Prospective associations between treatment for drug-use and sexually transmitted infections across racial and ethnic groups of women

= 826). Participants completed surveys and STI testing at baseline and 6 months. The primary exposure was baseline self-reported receipt of treatment for drug use in the prior 6 months. The outcome was incident chlamydia, gonorrhea, trichomoniasis, and/or syphilis at 6 months follow up. Modified Poisson regression with robust variance estimated race and ethnicity-specific risk ratios (RRs), adjusting for baseline sociodemographic, behavioral, and health factors.ResultsSTI incidence was highest among Black women (22%), followed by Hispanic/Latina women and those of other racial/ethnic groups (14%), and lowest among White women (5%). In unadjusted analyses, treatment for drug-use was associated with higher STI incidence among White women (RR = 2.83; 95% CI: 0.97, 8.29) and women of other racial/ethnic groups (RR = 3.21; 95% CI: 1.21, 8.50). In adjusted models, associations attenuated among White and Hispanic/Latina women, while among women of other racial/ethnic groups, self-help treatment remained associated with elevated STI risk (adjusted RR = 3.03; 95% CI: 1.22, 8.96). No associations were observed among Black women.ConclusionsAmong Black women who use drugs, STI risk may be shaped by structural and network-level factors rather than individual-level treatment for drug use. Integrating STI screening and prevention services into drug-related care settings may address elevated STI vulnerability. Additional research should examine mechanisms underlying racial and ethnic differences and how to reach the diverse population of women who use drugs.