title: Determinants of HIV seroconversion in injection drug users during a period of rising prevalence in Vancouver.
abstract: To identify determinants of HIV seroconversion among injection drug users (IDUs) during a period of rising prevalence, a case-control investigation was conducted. Cases were IDUs with a new positive test after 1 January 1994, and a negative test within the prior 18 months. Controls required 2 negative tests during the same period. Subjects completed a questionnaire on demographic, psychosocial, and behavioural factors. Eighty-nine cases and 192 controls were similar with respect to gender, age, ethnicity and inter-test interval. Multivariate analyses of events during the inter-test interval showed borrowing syringes (adj. OR = 2.96; P < 0.006), unstable housing (adj. OR = 2.01; P = 0.03) and injecting > or = 4 times daily (adj. OR = 1.71; P = 0.06) to be independently associated with seroconversion. Protective associations were demonstrated for sex with opposite gender (adj. OR = 0.36; P = 0.001) and tetrahydrocannabinol use (adj. OR = 0.41; P = 0.001). There is a need to evaluate programmes dealing with addiction, housing and the social underpinnings of risk behaviours in this population.
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: Patrick
authors.forename: S A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: C P
authors.initials: CP
authors.lastname: Archibald
authors.forename: M
authors.initials: M
authors.lastname: Ofner
authors.forename: K J
authors.initials: KJ
authors.lastname: Craib
authors.forename: P G
authors.initials: PG
authors.lastname: Cornelisse
authors.forename: M T
authors.initials: MT
authors.lastname: Schechter
authors.forename: M L
authors.initials: ML
authors.lastname: Rekart
authors.forename: M V
authors.initials: MV
authors.lastname: O'Shaughnessy
mesh_terms: D000328:Adult; D000367:Age Factors; D000932:Antiemetics / Q000627:therapeutic use; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D013759:Dronabinol / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000276:immunology*; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016485:Needle Sharing / Q000009:adverse effects; D015995:Prevalence; D012737:Sex Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000821:virology*
chemical_list: D000932:Antiemetics; D013759:Dronabinol