Characteristics of young adult crack-cocaine users in Brazil: A sex- and gender-based analysis

Crack-cocaine use represents a major social and public health challenge in Brazil. Important sex and gender differences have been found among crack users in other countries, but little comparative data exists regarding male and female crack users in Brazil. This secondary, sex-and-gender-based analysis explores potential sex differences in key characteristics of a community-based sample of young crack users (n=159) in two Brazilian cities. Participants completed an anonymous questionnaire on social, health and behavioural characteristics, and serological testing for HIV and HCV. Data was analyzed using univariate and stepwise discriminant analyses. Discriminant modeling found that: (1) Paid work, HIV testing, sex work, and begging differentiated male and female crack users; (2) Female sex independently predicted HIV testing history; and (3) Alcohol use, poor self-rated mental health and an absence of paid work predicted unprotected sex among participants. These findings suggest the need for gender-specific prevention strategies targeting sex-related risk among young Brazilian crack users.