244581 Associations between Herpes Simplex type 2 virus and Hepatitis C virus with HIV among injecting drug users in New York City: The current importance of sexual transmission of HIV

Monday, October 31, 2011

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
Courtney McKnight, MPH , 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
David C. Perlman, MD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Salaam Semaan, MPH, DrPH , National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Objectives: Examine relationships between herpes-simplex virus type 2 (HSV-2, a biomarker for sexual risk), and hepatitis C virus (HCV, a biomarker for injecting risk), with HIV among injecting drug users who began injecting after large-scale expansion of syringe exchange programs in New York City. Methods: 337 heroin and cocaine users who began injecting in 1995 or later were recruited from persons entering drug detoxification. A structured interview covering drug use and HIV risk behavior was administered and serum samples collected for HIV, HCV and HSV-2 testing. Results: HIV prevalence was 8%, HSV-2 39%, and HCV 55%. There was a significant association between HSV-2 and HIV (OR = 7.9, 95% CI 2.9-21.4), and no association between HCV and HIV (OR = 1.14, 95% CI 0.5-2.6). African-American IDUs had the highest prevalence of HSV-2 (76%) and HIV (24%) but the lowest prevalence of HCV (34%). Conclusions: The strong association between HSV-2 and HIV and the lack of an association between HCV and HIV suggests that the majority of HIV infections among these IDUs occurred through sexual transmission. The relative importance of injecting versus sexual transmission of HIV may be critical for understanding racial/ethnic disparities in HIV infection.

Learning Areas:
Biostatistics, economics
Epidemiology
Public health or related research

Learning Objectives:
Compare relationships between HCV and HSV-2 to HIV among injecting drug users in New York City. Analyse these differences in terms of injecting related and sexual transmission of HIV. Discuss the implications of the differences for HIV surveillance and prevention.

Keywords: HIV/AIDS, Intravenous Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Des Jarlais began his research on AIDS in 1982 and is recognized as a world leader in research on the epidemiology of HIV transmission among injection drug users. He is also a pioneer in the evaluation of a variety of harm reduction interventions, particularly syringe exchange programs, and was instrumental in the development and expansion of syringe exchange programs in New York City during the 1980s. Dr. Des Jarlais has published more than 350 articles on these topics. In 1989, Dr. Des Jarlais was jointly appointed by the President and Congress to serve as a Commissioner on the US National Commission on AIDS, a role he played until 1993. He has testified on many occasions before city and state legislative and Congressional committees on HIV prevention and syringe exchange. Since 1994, his research group at Beth Israel Medical Center has conducted annual surveys of syringe exchange programs in the United States. He was recently nominated and is currently serving on the PEPFAR Scientific Advisory Board and as a consultant to various institutions, including the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, the National Academy of Sciences, the United Nations and the World Health Organization. Dr. Des Jarlails is currently working on research studies in 20 different countries.
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.

See more of: Vaccination & Infectious Disease Epidemiology
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