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

Abstract #64148

Sherry Deren, PhD¹, Sung-Yeon Kang, PhD², Héctor M. Colón, PhD³, Jonny F. Andia, PhD², and Rafaela R. Robles, EdD³. (1) National Development and Research Institutes, Inc., 71 West 23 Street, 8 Floor, New York, NY 10010, 212-845-4463, Deren@NDRI.org, (2) Center for Drug Use and HIV Research, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, (3) Center for Addiction Studies, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032

BACKGROUND: While reductions in HIV seroprevalence among Puerto Rican drug users in Puerto Rico (PR) and in New York City (NYC) were reported in the 1990s, higher risk behaviors in PR indicate the need to compare seroincidence, a better measure of prevention needs. METHODS: Puerto Rican injection drug users (IDUs) and crack smokers were recruited in East Harlem, NYC and Bayamon, PR, through targeted sampling. A total of 899 seronegative participants were interviewed and tested for HIV during 1998-99; follow-up interviewing and testing are underway, conducted at approximately 6, 36 and 42 months after baseline; thus far 79% in NYC ( N=455); and 84% in PR (N=268) received at least one follow-up test. RESULTS: A total of 32 seroconverters (SCs) were identified, 9 in NYC and 23 in PR, for incidence rates of .88/100pyr in NYC (95%CI= .31-1.45) and 3.37/100pyr in PR (95%CI=2.02-4.72) (p<.001). Those most likely to seroconvert were younger (SCs, 31.9 vs non-SCs, 36.3, p<.01) and were less likely to have ever been in methadone treatment (MT) (SCs, 10%; non-SCs, 58%, p<.001). IDUs who were most at risk to seroconvert injected more frequently (SCs, 204/mo; non-SCs, 116/mo, p<.001), and were more likely to use shooting galleries (83% vs 42%, p<.001). MT and access to sterile syringes were less available in PR, where risk behaviors were higher. CONCLUSIONS: The alarmingly high incidence rate in Puerto Rico indicates that additional efforts to reduce risk are urgently needed, and should include expanding availability of methadone treatment and tools for risk reduction.

Learning Objectives:

At the conclusion of this session, the participant will be able to:
• Describe the difference in seroincidence between the two communities
• Identify factors related to seroincidence
• Articulate possible interventions to reduce seroincidence

Keywords: HIV/AIDS, Drug Injectors

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.