AEGiS-05CROI: The increasing impact of injecting drug use (IDU) on the AIDS epidemic, New York City (NYC), the first 100,000 AIDS cases.

5th Conference on Retroviruses and Opportunistic Infections


Chicago, IL - February 1-5, 1998



The increasing impact of injecting drug use (IDU) on the AIDS epidemic, New York City (NYC), the first 100,000 AIDS cases.

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:103 (abstract no. 128)

McFarland JW, Singh T, Vasquez F, Forlenza S; New York City Department of Health, Office of AIDS Surveillance (NYCDOH/OAS), New York, NY.

OBJECTIVE: To determine the proportion of AIDS cases where IDU contributed to infection, directly or through sex or birth, and describe trends over time.

METHODS: The first 100,000 AIDS cases in NYC collected using the CDC AIDS surveillance case definition were analyzed. An IDU associated case (IDU-A) is a case where the risk behavior was IDU or MSM/IDU, or heterosexual sex with an IDU, or birth from a mother with such a risk. Injecting drug using male sex partners of men is not recorded. No identified risk cases pending investigation were excluded.

RESULTS: IDU-A increased from 2,559 of 6,517 (39%) cases diagnosed before 1986, to 11,215 of 22,541 (50%) for 1986-89, 22,774 of 39,655 (57%) for 1990-93, and 14,776 of 25,385 (58%) for 1994-August 1997. IDU-A first became the most common risk in 1989. This increase is marked in cases directly attributable to IDU, from 30% before 1986, to 54% for 1994-97. IDU-A are more likely to be Black (OR=5.2; CI 5.0, 5.4) or Hispanic (OR=5.1, CI 4.8, 5.4) compared to Whites, and female (OR=3.5, CI 3.4, 3.7), but increases over time were greatest in Whites, increasing from 15% of cases before 1986 to 34% in 1994-97 (X2 trend, p less than .01), in males, increasing from 33% to 58% (X2 trends, p less than .01), and persons aged 40+ increasing from 27% to 67% (X2 trends, p less than .01). The highest rate of IDU-A is in perinatal cases (76%), but this is less than 2% of all cases.

CONCLUSION: IDU associated AIDS cases account for an ever increasing number and proportion of NYC AIDS cases. Through sexual networks, HIV infection via IDU spread outside the IDU needle sharing community, affecting minorities and women and their children the hardest. To reduce IDU-A HIV transmission, prevention strategies must attempt to stop unsafe drug use and sex by the drug user and increase awareness of the risk of sex with an IDU in non-drug users.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Disease Outbreaks, HIV Infections, Risk-Taking, Substance-Related Disorders, Sexual Partners, Disease Transmission, Vertical, Hispanic Americans, Centers for Disease Control and Prevention (U.S.), Blacks, Heterosexuality, New York City, Human, Female, Male, Child, transmission, AIDSKWDaegis,acquiredimmunodeficiencysyndrome,diseaseoutbreaks,hivinfections,risk-taking,substance-relateddisorders,sexualpartners,diseasetransmission,vertical,hispanicamericans,centersfordiseasecontrolandprevention(uKWDsKWD),blacks,heterosexuality,newyorkcity,human,female,male,child,transmission,aids

1998-02-01
128

Copyright © 1998 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.