Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities

Samuel R. Friedman, Benny Jose, Sherry Deren, Don C. Des Jarlais, Alan Neaigus

Research output: Contribution to journalArticle

Abstract

From 1988 to 1991, 6,882 drug injectors in 15 US cities were interviewed and had serum samples collected. The interviews and samples were analyzed for determination of significant predictors of human immunodeficiency virus (HIV) seroconversion in the 10 low seroprevalence cities and the five high seroprevalence cities. The unit of analysis was the period of observation between consecutive paired interviews/blood samples. In Cox proportional hazards regression, significant predictors of seroconversion in the low seroprevalence cities were: not being in drug treatment, injecting in outdoor settings or abandoned buildings, using crack cocaine weekly or more frequently, engaging in woman-to-woman sex, being of non-Latino race/ethnicity, and city seroprevalence. Predictors in high seroprevalence cities were: injecting with potentially infected syringes, not being in drug treatment, and having a sex partner who injected drugs. These findings suggest that HIV may be concentrated in sociobehavioral pockets of infection in low seroprevalence cities. For reducing HIV transmission, these results suggest: 1) in low seroprevalence cities, localized monitoring to detect specific emerging sociobehavioral pockets of infection, and quick implementation of appropriate targeted interventions if necessary; 2) in high seroprevalence cities, relatively more emphasis on locality-wide outreach and syringeexchange projects to reduce risky behavior; and 3) in both types of cities, considerable expansion of drug treatment programs.

Original languageEnglish (US)
Pages (from-to)864-874
Number of pages11
JournalAmerican Journal of Epidemiology
Volume142
Issue number8
StatePublished - Oct 15 1995

Fingerprint

Seroepidemiologic Studies
HIV
Pharmaceutical Preparations
Therapeutics
Seroconversion
Crack Cocaine
Interviews
Syringes
Infection
Observation
Demography

Keywords

  • Acquired immunodeficiency syndrome
  • HIV
  • Incidence
  • Intravenous.
  • Lesbianism
  • Risk factors
  • Sex behavior
  • Substance abuse,

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Epidemiology

Cite this

Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. / Friedman, Samuel R.; Jose, Benny; Deren, Sherry; Des Jarlais, Don C.; Neaigus, Alan.

In: American Journal of Epidemiology, Vol. 142, No. 8, 15.10.1995, p. 864-874.

Research output: Contribution to journalArticle

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