Knowledge of HIV serostatus is associated with lower HIV risk among a sample of injection drug users in Houston, Texas

Background: It is hypothesized that knowledge of one's own HIV serostatus is associated with reduced HIV risk behaviors among injection drug users (IDUs). This analysis aims to assess the association between knowledge of own HIV serostatus and HIV risk.

Methods: Our study includes 523 eligible IDUs, recruited into the 2009 National HIV Behavioral Surveillance project. We classified the sample of IDUs into HIV risk classes using latent class analysis. Class status was based on 9 observed drug and sexual behaviors. We compared the proportions of IDUs unaware and aware of their HIV serostatus between different HIV risk classes using Cochran-Armitage test. Subsequently, we compared the proportions of known negatives and known positives between HIV risk classes.

Results: We identified 3 HIV risk classes: high (42%), moderate (25%) and low (33%). The proportions of IDUs unaware of their HIV sero-status were 0.14 in the Low-risk class, 0.16 in the Moderate-risk class, and 0.29 in the High-risk class. This trend was statistically significant (p<0.001). However, among IDUs who were aware of their HIV serostatus, the proportions of HIV-positives in risk classes were similar (0.03, 0.06 and 0.05 respectively; p=0.45).

Conclusions: Our results show participants who were unaware of their HIV serostatus were more likely to be in high risk class compared to participants who were aware of their HIV serostatus. Routine screening and early detection can help to reduce subsequent inter- and intra-group HIV infection among injection drug users.