Behavioral risk reduction in a declining HIV epidemic: injection drug users in New York City, 1990-1997.
OBJECTIVE
This study assessed trends in HIV risk behaviors among injection drug users in New York City from 1990 to 1997.


METHODS
Injection drug users were recruited continuously from a large drug detoxification treatment program (N = 2588) and a research storefront located in a high-drug-use area (N = 2701). Informed consent was obtained, and a trained interviewer administered a structured interview covering sociodemographics, drug use history, HIV risk behavior, and participation in syringe exchange.


RESULTS
Trends were assessed for 5 risk behaviors in the 6-month period before the interview. The 3 injection risk behaviors declined significantly over time at each site (all P < .01). When data were pooled across sites, all 5 risk behaviors declined significantly over time (all P < .01). Participation in syringe exchange programs and in HIV counseling and testing increased greatly from 1990 to 1997.


CONCLUSIONS
The continuing risk reduction among injection drug users indicates a "declining phase" in the large HIV epidemic in New York City. HIV prevention programs appear to be making an important contribution to the declining phase.
Des Jarlais
C
C
Beth Israel Medical Center, Chemical Dependency Institute, New York, NY 10003, USA. dcdesjarla@aol.com
Perlis
T
T
Friedman
S R
SR
Chapman
T
T
Kwok
J
J
Rockwell
R
R
Paone
D
D
Milliken
J
J
Monterroso
E
E
D000328:Adult; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D015528:HIV Seroprevalence; D006801:Humans; D016015:Logistic Models; D008297:Male; D016485:Needle Sharing / Q000639:trends*; D009519:New York City / Q000453:epidemiology; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000821:virology*