Abstract
Six hundred and one injection drug users (IDUs) who attended drug treatment programs in Miami, Florida, were enrolled in a panel study to determine the prevalence and incidence of human immunodeficiency virus (HIV) and associated risk factors. A structured questionnaire which elicited injection and sexual behaviors was administered and blood was obtained by venipduncture. All participants were reassessed at six month intervals for 5 years. The baseline prevalence of HIV was 16.3%. African–Americans had a prevalence of HIV (37.1%) that was significantly higher than that of non-Hispanic whites (7.6%); the prevalence of HIV among Hispanics was 27.2%. Persons who were more than thirty years of age were more likely to test HIV positive (17.8%) than were younger participants (9.7%). The annual incidence per 1000 person-years of exposure for the 503 initially seronegative participants was consistently low for each year of the study. The 5 year incidence was 4.1 per 1000 person years; 7.5 for men and 1.7 for women, 7.5 for African–Americans and 3.8 for non-Hispanic whites. No Hispanic participants seroconverted. Multivariate logistic techniques were used to identify the independent risk factors for HIV prevalence. Earlier injection, ethnicity, and income were independently associated with HIV serostatus. A history of a sexually transmitted disease was marginally associated with HIV prevalence. Low incidence probably is a function of the reduction of risk behavior that occurred over the course of the study and the stage of the epidemic.
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Abdul-Quadar, A. S., Friedman, S. R., Des Jarlais, D. et al. (1987). Methadone maintenance and behavior by intravenous drug users that can transmit HIV, Contemp. Drug. Prob. 11: 425–434.
Anthony, J. C., Vlahov, D., Nelson, K. E., Cohn, S., Astemborski, J. & Solomon, L. (1991). New evidence on intravenous cocaine use and the risk of infection with human immunodeficiency virus type 1, Am. J. Epidemiol. 134: 1175–1189.
Ball, J. C., Lange, W. R., Myers, C. P. & Friedman, S. R. (1988). Reducing the risk of AIDS through methadone maintenance treatment, J. Health Soc. Behav. 29: 214–226.
Blaxhult, A., Janzon, R., Bottiger, M., Annell, A., Gabrielsson, G., Rantala, J. & Weiderman, A. (1992). A six year follow-up of HIV seroprevalence among 300 intravenous drug users in Stockholm, Scand. J. Infect. Dis. 24: 715–723.
Calsyn, D. A., Saxon, A. J., Freeman, G., Jr. & Whittaker, S. (1992). Ineffectiveness of AIDS education and HIV antibody testing in reducing high-risk behaviors among injection drug users, Am. J. Public Health 82: 573–575.
CDC (1986). Morbidity and Mortality Weekly Report 35: 17–21.
CDC (1997). HIV/AIDS Surveillance Report, HIV/AIDS 9(1) (mid-year edition).
Chaisson, R. E., Moss, A. R., Onishi, R., Osmond, D. & Carlson, J. (1987). Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco, Am. J. Public Health 77: 169–172.
Chaisson, R. E., Bacchetti, P., Osmond, D., Brodie, B., Sande, M. A. & Moss, A. R. (1989). Cocaine use and HIV infection in intravenous drug users in San Francisco, JAMA 261: 561–565.
Chamot, E., Hirschel, B., Deglon, J. J. & Perrin, L. H. (1992). Incidence of hepatitis C, hepatitis B and HIV infections among drug users in a methadone-maintenance programme, AIDS 6; 430–431.
Chitwood, D. D. & Comerford, M. (1990). Drugs, sex, and AIDS risk, Am. Behavioral Scientist 33: 465–477.
Chitwood, D. D., Comerford, M. & Weatherby, M. L. (1998). The initiation of the use of heroin in the age of crack, pp. 51–76, in: J. A. Inciardi & L. D. Harrison (eds.), Heroin in the Age of Crack Cocaine. Thousand Oaks, CA: Sage Publications.
Chitwood, D. D., Inciardi, J. A., McBride, D. C., McCoy, E. B., McCoy, H. V. & Trapido, E. A. (1991). A Community Approach to AIDS Intervention. New York: Greenwood Press.
Chitwood, D. D., Rivers, J. R., Comerford, M. & McBride, D. C. (1993). A comparison of HIV related risk behaviors of street recruited and treatment program injection drug users, Drugs & Society 7: 53–64.
D'Aquila, R. T., Peterson, L. R., Williams, A. B. and Williams, A. E. (1989). Race/ethnicity as a risk factor for HIV-1 infection among Connecticut intravenous drug users, J. AIDS 2: 503–513.
Des Jarlais, D. C., Friedman, S. R. & Stoneburner, R. L. (1988). HIV infection and intravenous drug use: critical issues in transmission dynamics, infection outcomes, and prevention, Rev. Infec. Dis. 10: 151–158.
Friedland, G. H. & Klein, R. S. (1987). Transmission of the human immunodeficiency virus, N. Engl. J. Med. 317: 1125–1135.
Gerstein, D. R. & Harwood, H. J., eds. (1990). Treating drug problems: a study of the evolution, effectiveness, and financing of public and private drug treatment systems, Vol. 1. Washington, DC: Institute of Medicine.
Gibson, D. R., Wermuth, L., Lovelle-Drache, J., Ham, J., & Sorensen, J. L. (1989). Brief counseling to reduce AIDS risk in intravenous drug users and their sexual partners: preliminary results, Counselling Psychology Quarterly 2: 15–19.
Griffin, D. K., Chitwood, D. D. & Comerford, M. (1994). Changes in HIV risk behaviors in a cohort of injecting drug users over a four-year period. Paper presented at the Association for Behavior Analysis, Atlanta GA, May 27–May 30, 1994(Abstract).
Hubbard, R. L., Marsden, M. E., Cavanaugh, E. et al. (1988). Role of drug abuse treatment in limiting the spread of AIDS, Rev. Infect. Dis. 10: 377–384.
Marmor, M., Des Jarlais, D. C., Cohen, H., Friedman, S. R., Beatrice, S. T., El-Sadr, W., Mildvan, D., Yancovitz, S., Mathur, U. & Holtzman, R. (1987). Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City, AIDS 1: 39–44.
Mascola, L., Lieb, L., Iwakoshi, K. A., McAllister, D., Siminowski, T., Giles, M., Run, G., Fannin, S. L. & Strantz, I. H. (1989). HIV seroprevalence in intraveous drug users: Los Angeles, California, 1986, Am. J. Public Health 79: 81–82.
McCoy, C. B., Rivers, J. E. & Chitwood, D. D. (1993), Community outreach for injection drug users, pp. 190–202, in: F. Timms & C. G. Leukefeld (eds.), Advances in Cocaine Treatment. NIDA Research Monograph 135. Washington, DC: US Govt. Printing Office.
Metzger, D. S., Woody, G. E., DePhilippis, D., McLellan, A. T., O'Brien, C. P., & Platt, J. J. (1993). Human immunodeficiency.
Nicolosi, A., Leite, M. L. C., Molinari, S., Musicco, M., Saracco, A. & Lazzarin, A. (1992). Incidence and prevalence trends of HIV infection in intravenous drug users attending treatment centers in Milan and Northern Italy, 1986–1990, J. AIDS 5: 365–373.
Schlesselman, J. J. (1982). Case Control Studies.New York: Oxford University Press.
Schoenbaum, E. E., Hartel, D., Selwyn, P. A., Klein, R. S., Davenny, K., Rogers, M., Feiner, C. & Freidland, G. (1989). Risk factors for human immunodeficiency virus infection in intravenous drug users, N. Engl. J. Med. 321: 874–879.
Siddiqui, S. S., Brown, L. S., Jr., Meyer, T. J. & Gonzalez, V. (1993). Decline in HIV-1 seroprevalence and low seroconversion rate among injecting drug users at a methadone maintenance program in New York City, Journal of Psychoactive Drugs 25: 245–250.
Stephens, R. C., Simpson, D. D., Coyle, S. L., McCoy, C. B. & National AIDS Research Consortium (1993). Comparative effectiveness of NADR interventions, pp. 519–556, in: B. S. Brown & G. M. Beschner (eds.), Handbook on Risk of AIDS: Injection Drug Users and Sexual Partners. New York: Greenwood Press.
van Ameijden, E. J. C., van den Hoek, J. A. R., van Haastrecht, H. J. A. & Coutinho, R. A. (1992). The harm reduction approach and risk factors for human immunodeficiency virus (HIV) seroconversion in injecting drug users, Amsterdam, Am. J. Epidemiol. 136: 236–243.
Vlahav, D. (1994). HIV seroconversion studies among intravenous drug users, AIDS 8: 263.
Vlahov, D., Munoz, A., Anthony, J. C., Cohn, S., Celentano, D. D. & Nelson, K. E. (1990), Association of drug injection patterns with antibody to human immmunodeficiency virus type 1 among intravenous drug users in Baltimore, Maryland, Am. J. Epidemiol. 132: 847–856.
Wiebel, W. W., Jimenez, A., Johnson, W. & Ouellet, L. (1996). Risk behavior and HIV seroincidence among out-of-treatment injection drug users: a four-year prospective study, J. AIDS 12: 282–289.
Worm, A. M. & Gottschau, A. (1993). No change in incidence and prevalence of HIV among intravenous drug users in Copenhagen from 1985 to 1990, J. AIDS 6: 845–848.
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Chitwood, D.D., McCoy, C.B., Comerford, M. et al. The prevalence and incidence of HIV among injection drug users: A five year panel study. Population Research and Policy Review 18, 39–53 (1999). https://doi.org/10.1023/A:1006148711071
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DOI: https://doi.org/10.1023/A:1006148711071