AEGiS-13IAC: HIV seroincidence among injection drug users in San Francisco, 1986 to 1998: sexual transmission.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

HIV seroincidence among injection drug users in San Francisco, 1986 to 1998: sexual transmission.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC501)

Kral A, Bluthenthal R, Lorvick J, Gee L, Bacchetti P, Edlin B
A. Kral, U.C.S.F., 3180 18th Street Suite 302, San Francisco, CA 94110, United States, Tel.: +1 415 502 7221, Fax: +1 415 476 3406, E-mail: alkral@itsa.ucsf.edu

BACKGROUND: Cohort studies of injection drug users (IDUs) in the U.S. have found that among IDUs, HIV seroconversion is predominantly associated with injection-related risk behaviors. The objective of this study was to determine whether injection or sex-related risk factors were associated with HIV antibody seroconversion among street-recruited IDUs in San Francisco from 1986 to 1998.

METHODS: IDUs were recruited from street settings in 4 San Francisco neighborhoods semi-annually (22 waves). Respondents who participated more than once and seroconverted between visits were considered cases (n = 60) and were matched to control respondents who participated in the same waves as the cases but remained HIV negative (n = 1,404).

RESULTS: Separate multivariate conditional logistic regression models of HIV seroconversion were constructed for men and women. Among men, those who had sex with men and were recruited in the Tenderloin neighborhood were more likely to seroconvert (adjusted odds ratio `AOR' = 12.5; 95% confidence interval `CI' = 4.5, 34.7) than those who did not have sex with men and were recruited in other neighborhoods. African American men were less likely to seroconvert (AOR = 0.40; 95% CI = 0.16, 0.95) than other men. Among women, reporting sex for money or drugs (sex trade) with 1-30 partners in the past year was predictive of seroconversion (AOR = 9.5; 95% CI = 2.4, 37.6), as was sex trade with >30 sex partners (AOR = 4.5; 95% CI = 1.0, 20.7), when compared with women who reported no sex trade in the past year. Having a steady sex partner who injected drugs was protective (AOR = 0.24; 95% CI = 0.07, 0.80), and having injected drugs for >21 years was predictive (AOR = 8.1; 95% CI = 1.6, 40.0) of seroconversion.

CONCLUSIONS: HIV seroconversion among street-recruited injection drug users in San Francisco in 1986-1998 was primarily associated with sexual risk behaviors. Interventions with IDUs need to focus on the reduction of sexual risks.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Sex Behavior, Risk-Taking, Risk Factors, San Francisco, Cohort Studies, Logistic Models, Coitus, Case-Control Studies, United States, Human, Male, Female, transmission
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