Jose B, Friedman SR, Neaigus A, Curtis R, Des Jarlais DC; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: Th76 (abstract no. ThC 1551).
Narcotic and Drug Research, Inc., NY, NY.
OBJECTIVE: To assess the extent to which 'frontloading' is associated with exposure to HIV among injecting drug users (IDUs). 'Frontloading' is a drug sharing practice in which an injector's syringe is used to measure drugs and to give a 'fair share' to another injector by 'spouting' the drug into another's syringe. METHODS: Since August 1991, 214 street recruited IDUs were interviewed about their drug and sex behaviors during the previous 30 days and previous 2 years; 199 were tested for the HIV antibody (48% +). (Sample: Blacks 23%, Latinos 38%, Whites 36%, others 3%; males 71%; median age 34). Subjects were asked about the frequency with which they shared drugs via 'frontloading' and shared used syringes. All reported relationships are significant at p less than .01 (chi-square test, multiple logistic regression). RESULTS: (1) Frontloading is widespread: During the prior 2 years, 39% (80/207) of subjects frontloaded, as did 30% (63/210) during the past 30 days. Of those who report never sharing syringes in the prior 2 years, 22% (24/110) frontloaded, as did 18% (23/129) of those who say they did not share in the last 30 days. (2) Frontloading is associated with HIV infection: HIV seroprevalence is higher among IDUs who frontloaded during the past 2 years than among those who did not (71% vs. 36%). This relationship holds true for subsets of IDUs who had: a) injected less than or equal to 7 years (83% vs. 19%), b) injected greater than 7 years (69% vs. 41%), c) ever shared syringes in the prior 2 years (66% vs. 41%), and d) never shared syringes in the prior 2 years (84% vs. 33%). In multivariate stepwise logistic regression with other correlates of HIV seropositivity (race/ethnicity, years of injection, injection frequency, shooting gallery use, needle sharing, number of sex partners, frequency of unprotected sex), engaging in frontloading in the last 2 years remained significant as an independent predictor of HIV seropositivity (odds ratio 3.74). CONCLUSIONS: Grund et al., in 1990, first reported the practice of frontloading to be widespread among IDUs in Rotterdam. Among a sample of IDUs in Baltimore, in 1991, Samuels et al. found no significant association of this practice with HIV infection. Our results from New York City suggest that frontloading can be an important route of viral transmission which may have been overlooked by most researchers as well as by IDUs who otherwise avoid syringe sharing and/or other risk practices. Prevention campaigns should include information on the risks of frontloading, and research instruments should attempt to measure this behavior.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Baltimore
- HIV Infections
- HIV Seropositivity
- HIV Seroprevalence
- Hispanic Americans
- Humans
- Male
- Needle Sharing
- New York City
- Sexual Behavior
- Substance Abuse, Intravenous
- Syringes
- Unsafe Sex
Other ID:
UI: 102197840
From Meeting Abstracts