AEGiS-08IAC: HIV infection and crack cocaine smoking in street-recruited urban youth, USA. The Multicenter Crack Cocaine and HIV Infection Study Team.

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

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HIV infection and crack cocaine smoking in street-recruited urban youth, USA. The Multicenter Crack Cocaine and HIV Infection Study Team.

Int Conf AIDS 1992 Jul 19-24; 8:We50 (abstract no. WeC 1028)
Edlin BR, Irwin KL, Ludwig DD, Serrano Y, Word C, McCoy C, Byers RH, Holmberg SD; CDC, Atlanta, Ga.

OBJECTIVE: Crack cocaine use is prevalent among youth in many U.S. urban neighborhoods. Preliminary reports suggest that crack smokers may be at high risk of acquiring HIV infection heterosexually. We undertook a study to determine the prevalence of HIV infection among crack smokers and their risk factors for infection.

METHODS: Current, regular crack smokers and nonsmokers aged 18-29 years in New York, Miami, and San Francisco were recruited by street outreach workers, interviewed, and tested for HIV and syphilis. We analyzed the 877/1089 (81%) enrolled thus far who had never injected drugs nor had male homosexual intercourse.

RESULTS: Of the 877, 52% were men; 84% were black; 11% were Hispanic. HIV seroprevalence was 17% among crack smokers and 6% among nonsmokers (78/457 vs. 26/420, relative risk [RR] = 2.8, 95% confidence interval [CI] = 1.8-4.2). In univariate analyses, HIV infection was also associated with female sex (68/419 [16%] vs. 36/458 [8%], RR = 2.1, CI = 1.4-3.0), older age (chi 2 trend p less than 0.02), city (New York, 58/295 [20%]; Miami, 43/331 [13%]; San Francisco, 3/251 [1%]), having greater than or equal to 100 lifetime sex partners (41/241 vs. 62/624, RR = 1.7, CI = 1.2-2.5), having ever received money or drugs for sex ("sex-trading") (57/230 vs. 47/644, RR = 3.4, Cl = 2.4-4.9), self-reported genital ulcer disease (GUD) (41/148 vs. 62/723, RR = 3.2, CI = 2.3-4.6), and positive syphilis serology (31/132 vs. 55/695, RR = 3.0, CI = 2.0-4.4). In a logistic regression model, only sex-trading (adjusted odds ratio [AOR] = 2.4, CI = 1.4-4.0), GUD (AOR = 2.3, CI = 1.3-4.0), and city (AORNY/SF = 15.3, CI = 4.7-50; AORMiami/SF = 8.1, CI = 2.4-28) were significantly associated with HIV infection; after adjusting for these factors, crack smokers were no more likely than nonsmokers to be HIV infected (AOR = 1.2, CI = 0.6-2.4).

CONCLUSIONS: Crack smokers who do not inject drugs or have male homosexual sex are nonetheless at high risk of acquiring HIV infection heterosexually. HIV prevention programs should target crack smokers in urban neighborhoods where crack use is common.

Keywords: AEGIS, Crack Cocaine, HIV Infections, HIV Seroprevalence, Smoking, Syphilis, Acquired Immunodeficiency Syndrome, Risk Factors, Cocaine-Related Disorders, Prevalence, Logistic Models, San Francisco, New York, United States, Human, Male, Female, ICA8KWDaegis,crackcocaine,hivinfections,hivseroprevalence,smoking,syphilis,acquiredimmunodeficiencysyndrome,riskfactors,cocaine-relateddisorders,prevalence,logisticmodels,sanfrancisco,newyork,unitedstates,human,male,female,ica8
920719
WeC1028

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.