3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

IDENTIFICATION OF SELECTION FACTORS THAT EXPLAIN ELEVATED RATES OF HIV SEROCONVERSION AMONG PARTICIPANTS IN ONE OF NORTH AMERICA'S LARGEST SYRINGE EXCHANGE PROGRAMS

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WeOa0301

Lloyd-Smith E., Kerr T., Li K., Hogg R., Tyndall M., Montaner J., Wood E.
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada

INTRODUCTION: Evaluations of HIV rates and needle exchange program (NEP) attendance in Vancouver, Canada have demonstrated a statistical association between NEP attendance and HIV seroconversion. Although an early analysis suggested that this association was due to confounding, persistent questions have remained. Sufficient follow-up is now available for a full evaluation HIV rates and potential selection factors among injection drug users (IDUs) in this setting.

METHODS: The Vancouver Injection Drug User Study (VIDUS) is an open prospective cohort study of over 1,500 IDUs recruited in the Downtown Eastside of Vancouver, beginning in May 1996. We examined baseline differences between IDUs that did and did not report using the NEP at least once a week. We then calculated overall and stratified HIV incidence rates using Kaplan-Meier methods.

RESULTS: 1035 baseline HIV negative participants were eligible for this study. Within this population, 334 (32%) were non-weekly NEP attendees, whereas, 701 (68%) were weekly NEP attendees at baseline. Weekly NEP attendees were more likely to report daily heroin use (OR = 2.8, [95% CI: 2.1-3.8]; p<0.001), daily cocaine use (OR = 3.2, [95% CI: 2.3-4.5]); p<0.001), to inject drugs in shooting galleries (OR = 1.8, [95% CI: 1.3-2.5]; p<0.001) and to be involved in the sex trade (OR = 1.5, [95% CI: 1.1-2.0]; p=0.009).

CONCLUSIONS: These data demonstrate that the HIV seroconversion differences between frequent and non-frequent NEP attendees may be explained by the higher risk profile of frequent NEP attendees.

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050724
Prevention | WeOa0301 | Elisa Lloyd-Smith
Harm reduction and IDU-related strategies

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