HIV seroconversion in intravenous drug users in San Francisco, 1985-1990 [see comments] NLM AIDSLINE Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

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HIV seroconversion in intravenous drug users in San Francisco, 1985-1990 [see comments]

AIDS. 1994 Feb;8(2):223-31. Unique Identifier : AIDSLINE MED/94318206
Moss AR; Vranizan K; Gorter R; Bacchetti P; Watters J; Osmond D; Department of Epidemiology and Biostatistics, University of; California, San Francisco.

Abstract: OBJECTIVE: To examine the HIV seroconversion rate, risk factors for seroconversion, and changes in risk behavior over time in intravenous drug users (IVDU) in San Francisco, 1985-1990. DESIGN: Observational study. SETTING: All methadone maintenance and 21-day methadone detoxification programs in San Francisco. PARTICIPANTS: A total of 2351 heterosexual IVDU, of whom 681 were seronegative at first visit and seen at least twice ('repeaters'). MAIN OUTCOME MEASURES: HIV seroconversion rates, risk factors for seroconversion, and changes in behavior. RESULTS: The HIV seroconversion rate in repeaters was 1.9% per person-year (ppy) of follow-up [2.1% in women versus 1.7% in men (not significant); 4% in African Americans versus 1% in whites (P = 0.006); 3.9% ppy in the first third of the study, 1.2% in the second (P = 0.007), and 1.9% in the last (not significant)]. Risk factors for seroconversion were five or more sexual partners per year [hazard ratio (HR) = 2.6; P = 0.02], use of shooting gallery ever (HR = 2.9; P = 0.02), and less than 1 year (lifetime) in methadone maintenance (HR = 2.7; P = 0.02). Self-reported intravenous cocaine use fell from 33 to 15% over 5 years, shooting gallery use fell from 19 to 6%, and the proportion with five or more sexual partners fell from 25 to 10%. Bleach use rose to 75% of needle-sharers. CONCLUSIONS: The 1985-1990 HIV seroconversion rate in IVDU (1.9% ppy) was comparable to that in San Francisco cohorts of homosexual men (1.4% ppy). A decline in HIV seroconversion coincided with changes in risk behavior. Stable attendance of methadone maintenance was highly protective: the seroconversion rate in subjects with 1 year or more in methadone was 12% ppy.
Keywords: Adult Amphetamines Bias (Epidemiology) Cocaine/ADMINISTRATION & DOSAGE Cohort Studies Comorbidity Disinfection Equipment Contamination Ethnic Groups Female Heroin Dependence/EPIDEMIOLOGY/REHABILITATION Human HIV Infections/PREVENTION & CONTROL/TRANSMISSION HIV Seropositivity/*EPIDEMIOLOGY HIV Seroprevalence/TRENDS Injections, Intravenous/ADVERSE EFFECTS Male Needle Sharing Risk Factors San Francisco/EPIDEMIOLOGY Sex Behavior/STATISTICS & NUMER DATA Sexual Partners Sodium Hypochlorite Substance Abuse Treatment Centers Substance Abuse, Intravenous/*EPIDEMIOLOGY Substance Dependence/EPIDEMIOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Urban Population JOURNAL ARTICLE


Comment in: AIDS 1994 Feb;8(2):263-5 Comment in: AIDS 1994 Nov;8(11):1629-30
941130
M94B0771

Copyright © 1994 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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