HIV incidence among injection drug users in New York City, 1992-1997: evidence for a declining epidemic.
OBJECTIVE
We assessed recent (1992-1997) HIV incidence in the large HIV epidemic among injection drug users in New York City.


METHODS
Data were compiled from 10 separate studies (N = 4979), including 6 cohort studies, 2 "repeat service user" studies, and 2 analyses of voluntary HIV testing and counseling services within drug treatment programs.


RESULTS
In the 10 studies, 52 seroconversions were found in 6344 person-years at risk. The observed incidence rates among the 10 studies were all within a narrow range, from 0 per 100 person-years at risk to 2.96 per 100 person-years at risk. In 9 of the 10 studies, the observed incidence rate was less than 2 per 100 person-years at risk. The weighted average incidence rate was 0.7 per 100 person-years at risk.


CONCLUSIONS
The recent incidence rate in New York City is quite low for a high-seroprevalence population of injection drug users. The very large HIV epidemic among injection drug users in New York City appears to have entered a "declining phase," characterized by low incidence and declining prevalence. The data suggest that very large high-seroprevalence HIV epidemics may be "reversed."
Des Jarlais
D C
DC
Beth Israel Medical Center, New York, NY 10003, USA.
Marmor
M
M
Friedmann
P
P
Titus
S
S
Aviles
E
E
Deren
S
S
Torian
L
L
Glebatis
D
D
Murrill
C
C
Monterroso
E
E
Friedman
S R
SR
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D009519:New York City / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications*