The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60915

Susan G. Sherman, MPH, PhD¹, Sabrina Plitt, MPH², Marcella Sapun², Crystal Fuller, MPH, PhD³, and Steffanie Strathdee, PhD². (1) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6006, Baltimore, MD 21205, (410) 614-3518, ssherman@jhsph.edu, (2) Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, (3) Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th Street, 4th floor, Room 422, New York, NY 10032

Background: Initiates to injection drug use are at high risk of HIV infection, although data among non-injection drug users (NIDUs) are sparse. We studied correlates of HIV infection among young newly initiated injection drug users (IDUs) and NIDUs.

Methods: Participants were aged 15-30 and had first injected or used cocaine/crack or heroin by non-injectable means for less than 5 years. Participants underwent interviews about drug and sexual behaviors within the past 6 months and antibody testing for HIV, Herpes Simplex–2 virus (HSV-2), and Human Papillomavirus subtypes 16 and 18. HIV-infected and uninfected participants were compared using Chi-square, Mann-Whitney tests, and logistic regression.

Results: Of 578 participants: 73% were IDUs; 57% male; 40% African American; and the median age was 24. HIV prevalence was 4% and did not differ between IDUs and NIDUs (5% vs. 4%). HIV was more common among: those who those who were HPV16+ versus HPV16- (40.0% vs. 20.0%, p=0.05); HPV18+ versus HPV18- (52.4% vs. 23.1%, p<0.01); HSV-2+ versus HSV-2- (10% vs. 0.06%, p<0.01); and those who reported trading sex versus those who did not (10% vs. 4%, p=0.03). Controlling for age, gender, race, and IDU status, testing positive for HSV-2 was independently associated with being HIV+ (AOR=16.0, 95% CI: 3.3- 72.3).

Conclusions: Among our sample, HIV prevalence among young IDUs and non-IDUs was surprisingly identical. HIV+ participants had significantly higher rates of STIs, suggestive of sexual transmission. These data underscore the need to integrate HIV and STI prevention.

Learning Objectives:

• To learn correlates of HIV among young, newly initiated injection and noninjection drug users.
• To understand the relationship between HIV and sexually transmitted infections among young, newly initiated injection and noninjection drug users.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.