Convergence of HIV seroprevalence among injecting and non-injecting drug users in New York City.
OBJECTIVE
To compare HIV prevalence among injecting and non-injecting heroin and cocaine users in New York City. As HIV is efficiently transmitted through the sharing of drug-injecting equipment, HIV infection has historically been higher among injecting drug users.


METHODS
Two separate cross-sectional surveys, both with HIV counseling and testing and drug use and HIV risk behavior questionnaires.


METHODS
Injecting and non-injecting heroin and cocaine users recruited at detoxification and methadone maintenance treatment from 2001-2004 (n = 2121) and recruited through respondent-driven sampling from a research storefront in 2004 (n = 448).


RESULTS
In both studies, HIV prevalence was nearly identical among current injectors (injected in the last 6 months) and heroin and cocaine users who had never injected: 13% [95% confidence interval (CI), 12-15%] among current injectors and 12% (95% CI, 9-16%) among never-injectors in the drug treatment program study, and 15% (95% CI, 11-19%) among current injectors and 17% (95% CI, 12-21%) among never injectors in the respondent driven sampling storefront study. The 95% CIs overlapped in all gender and race/ethnicity subgroup comparisons of HIV prevalence in both studies.


CONCLUSIONS
The very large HIV epidemic among drug users in New York City appears to be entering a new phase, in which sexual transmission is of increasing importance. Additional prevention programs are needed to address this transition.
Des Jarlais
Don C
DC
Beth Israel Medical Center, New York, New York 10038, USA. dcdesjarla@aol.com
Arasteh
Kamyar
K
Perlis
Theresa
T
Hagan
Holly
H
Abdul-Quader
Abu
A
Heckathorn
Douglas D
DD
McKnight
Courtney
C
Bramson
Heidi
H
Nemeth
Chris
C
Torian
Lucia V
LV
Friedman
Samuel R
SR
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D015528:HIV Seroprevalence; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology