Risk correlates of prevalent HIV, hepatitis B virus, and hepatitis C virus infections among noninjecting heroin users.
OBJECTIVE
To examine lifetime correlates of HIV and hepatitis B and C (HBV and HCV) infections among noninjecting heroin users (NIUs).


METHODS
Between March 1996 and March 2001, 483 eligible NIUs were tested for HIV, HBV, and HCV antibodies and administered structured interviews. Multivariate logistic regression analyses were stratified by injecting history.


RESULTS
Among never-injectors (69.8%), significant (p <.05) correlates were unprotected sex with men who have sex with men (HIV and HBV), unprotected sex with NIUs (HIV), self-reported syphilis infection (HBV), longer duration of heroin use (HBV and HCV), shorter duration of cocaine use (HIV), blood transfusion before 1986 (HIV), and having been tattooed (HCV). Among former injectors (30.2%), significant correlates were receptive syringe sharing (HIV and HBV), frequent lifetime injection (HCV), longer duration of sexual activity (HBV), and having been tattooed (HCV).


CONCLUSIONS
Never-injectors infected with HIV and HBV appear to have become infected mainly through sexual transmission, whereas former injectors appear to have become infected with HIV and HCV mainly though injecting risk and with HBV through both injecting and sexual risk. Interventions targeted at NIUs should prevent unsafe sex as well as the initiation or resumption of injecting. In addition, unhygienic tattooing, which may lead to HCV exposure, should be a focus of prevention efforts.
Gyarmathy
V Anna
VA
National Development and Research Institutes, Inc., New York City, New York 10010, USA. gyarmathy@ndri.org
Neaigus
Alan
A
Miller
Maureen
M
Friedman
Samuel R
SR
Des Jarlais
Don C
DC
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications; D013587:Syphilis / Q000150:complications