Background:
National STD surveillance systems and research studies on STDs in high risk populations such as sex workers and incarcerated populations do not provide estimates of the STD burden in drug users. A limited number of research studies, conducted as part of HIV research projects, form the primary source of information on the burden of STDs in drug users and on relevant STD prevention and control activities.


Objective:
To assess the burden of STDs in drug users and to examine the relevant behavior change and health-related interventions that can be used to prevent and control STDs in drug users.


Method:
We used automated and manual search strategies to locate the articles published between 1995 and 2005. We located the articles that presented information on the STD burden in injection users of heroin and cocaine and in smokers of crack. We also located the articles that presented information on relevant interventions.


Result:
Seropositivity rates for syphilis ranged from 1% to 6%. Rates for genital herpes ranged from 38% to 61%. Prevalence rates for gonorrhea ranged from 1% to 3% and for chlamydia from 1% to 5%. Higher rates were found in subgroups of drug users who engaged in high risk sexual activities. Few STD behavior change interventions were implemented with drug users. Activities such as risk reduction interventions, testing and treatment for STDs, targeted interventions for subgroups of drug users, and integrated services for drug users have the potential to control STDs in drug users.


Conclusion:
The burden of STDs in drug users is relatively high and controlling STDs among drug users is critical for their health and the health of their communities.


Implications:
Assessment and delivery of preventive and curative STD services to drug users is needed to keep these infections under control.