Young adult injection drug users in the United States continue to practice HIV risk behaviors

Drug Alcohol Depend. 2009 Sep 1;104(1-2):167-74. doi: 10.1016/j.drugalcdep.2009.05.013. Epub 2009 Jun 25.

Abstract

Background: Injection drug users (IDUs) are at risk of acquiring HIV through injection and sexual practices.

Methods: We analyzed data collected in five U.S. cities between 2002 and 2004 to identify correlates of HIV infection among 3285 IDUs ages 15-30 years.

Results: Overall, HIV prevalence was 2.8% (95% CI 2.3-3.4), ranging from 0.8% in Chicago to 6.3% in Los Angeles. Mean age was 24 years, 70% were male, 64% non-Hispanic (NH) white, 7% NH black, 17% Hispanic, and 12% were other/mixed race. HIV infection was independently associated with: race/ethnicity (NH black [AOR 4.1, 95% CI 1.9-9.1], Hispanic [AOR 3.6, 95% CI 1.5-8.4], or other/mixed [AOR 2.3, 95% CI 1.1-5.2] vs. NH white); males who only had sex with males compared to males who only had sex with females (AOR 15.3, 95% CI 6.8-34.5); injecting methamphetamine alone or with heroin compared to heroin only (AOR 4.0, 95% CI 1.7-9.7); reporting inconsistent means of obtaining income compared to regular jobs (AOR 2.3, 95% CI 1.1-4.8); and having a history of exchanging sex for money/drugs (AOR 2.8, 95% CI 1.5-5.2).

Conclusions: More than two decades after injection and sexual practices were identified as risk factors for HIV infection, these behaviors remain common among young IDUs. While racial/ethnic disparities persist, methamphetamine may be replacing cocaine as the drug most associated with HIV seropositivity. HIV prevention interventions targeting young IDUs and address both sexual and injection practices are needed.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / psychology
  • Cocaine-Related Disorders / epidemiology
  • Crime / statistics & numerical data
  • Cross-Sectional Studies
  • Education
  • Ethnic Groups
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / psychology*
  • Heroin Dependence / epidemiology
  • Housing
  • Humans
  • Income
  • Male
  • Methamphetamine
  • Patient Selection
  • Risk-Taking*
  • Socioeconomic Factors
  • Substance Abuse, Intravenous / epidemiology*
  • Substance Abuse, Intravenous / psychology*
  • United States / epidemiology
  • Unsafe Sex*
  • Urban Population
  • Young Adult

Substances

  • Methamphetamine