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Objective: To determine how female intravenous drug users (IDUs) have reacted to the HIV epidemic in terms of risk practices and other variables associated with HIV infection, during the period 1987-1996 in Valencia, Spain.Method: We included in our study 1064 women and 4237 men attending the AIDS Prevention and Information centers (CIPS) of the Autonomous Region of Valencia during the period 1987-1996. Information regarding drug use (needle sharing and duration of consumption) and sexual relations (use of condoms, steady partner) over the previous three months was collected at a personal interview during each patient's first visit to the center. In order to study the association between gender and HIV risk behaviors the adjusted odds ratios with 95%o confidence interval were calculated by means of a logistic regression analysis.Results: More women than men said they had a steady partner (70.9% vs. 49.6%). More women than men had IDU partners (OR = 7.8; 95%CI: 5.6-10.9) and women were eight times as likely to have a steady partner who was a carrier of HIV antibodies (OR = 7.73; 95% CI: 6.0-9.96). Prevalence of HIV infection was slightly greater among women. After adjusting for age, marital status, level of education, and year of first visit, no differences were seen between male and female IDUs in the use of condoms and needle sharing.Conclusion: The results of this study demonstrate that differences still exist in the way male and female IDUs respond to the HIV epidemic. Both men and women show a similar decrease in traditional risky practices, but women have not changed their overall sexual behavior and continue to have more IDUs and/or HIV partners than men. This could partly explain the higher prevalence of HIV infection observed among women in our study. The type of relationships they have with their partner implies that women are exposed to a greater risk of infection, which may, in the long term, have the effect of prolonging the epidemic through sexual transmission. Preventive strategies should be devised specifically with couples and groups of drug users in mind, rather than focusing primarily on individual practices. [ABSTRACT FROM AUTHOR]