AEGiS-14IAC: Correlates of HIV Infection among Young New Initiates to Injection Drug Use in Baltimore, Maryland: 1994-2000.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Correlates of HIV Infection among Young New Initiates to Injection Drug Use in Baltimore, Maryland: 1994-2000.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1393)

Strathdee SA, Safaeian M, Doherty M, Garfein RS, Fuller CM, Sherman SG, Ompad DC, Vlahov D
Johns Hopkins University, Baltimore, United States

BACKGROUND: Few studies have examined correlates of HIV infection among young, newly initiated injection drug users (IDUs). Existing studies have been limited by low study power. We identified correlates of HIV infection among three study waves of young IDUs in Baltimore, USA.

METHODS: IDUs aged 18-29 who had first injected < 5 years prior were studied in 3 consecutive waves from 1994-2000 using similar recruitment strategies and interviewer-administered surveys. Logistic regression was used to identify correlates of HIV infection overall, stratified by gender, adjusting for calendar time and including repeaters once only.

RESULTS: Of 676 IDUs, 49% were male; 54% were African American. Median age and age at first injection were 24 and 21, respectively. HIV prevalence was 9% and higher among females vs males (12% vs 6%, p=0.01), African Americans vs others (14% vs 4%, p<0.001) and MSM vs non-MSM (12% vs 1%). IDUs who transitioned from non-injection to injection within 12 months were more likely to be HIV+ than those with longer durations (20% vs. 10%, p=0.02). Overall, correlates independently associated with HIV infection included being: female (AdjOR=2.5; 95% CI: 1.3-4.9), >25 years old (AdjOR=2.0), ever having an STD (AdjOR=2.8; 95% CI: 1.5-5.3), having transitioned from non-injection to injection within 12 months (AdjOR= 1.9; 95% CI: 0.9-4.1), ever injecting cocaine/speedballs (AdjOR=2.2) and identifying as MSM (AdjOR=19.9). Among males, additional risk factors were being African American (AdjOR= 12.9) and needle sharing (AdjOR=9.8). Among females, having an HIV+ steady sex partner was also associated with HIV infection (AdjOR=10.2).

CONCLUSIONS: Young, recent onset IDUs especially vulnerable to HIV through parenteral and sexual transmission include women, MSM and African Americans. Interventions to reduce sexual and parenteral transmission risks among young IDUs and discourage transition from non-injection to injection are urgently needed.

Keywords: AEGIS, HIV Infections, Needle Sharing, Prevalence, Baltimore, Substance-Related Disorders, Risk Factors, Maryland, Sexual Partners, Injections, HIV Seropositivity, Logistic Models, Interviews, Human, Female, Male

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