257882 “Double Trouble”: Receptive syringe sharing and unprotected sex among HIV negative injection drug users in New York City

Monday, October 29, 2012

Alan Neaigus, PhD , HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York, NY
Kathleen H. Reilly, PhD MPH , HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York, NY
Samuel M. Jenness, MPH , Department of Epidemiology, University of Washington, Seattle, WA
Holly Hagan, PhD , College of Nursing, New York University, New York, NY
Travis Wendel, PhD JD , Department of Anthropology, John Jay College of Criminal Justice, New York, NY
Camila Gelpi-Acosta, MA , Institute of Special Populations Research, National Development and Research Institutes, New York, NY
Arpi Terzian, PhD, MPH , HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, Queens, NY
Background: HIV-negative injection drug users (IDU) who engage both in receptive syringe sharing and unprotected sex ("double trouble") are at combined and heightened risk of HIV infection. Little is known about this high-risk group of IDU. Methods: Active IDU aged ≥18 years were recruited in New York City in 2009 for the National HIV Behavioral Surveillance System, a cross-sectional study. Participants were offered HIV testing and interviewed about their sociodemographics, and their drug and sexual risk behaviors. Adjusted odds ratios (aOR) and 95% Confidence Intervals (95%CI) were estimated using multinomial logistic regression. Results: Of the 444 who tested negative, 22% were female and 78% male; 54% were Hispanic, 36% white, 9% African-American/black, and 1% other race/ethnicity. The; mean age was 39.3 years (standard deviation (SD)=9.5) and the mean years of injecting 17.4 (SD=11.0). Engaging both in receptive syringe sharing and unprotected sex (vaginal or anal) was reported by 26.0 %, only receptive syringe sharing by 3%, only unprotected sex by 49%, and neither by 21%. Variables independently associated with engaging both in receptive syringe sharing and unprotected sex vs. neither included Hispanic race/ethnicity (vs. white) (aOR=2.0, 95%CI=1.0-4.0), age 18-29 years (vs. ≥30) (aOR=2.5, 95%CI=1.1-5.8), homelessness (aOR=3.3, 95%CI=1.6-6.8), and injecting speedball (aOR=2.2, 95%CI=1.1-4.4). Conclusions: A large majority of HIV negative IDU were at risk of HIV infection from either injection or sexual risk behaviors, with a quarter in "double trouble". Interventions among IDU in "double trouble" should target those who are Hispanic, young, homeless, or who inject speedball.

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

Learning Objectives:
Describe the prevalence of the joint occurence of receptive syringe sharing and unprotected sex among injection drug users. Identify the risk factors associated with the joint occurence of receptive syringe sharing and unprotected sex among injection drug users.

Keywords: HIV/AIDS, Injecting Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The NYC Dept. of Health will not provide funding for attendance to the first author. No other authors are attending the conference. I am an Epidemiologist in the Bureau of HIV Prevention and Control and a colleague of the first author at the NYC Dept. of Health. I have reviewed the content of the poster, have found it acceptable, and have agreed to present it at the conference.
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.

Back to: 3286.0: HIV/AIDS Risks among Substance Using and Abusing Populations