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M9490151.TXT
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1994-09-03
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Document 0151
DOCN M9490151
TI HIV seroconversion in intravenous drug users in San Francisco, 1985-1990
[see comments]
DT 9411
AU Moss AR; Vranizan K; Gorter R; Bacchetti P; Watters J; Osmond D;
Department of Epidemiology and Biostatistics, University of; California,
San Francisco.
SO AIDS. 1994 Feb;8(2):223-31. Unique Identifier : AIDSLINE MED/94318206
CM Comment in: AIDS 1994 Feb;8(2):263-5
AB OBJECTIVE: To examine the HIV seroconversion rate, risk factors for
seroconversion, and changes in risk behavior over time in intravenous
drug users (IVDU) in San Francisco, 1985-1990. DESIGN: Observational
study. SETTING: All methadone maintenance and 21-day methadone
detoxification programs in San Francisco. PARTICIPANTS: A total of 2351
heterosexual IVDU, of whom 681 were seronegative at first visit and seen
at least twice ('repeaters'). MAIN OUTCOME MEASURES: HIV seroconversion
rates, risk factors for seroconversion, and changes in behavior.
RESULTS: The HIV seroconversion rate in repeaters was 1.9% per
person-year (ppy) of follow-up [2.1% in women versus 1.7% in men (not
significant); 4% in African Americans versus 1% in whites (P = 0.006);
3.9% ppy in the first third of the study, 1.2% in the second (P =
0.007), and 1.9% in the last (not significant)]. Risk factors for
seroconversion were five or more sexual partners per year [hazard ratio
(HR) = 2.6; P = 0.02], use of shooting gallery ever (HR = 2.9; P =
0.02), and less than 1 year (lifetime) in methadone maintenance (HR =
2.7; P = 0.02). Self-reported intravenous cocaine use fell from 33 to
15% over 5 years, shooting gallery use fell from 19 to 6%, and the
proportion with five or more sexual partners fell from 25 to 10%. Bleach
use rose to 75% of needle-sharers. CONCLUSIONS: The 1985-1990 HIV
seroconversion rate in IVDU (1.9% ppy) was comparable to that in San
Francisco cohorts of homosexual men (1.4% ppy). A decline in HIV
seroconversion coincided with changes in risk behavior. Stable
attendance of methadone maintenance was highly protective: the
seroconversion rate in subjects with 1 year or more in methadone was 12%
ppy.
DE Adult Amphetamines Bias (Epidemiology) Cocaine/ADMINISTRATION &
DOSAGE Cohort Studies Comorbidity Disinfection Equipment
Contamination Ethnic Groups Female Heroin
Dependence/EPIDEMIOLOGY/REHABILITATION Human HIV Infections/PREVENTION
& CONTROL/TRANSMISSION HIV Seropositivity/*EPIDEMIOLOGY HIV
Seroprevalence/TRENDS Injections, Intravenous/ADVERSE EFFECTS Male
Needle Sharing Risk Factors San Francisco/EPIDEMIOLOGY Sex
Behavior/STATISTICS & NUMER DATA Sexual Partners Sodium Hypochlorite
Substance Abuse Treatment Centers Substance Abuse,
Intravenous/*EPIDEMIOLOGY Substance Dependence/EPIDEMIOLOGY Support,
Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Urban Population JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).