186027 Prevalence and correlates of HIV infection among young adult injection drug users (IDUs): The Collaborative Injection Drug Users Study III/Drug Users Intervention Trial (CIDUS III/DUIT) 2002-2004

Wednesday, October 29, 2008: 11:15 AM

Amanda J. Rondinelli, MPH , Graduate School of Public Health, San Diego State University, San Diego, CA
Steffanie A. Strathdee, PhD , Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
Mary H. Latka, PhD , Aurum Insitute for Health Research, Johannesburg, Gauteng, South Africa
Lawrence J. Ouellet, PhD , Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL
Sharon M. Hudson, PhD , Health Research Association, Los Angeles, CA
Holly Hagan, PhD , College of Nursing, New York University, New York, NY
Richard S. Garfein, PhD, MPH , Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
BACKGROUND: Drug injection is the third-leading HIV transmission category in the U.S. We examined correlates of HIV infection among young IDUs recruited in Baltimore, Chicago, Los Angeles, New York, and Seattle.

METHODS: Baseline computer-assisted self-interviews and venipuncture for serologic tests (including HIV) were conducted. Logistic regression was used to identify factors independently associated with HIV infection.

RESULTS: Of 3,285 IDUs, 70% were male, 8% black, 64% non-Hispanic (NH) white, 17% Hispanic, and 11% were other/mixed. HIV prevalence was 2.8% (95%CI:2.3-3.4), ranging from 0.77% in Chicago to 6.3% in LA. After controlling for site, income source and years of injecting, HIV was independently associated with: race/ethnicity [Hispanic (OR=4.13, 95%CI:1.6–10.4), black (OR=7.0, 95% CI:2.9–16.6) or other/mixed (OR=2.5, 95%CI:1.0–5.8) vs. NH-white]; ever exchanging sex for money/drugs (OR=2.5, 95%CI:1.3–4.9); and injecting methamphetamine alone or with heroin (OR=4.1, 95%CI:1.7–9.8) vs. heroin alone. Additionally, compared to males who only had female sex partners (non-MSM), males who had sex with men (MSM) were more likely to be HIV-positive (OR= 8.5, 95%CI:3.9–18.3), and women were similar to non-MSM men (OR=0.8, 95%CI:0.4–1.9). Sharing injection equipment was not significant. High-risk sexual behaviors were more common among methamphetamine injectors.

CONCLUSIONS: Racial disparities in HIV infection exist among young IDUs. Sexual behaviors appear more closely associated with HIV than injection behaviors. Methamphetamine injection was the only significant injection variable among those examined, and may be linked to increased sexual risk. HIV prevention interventions for young IDUs should include sexual risk reduction, particularly among methamphetamine-using MSM.

Learning Objectives:
1. Report the prevalence of HIV infection in this population of young injections drug users. 2. Identify risk behaviors associated with HIV infection in this population of young injection drug users. 3. Apply these findings to effectively target interventions aimed at reducing injection and sexual risk behaviors among young injection drug users.

Keywords: Injection Drug Users, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have performed all statistical analysis for this 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.