Prevalence and correlates of HIV infection among young injection drug users in San Francisco.
OBJECTIVE
We assessed the prevalence of HIV infection and associated risk behaviors among street-recruited young injection drug users (IDUs) in San Francisco.


METHODS
In a cross-sectional study, 304 young (age <30 years) IDUs with a history of injecting in the previous 30 days were interviewed and tested for antibodies to HIV. Analyses assessing independent associations with HIV infection were limited to males only, due to the low number of infections in women.


RESULTS
The prevalence of HIV infection was 5.3% overall but was highly stratified by gender and sexual preference (15.6% among homosexual/bisexual men vs. heterosexual men) and recruitment neighborhood (18% in the Polk Street area). Of 16 HIV infections, 14 (88%) were in males. Factors independently associated with HIV infection in males included sexual preference (homosexual/bisexual vs. heterosexual: adjusted odds ratio [AOR], 7.5; 95% confidence interval [CI], 1.5-36.6), recruitment neighborhood (Polk Street neighborhood vs. other neighborhoods: AOR, 4.8; 95% CI, 1.4-16.7), and duration of residence in San Francisco (>or=1 year vs. <1 year: AOR, 11.8; 95% CI, 1.4-95.8).


CONCLUSIONS
The prevalence of HIV infection was highest among male IDUs who have sex with men. The strong associations between HIV infection and sexual orientation and HIV infection and recruitment locale suggest that risk may be attributable largely to sexual risk. In addition to successful prevention efforts aimed at reducing needle-associated risk, current intervention models aimed at young IDUs should target high-risk neighborhoods and emphasize sexual risk reduction measures, in particular among men who have sex with men.
Shafer
Kimberly Page
KP
Center for AIDS Prevention Studies, Department of Medicine, University of California at San Francisco, 94105, USA. shafer@psg.ucsf.edu
Hahn
Judith A
JA
Lum
Paula J
PJ
Ochoa
Kristen
K
Graves
Alison
A
Moss
Andrew
A
D000293:Adolescent; D000328:Adult; D003376:Counseling; D003430:Cross-Sectional Studies; D003710:Demography; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D015995:Prevalence; D044469:Racial Groups; D012017:Referral and Consultation; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012727:Sex Characteristics; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications