Doherty MC, Garfein RS, Monterroso E, Brown D, Huang H, Park M, Vlahov D; International Conference on AIDS.

Int Conf AIDS. 1996 Jul 7-12; 11: 41 (abstract no. Mo.C.464).

Johns Hopkins SHPH, Baltimore, MD. Fax: 410-550-5385. E-mail: mdoherty@phnet.sph.jhu.edu.

Objective: To describe the events surrounding initiation of injecting drug use (IDU) and other risks of HIV infection, by age of initiation, in a cohort of short-term injectors. Methods: In Baltimore, 18-25 year old IDUs (N=218) recruited via street outreach, were interviewed regarding the circumstances of initiating IDU, the characteristics of persons present at initiation, and lifetime and current HIV-related injecting and sexual risks. Blood was assayed for antibodies to HIV. Data were analyzed using logistic regression methods. Results: IDUs who initiated at less than or equal to 19 years (N=103) compared to those at greater than 19 years (N=115) were more likely to be HIV+ (19% vs. 11%, p=.14), white (24% vs. 8%, p is less than.005) and have less than 12 years of education (69% vs. 53%, p is less than.05). At first injection, most were initiated by the same sex peers, but younger initiates (less than or equal to 19) were more likely to report a larger network (greater than or equal2 other people) at initiation (OR=2.1, 95% CI 1.2-3.9) and risky injecting behaviors such as: cocaine injection (OR=2.3, 95% CI 1.3-4.1), "shooting gallery" use (OR=2.2, 95% CI 1.2-3.8), "backloading" (OR=2.1, 95% CI 1.1-4.0) and being assisted in injecting by a person known to be (OR=3.6, 95% CI 1.1-16.7). Younger initiates also reported being assisted by greater than or equal2 different people before being able to inject on their own (OR=2.4, 95% CI 1.3-4.6). In terms of HIV-related sexual practices, younger initiates more often reported being bisexual/gay (OR=6.4, 95% CI 2.0-19.8), having anal intercourse (OR=3.7, 95% CI 1.8-7.7), a history of sexual assault (OR=1.8, 95% CI 1.0-3.3), and trading sex for money or drugs after starting to inject (OR=1.6, 95% CI 0.9-2.9). In a multivariate model, trading sex for money or drugs was associated with HIV prevalence among younger initiates (OR=3.1, 95% CI 1.1-9.3) when adjusting for cocaine injection and being bisexual/gay. In a model for the entire cohort, regardless of age of initiation, trading sex for money or drugs (OR=2.5, 95% CI 1.1-5.6), cocaine injection (OR=7.8, 95% CI 1.8-34.5), and being bisexual/gay (OR=3.2 95% CI, 1.1-9.4) were associated with HIV. Conclusions: Among short-term injectors, younger age of initiation was associated with more frequently reported risky drug use and sex practices, as well as, higher rates of HIV infection. Even though younger initiates practice risky injecting behaviors, risky sexual practices are more important for HIV infection in younger initiates; interventions should target these behaviors.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Aged
• Baltimore
• Bisexuality
• HIV Infections
• HIV Seropositivity
• Homosexuality, Male
• Humans
• Logistic Models
• Male
• Prevalence
• Substance Abuse, Intravenous
• Substance-Related Disorders

Other ID:

• 96921010

UI: 102216909

From Meeting Abstracts