The 131st Annual Meeting (November 15-19, 2003) of APHA |
Don C. Des Jarlais, PhD1, Theresa E. Perlis, PhD2, Kaymar Arasteh, PhD2, Holly Hagan, PhD3, Carey Maslow, PhD4, Judith Milliken1, Naomi Braine, PhD1, Alan Neaigus, PhD5, and Samuel R. Friedman, PhD5. (1) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003, 212-387-3803, dcdesjarla@aol.com, (2) National Development and Research Institutes, Inc, Two World Trade Center, 16th floor, New York, NY 10048, (3) NDRI, 71 West 23rd, 8th floor, New York, NY 10010, (4) National Development and Research Institutes, Inc. (NDRI), 2 World Trade Center, 16th Floor, New York, NY 10048, (5) Center for Drug Use and HIV Research, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York City, NY 10010
Objective: To assess trends in HIV infection among new initiates to injecting drug use in New York City.
Methods: Serial cross-sectional surveys of new drug injectors (persons who began injecting illicit drugs within the previous five years) entering treatment from 1990 to 2001 at the Beth Israel Medical Center drug detoxification program (n = 612), and from 1996 to 2001 at the Beth Israel methadone maintenance program (n = 291). Serum samples for HIV testing were obtained and a trained interviewer administered a structured interview on drug use and HIV risk behavior. Data from long-term injectors (persons injecting five years or longer) were also available for comparison.
Results: HIV prevalence decreased over time among new injectors—from an average of 18% among new injectors recruited between 1990-92 to an average of 5% among new injectors recruited from 1997-2001. There were two areas of increasing differences by race/ethnic group. The proportion of African-Americans was substantially lower among the new injectors, 12% among detoxification subjects and 8% among methadone subjects, compared to 32% and 23% among the long-term injectors at the two programs. HIV prevalence was substantially higher among African-American new injectors, 20% among detoxification subjects and 22% among methadone subjects than among White new injectors, 3% among detoxification subjects and 2% among methadone subjects. (All p < .01 by chi square tests.) HIV prevalence among Hispanic new injectors was intermediate between African-Americans and Whites.
Conclusions: Within a context of an overall reduced HIV infection level among new injectors, there is substantial divergence among race/ethnic groups. HIV prevention programs need to be adapted to this emerging divergence.
Learning Objectives:
Keywords: HIV/AIDS, Injection 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.