176441 Using HSV-2 and HCV co-infections to track sexual and injecting risk for HIV among injecting drug users

Wednesday, October 29, 2008: 10:30 AM

Don C. Des Jarlais, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Kamyar Arasteh, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Holly Hagan, PhD , College of Nursing, New York University, New York, NY
Courtney McKnight, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Samuel R. Friedman, PhD , Iar, National Develpment & Research Institutes, New York, NY
     
Objective: Assess relationships between HIV, hepatitis C virus (HCV) and herpes simplex virus-2 (HSV-2) seroprevalence among injecting drug users in New York City. HCV is readily transmitted through unsafe drug injecting but only inefficiently through unsafe sexual behavior, and can serve as a biomarker for unsafe injections. HSV-2 is transmitted sexually but not through unsafe injecting, and can serve as a biomarker for unsafe sexual behavior.

Methods: 397 injecting drug users were recruited from a drug detoxification program in New York City from 2005-07. A questionnaire covering demographics, drug use and HIV risk behavior was administered and serum samples were collected and tested for antibody to HIV, HCV and HSV-2.

Results: HIV prevalence was 19%, HCV seroprevalence 72%, and HSV-2 prevalence 49%. Among IDUs who began injecting before 1995, HIV prevalence was 32%, and there was a very strong relationship between HCV and HIV (OF = 10.98), and a non-significant relationship between HSV-2 and HIV (OR = 1.60). Among IDUs who began injecting in 1995 or later, HIV prevalence was 6%, and there was no relationship between HCV and HIV (OR= 1.16) and a very strong relationship between HSV-2 and HIV (OR = 17.66).

Conclusions: Since large-scale implementation of syringe exchange in the mid-1990s, HIV infection is no longer associated with a biomarker for injection risk, but is strongly associated with a biomarker for sexual risk. Prevention efforts need to focus on HSV-2 facilitated sexual transmission of HIV.

Learning Objectives:
1. Understand the use of HSV-2 as a biomarker for sexual risk for HIV infection. 2. Understand the use of HCV as a biomarker for injection-related risk for HIV infection. 3. Understand the relationships between provision of syringe exchange in New York City and the reduction in HIIV transmission and the shift from injecting to sexual transmission of HIV.

Keywords: Injection Drug Users, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a researcher for over thirty years and this is my original research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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