title: HIV drug resistance and HIV transmission risk behaviors among active injection drug users.
abstract: HIV(+) injection drug users in clinical care may harbor and transmit drug-resistant HIV. We performed a retrospective study of HIV drug resistance and risk behavior among HIV(+) injection drug users in care to determine the number of needle-sharing events that involved and the proportion of sharing partners exposed to drug-resistant HIV. Among 180 HIV injection drug users, 55 (31%) reported injecting drugs in the previous month, and 22 of these (40%) shared needles and/or works 148 times with 296 partners, of whom 271 (92%) were thought to be HIV(-) or status unknown. Further, 55 (31%) drug users harbored resistant HIV, including 5 (3% of total) who also shared needles and/or works a total of 27 times with 44 partners (18% of all sharing events and 15% of all exposed partners). A small proportion of injection drug users receiving clinical care engage in injection risk behavior and carry resistant HIV; however, because of multiple partners and needle-sharing events, they expose a substantial number of individuals to drug-resistant HIV. Strategies to reduce injection drug use risk behaviors among patients in clinical care are needed to reduce the transmission of sensitive and resistant HIV.
authors.affiliation: AIDS Program, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06510, USA. Michael.Kozal@yale.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kozal
authors.forename: K Rivet
authors.initials: KR
authors.lastname: Amico
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chiarella
authors.forename: Deborah
authors.initials: D
authors.lastname: Cornman
authors.forename: William
authors.initials: W
authors.lastname: Fisher
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fisher
authors.forename: Gerald
authors.initials: G
authors.lastname: Friedland
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious; D004351:Drug Resistance; D005260:Female; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000635:transmission* / Q000821:virology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects; D012189:Retrospective Studies; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous
chemical_list: D019380:Anti-HIV Agents