AEGiS-14IAC: Predictors of HIV transmission among street youth.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Predictors of HIV transmission among street youth.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1391)

Roy E, Haley N, Leclerc P, Cedras L, Boivin JF
Montreal Regional Public Health, McGill University, Montreal, Canada

BACKGROUND: To identify predictors of HIV seroconversion among Montreal street youth cohort participants.

METHODS: This analysis was restricted to participants who were HIV-negative at study entry, recruited between 01/1995 and 03/2000, and had completed at least one follow-up questionnaire by 09/2000. Predictors of HIV seroconversion were identified using Cox regression analysis. Two series of analysis were conducted: the first included only the youth's characteristics; the second also included the characteristics of the youth's sexual partners.

RESULTS: Among the 862 selected subjects (575 boys, 287 girls), 16 seroconversions were observed by 09/2000 for an HIV incidence rate of 0.69 per 100 person-years (95% CI: 0.39-1.12). Age at seroconversion ranged from 17 to 27 years. Eleven seroconverters were boys. Fifteen were born in Canada and one in Western Europe; none had ever received blood/blood products or medical treatments outside Canada. In univariate analysis, sex (p=0.91), age less than 19 years (p=0.44), and being a boy having had same sex partners in the past 6 months (p=0.41) were not associated with seroconversion. However, involvement in survival sex (Hazard Ratio=4.0; 95% CI: 1.4-11.1) and drug injection (HR=7.0; 95% CI: 2.2-21.7), both in the past 6 months, were significant predictors. In the first series of multivariate analyses, drug injection during the past 6 months was the only variable retained in the final model. In the second series of multivariate analyses (n=14 seroconversions due to missing data), drug injection during the past 6 months (adjusted HR=6.4; 95% CI: 1.8-23.6) and having had a male sexual partner involved in survival sex in the past 6 months (adjusted HR=4.9; 95% CI: 1.5-16.4) were independent predictors of HIV seroconversion.

CONCLUSIONS: Injection drug use is the strongest predictor of HIV seroconversion among Montreal street youth. Sexual transmission also appears to play a role in HIV seroconversion in this population.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Homeless Youth, Incidence, Substance-Related Disorders, Sexual Partners, Regression Analysis, Questionnaires, Canada, Europe, Male, Female, transmission

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ThOrC1391