of the relationship between methamphetamine abuse and sexual dysfunction in male substance abusers","volume":"5","author":"Dolatshahi","year":"2016","journal-title":"Int J High Risk Behav Addict"},{"key":"2025121407433864000_8.6.e019730.30","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1111\/jsm.12926","article-title":"The impact of illicit use of amphetamine on male sexual functions","volume":"12","author":"Chou","year":"2015","journal-title":"J Sex Med"},{"key":"2025121407433864000_8.6.e019730.31","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/10550490701389864","article-title":"Methamphetamine dependence: a closer look at treatment response and clinical characteristics associated with route of administration in outpatient treatment","volume":"16","author":"Rawson","year":"2007","journal-title":"Am J Addict"},{"key":"2025121407433864000_8.6.e019730.32","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00213-016-4493-5","article-title":"Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV","volume":"234","author":"Johnson","year":"2017","journal-title":"Psychopharmacology"},{"key":"2025121407433864000_8.6.e019730.33","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1080\/10550887.2011.581989","article-title":"Comparing injection and non-injection routes of administration for heroin, methamphetamine, and cocaine users in the United States","volume":"30","author":"Novak","year":"2011","journal-title":"J Addict Dis"},{"key":"2025121407433864000_8.6.e019730.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2009.11.007"},{"key":"2025121407433864000_8.6.e019730.35","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.3109\/10826084.2014.912230","article-title":"Response inhibition moderates the association between drug use and risky sexual behavior","volume":"49","author":"Nydegger","year":"2014","journal-title":"Subst Use Misuse"},{"key":"2025121407433864000_8.6.e019730.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2015.03.005"},{"key":"2025121407433864000_8.6.e019730.37","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/OLQ.0000000000000184","article-title":"Synthetic drug boom: potential threat to HIV\/AIDS transmission in China","volume":"41","author":"Chen","year":"2014","journal-title":"Sex Transm Dis"},{"key":"2025121407433864000_8.6.e019730.38","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.1007\/s10461-012-0380-1","article-title":"Sexual risk behaviors among club drug users in Shanghai, China: prevalence and correlates","volume":"17","author":"Ding","year":"2013","journal-title":"AIDS Behav"},{"key":"2025121407433864000_8.6.e019730.39","first-page":"261","article-title":"Epidemiology of hepatitis C virus","volume":"20","author":"Liu LJ","year":"2007","journal-title":"Infectious Disease Information"},{"key":"2025121407433864000_8.6.e019730.40","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70216-4"},{"key":"2025121407433864000_8.6.e019730.41","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix202"},{"key":"2025121407433864000_8.6.e019730.42","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1477-7517-10-8","article-title":"Ability to access community-based needle-syringe programs and injecting behaviors among drug users: a cross-sectional study in Hunan Province, China","volume":"10","author":"Zhang","year":"2013","journal-title":"Harm Reduct J"},{"key":"2025121407433864000_8.6.e019730.43","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0068906","article-title":"Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis","volume":"8","author":"Zhang","year":"2013","journal-title":"PLoS One"},{"key":"2025121407433864000_8.6.e019730.44","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.drugalcdep.2013.12.002","article-title":"Emergence of cocaine and methamphetamine injection among HIV-positive injection drug users in northern and western India","volume":"135","author":"Mehta","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"2025121407433864000_8.6.e019730.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.07.011"},{"key":"2025121407433864000_8.6.e019730.46","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130295"},{"key":"2025121407433864000_8.6.e019730.47","doi-asserted-by":"crossref","first-page":"762","DOI":"10.2174\/1570159X15666161117151148","article-title":"When \"chems\" meet sex: a rising phenomenon Called \"ChemSex\"","volume":"15","author":"Giorgetti","year":"2017","journal-title":"Curr Neuropharmacol"},{"key":"2025121407433864000_8.6.e019730.48","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5790"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:43:52Z","timestamp":1765727032000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":48,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,6,30]]},"published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1136\/bmjopen-2017-019730"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019730","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}