2nd National Conference Human Retroviruses and Related Infections Washington, DC - January 29 - February 2, 1995

Natl Conf Hum Retrovir Relat Infect 1995 Jan 29-Feb 2;2: (abstract no. 10)

Brian RE¹, Word CO², McCoy CB³, Faruque S⁴, Dushku JC¹, Holmberg SD¹, and the Multicenter Crack Cocaine and HIV Infection Study Team
¹CDC, Atlanta, GA; ²Bayview-Hunter’s Point, San Francisco, CA; ³Univ. of Miami, Miami, FL; ⁴ADAPT, New York, NY

BACKGROUND: Crack cocaine smokers in some areas have high HIV prevalences because of high-risk sex practices. Their HIV incidence rates, however, have not been measured.

METHODS: We recruited crack smokers and nons smokers, aged 18-29 years, from the streets of high drug-use neighborhoods in three cities for two sets of interviews and HIV tests 6- 29 months apart.

RESULTS: of 909 initially HIV-negative participants, 29 (3.2%) were HIV-positive on their follow-up tests. Incidence rates per year were 6.2% in New York (NY), 5.1% in Miami (M), and 0% in San Francisco. In NY and M, 6 of 38 injecting drug users (17%/year, 95% Cl, 8-37) and 4 of 21 men who had sex with men (17%/year, 95% Cl, 6-46) became positive; excluding these groups, 16 of 285 crack smokers (5.3%/year, 95% Cl, 3.3-8.7) and 3 of 190 nonsmokers (1.6%/year; 95% CI, 0.5-5.1) became positive; rates were similar in men and women. Of 105 women in NY and M who reported exchanging sex for money or drugs, 8 became positive (7.3%/year, 95% Cl, 3.7-15); after controlling for this practice, crack-smoking and nonsmoking women had similar HIV incidences.

CONCLUSIONS: These HIV incidence rates are among the highest ever reported in the United States. HIV is being rapidly transmitted heterosexually among young adults in these inner city areas, particularly among crack smokers, and especially among women who exchange sex for money or drugs.

Keywords: AIDS Vaccines, Acquired Immunodeficiency Syndrome, Adult, Crack Cocaine, Female, HIV Infections, HIV Seropositivity, Humans, Male, New York, San Francisco, Social Environment, Substance-Related Disorders, United States, epidemiology

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1995-01-29
10

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