244774 Correlates of HIV risk among injection drug users: A Latent Class Analysis

Wednesday, November 2, 2011

Syed Noor, MSS, MA, MPH , School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
Michael W. Ross, PhD , WHO Center for Health Promotion Research and Development, The University of Texas - Houston School of Public Health, Houston, TX
Dejian Lai, PhD , School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
Jan Risser, PhD , Department of Epidemiology and Disease Control, University of Texas School of Public Health, Houston, TX
Background: Injection drug users (IDUs) are at increased risk of HIV infection because they are more likely to engage in high risk injection behaviors (e.g. needle sharing) as well as in high risk sexual behaviors (e.g. exchange sex). This analysis examines factors associated with HIV risk using a latent class approach.

Methods: Our study includes 523 eligible injection drug users, recruited into the 2009 National HIV Behavioral Surveillance project. Using maximum likelihood we calculated the posterior probability of being in an HIV risk class from 9 drug and sexual behaviors. We simultaneously fitted a multinomial regression model to identify socio-demographic factors associated with HIV risk class.

Results: We identified 3 HIV risk classes: high (42%), moderate (25%) and low risk (33%). Compared to the high HIV risk class, homeless IDUs had lower odds to be in the moderate (OR=0.16, 95% CI: 0.04-0.70) and in low risk HIV class (OR=0.28, 95% CI: 0.15-0.52). Moreover, IDUs who were arrested in the past 12 month had also lower odds to be in low risk class (OR=0.52, 95% CI: 0.32-0.86) compared to high HIV risk class.

Conclusions: Our results show that the majority of our IDUs were engaged in high HIV risk behaviors. Though temporality cannot be established due to the cross-sectional study design our findings indicate that homelessness and history of incarceration are associated with HIV risk. Interventions targeting system-level change may help to reduce the burden of HIV among the injection drug user population.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Learners will be able to 1. describe Latent Class Analysis approach to identify HIV risk classes based on observed drug and sexual risk behaviors. 2. list factors contextual to injection drug related HIV risk among a sample of injection drug users. 3. compare drug and sexual risk behaviors among high, moderate and low HIV risk injection drug users.

Keywords: HIV Risk Behavior, Injection Drug Users

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized and conducted this analysis
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.