Methods: Twenty African-American men, part of a longitudinal NIDA HIV prevention study, completed a questionnaire modified from a clinical screening instrument created by Carroll (1998).  Questions included perceptual ratings of sexual behavioral issues and risk for HIV infection.  Another twenty African-American women involved in another clinical HIV risk reduction intervention, completed the same questionnaire. Both sets of  respondents were invited to  participate in an hour-long audiotaped, focus group interview (one each for men and women) about their understanding of reproductive health, biology, sexual history, sexual behavior, and drug use.  Responses were transcribed and coded by theme.

Results:  The findings revealed severe gaps in knowledge of reproductive health, reproductive anatomy, and connections between chronic drug use and sexual dysfunction.  Participants reported risky sex and drug behaviors, e.g. heavy use of viagra, “dry” vaginal and rectal sex without condoms or lubrication as compensatory for sexual disinterest, neuropathy, or sensation loss.

Implications for Practice: This study supported rates of reported sexual dysfunction (25%-30%) among male and female participants in drug treatment programs (Carroll et al, 1998).  Lack of knowledge about sexual behaviors and chronic drug use  may explain the limited success of HIV prevention programs in changing sex behaviors of drug users in treatment (DesJarlais et al, 2002).  Findings lead to the development of special modules that  address this issue.  Social workers need to become client educators and may need to screen potential drug treatment candidates for sexual dysfunction as a risk factor for HIV disease.