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APHA Scientific Session and Event Listing

Recorded presentation

Don C. Des Jarlais, PhD¹, Kamyar Arasteh, PhD¹, Theresa Perlis, PhD¹, Holly Hagan, PhD², Abu Abdul-Quader, PhD³, Douglas Heckathorn, PhD⁴, Courtney McKnight, MPH¹, Heidi Bramson, BA¹, Chris Nemeth⁵, Lucia V. Torian, PhD⁶, and Samuel R. Friedman, PhD⁷. (1) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 160 Water Street - 24th Floor, New York, NY 10038, 212.256.2548, dcdesjarla@aol.com, (2) Center for Drug Use & HIV Research, National Development & Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010, (3) Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MSE 46, Atlanta, GA 30333, (4) Cornell University, 344 Uris Hall, Ithaca, NY 14853, (5) Bureau of HIV/AIDS Epidemiology, New York State Department of Health, Corning Tower, ESP, Albany, NY 12237, (6) New York City Department of Health and Mental Hygiene, 346 Broadway, New York, NY 10013, (7) IAR, National Develpment & Research Institutes, 71 West 23d Street, 8th floor, New York, NY 10010

Background: We compared current HIV prevalence among injecting and non-injecting heroin and cocaine users in New York City to assess the relative importance of injecting and sexual transmission among drug users in New York City. Given the greater efficiency of needle-borne transmission, one would expect substantially higher HIV prevalence among injectors. Prevalence among injectors was approximately 50% level from 1980 to 1995. Methods: Risk behavior and HIV prevalence surveys were conducted with injecting and non-injecting heroin and cocaine users entering drug treatment from 2000-04 (N = 2121) and recruited through respondent driven sampling from a research storefront in 2004 (N = 448). Results: In both studies, HIV prevalence was nearly identical among current injectors and users who had never injected: 13% among current injectors and 12% among never-injectors in the drug treatment program study, and 15% among current injectors and 17% among never injectors in the respondent driven sampling storefront study. There were overlaps in the 95% CIs in all gender and race/ethnicity subgroup comparisons in both studies. Sexual risk behavior was similar among injecting and non-injecting drug users. Conclusions: The very large HIV epidemic among drug users in New York City appears to be entering a new phase, in which heterosexual transmission may be equally or more important than injecting related transmission. Over long time periods, high HIV prevalence epidemics may generate large self-sustaining heterosexual transmission among both injecting and non-injecting drug users. New prevention programs are needed to address this transition.

Learning Objectives:

1.Assess the relative importance of injection related and sexual transmission of HIV among drug users in NewYork City 2.Summarize the history of the HIV epidemic in New York City
• Apply the New York City results to his/her local situation.

Keywords: HIV/AIDS, Drug Injectors

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation