 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
Mahboobeh Safaeian, MPH1, Noya Galai, PhD2, David D. Celentano, ScD3, David Vlahov, PhD4, and Steffanie A. Strathdee, PhD3. (1) Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 627 North Washington Street, 3rd Floor, Baltimore, MD 21205, 410-955-4397, msafaeia@jhsph.edu, (2) Dept of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington St., Baltimore, MD 21205, (3) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Infectious Diseases Program, 615 N. Wolfe Street, Baltimore, MD 21205, (4) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029
Objective: To identify risk behaviors of injection drug users (IDUs) following HIV seroconversion .
Methods: Between 1988 to 2001, IDUs participating in a prospective cohort study in Baltimore, MD completed semi-annual questionnaires regarding their drug use and sexual risk behaviors. HIV seroconverters with at least 4 visits post notification of HIV seroconversion were studied. Risk behaviors associated with transmission included sharing needles, attending shooting galleries and prostitution. Predictors of these risk behaviors reported at any time post notification were obtained from the first HIV positive visit and assessed using logistic regression.
Results: Of 263 seroconverters, 24 (9.1%) stopped injecting, 36 (17%) stopped trading sex, 91 (36%) stopped sharing , 179 (73%) stopped shooting gallery use, 63 (23.9%) remained persistent injectors and 176 (66.9%) had repeated relapses. Similarly, 176 (83%) traded sex, 162 (64%) shared needles and 66 (27%) visited shooting gallery post-seroconversion. Overall, compared to the pre-notification visits, the frequency of risk behaviors tended to decrease: sharing needles from 42 to 20%, galleries from 15 to 5% and prostitution from 16 to 8%. Significant predictors of risk behavior with transmission potential were injecting speedball (OR=2.8), being male (OR=2.2) and an annual income less than $5000 (OR=2.1).
Conclusions: IDUs who underwent HIV seroconversion reduced their risk behaviors but substantial sexual and parenteral risk of transmission remains. Together with existing prevention programs, limiting the spread of HIV requires focused efforts among HIV-positive IDUs to reduce the risk of transmission.
Learning Objectives:
Keywords: HIV/AIDS, Injection Drug Users
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.