AEGiS-11IAC: Risk factors for HIV infection in a sample of out-of-treatment injection drug users in California.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Risk factors for HIV infection in a sample of out-of-treatment injection drug users in California.

Int Conf AIDS 1996 Jul 7-12; 11:32 (abstract no. LB.C.6052)
Mikanda J, Ruiz J, Flynn N, Walters J, Sun R; California Department of Health Services, Office of AIDS, Sacramento, CA. Fax: (916) 327-3252. E-mail: jmikanda@hwl.cahwnet.gov.

OBJECTIVE: To examine changes of risk behaviours and its determinants as well as risk factors for HIV infection among Out-of-Treatment Injection Drug Users (OTIDUs) with a particular attention to incarceration status and its risk patterns.

METHODS: In 1994 a multisite cross-sectional study was conducted among 1550 OTIDUs in the following areas: Fresno, Sacramento, San Diego and the City of East Palo Alto. We used a standardized questionnaire, and blood specimens were collected via finger stick.

RESULTS: Multifactorial analysis revealed that the most important risk factor for HIV infection among OTIDUs was injection of stimulants such as cocaine and amphetamines (p=0.03). Of the 1550 OTIDU sample, 586 (37.8%) reported a prior incarceration status. The HIV seropositivity rate in this subgroup was 3.9%. Ninety percent (525/586) reported a reduction in risk behaviors (80.5% drug using behaviors compared to 67.7% sexual behaviors). However, important determinants for needle sharing in the last 6 months were age at which they first injected drugs (p=0.002), injecting stimulants (p=0.0001), prior incarceration (p=0.0002) and knowledge of a negative HIV test (p=0.0003).

CONCLUSIONS: Although the majority of OTIDUs with a prior incarceration status, reported a reduction in risk behaviors, it is evident that high risk behaviors such as needle sharing are prevalent in this group. The reliability of self-reported drug use is an issue, and may preclude an accurate assessment of risk behaviors into his population. A crucial task for future strategies by public health officials should be to provide OTIDUs with access to the health care system for preventive services.

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