title: Sexual and other noninjection risks for HBV and HCV seroconversions among noninjecting heroin users.
abstract: BACKGROUND
  Many heroin users do not inject drugs but may still be at risk of infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), via sexual or other noninjection-related activity.
  
  
  METHODS
  Noninjecting heroin users (NIUs) in New York City who were recruited and prospectively followed during March 1996-February 2003 were tested for anti-HIV, anti-hepatitis B core antigen, and anti-HCV and were interviewed about their sexual and other noninjecting risk. A seroconversion is represented by the first positive test result after the last negative test result. Hazard ratios (HRs) (P<.05) were estimated by use of Cox proportional hazards regression.
  
  
  RESULTS
  Of 253 HIV-negative participants, 2 seroconverted (0.29/100 person-years at risk [pyar]); of 184 HBV-negative participants, 16 (3.3/100 pyar); and, of 219 HCV-negative participants, 16 (2.7/100 pyar). Independent predictors of seroconversion were, for HBV, being a female who engages in unprotected receptive anal sex (HR, 6.8), having short-term sex partners (HR, 6.2), and being a male with male sex partners (HR, 5.7); for HCV, being a male who receives money/drugs for sex (HR, 5.6) and sharing noninjecting crack-use equipment (HR, 4.5).
  
  
  CONCLUSIONS
  NIUs are at considerable risk of HBV infection via high-risk sex; and, for HCV, via high-risk sexual activity and the sharing of noninjecting crack-use equipment. Interventions in NIUs must seek to reduce high-risk sexual activity and the sharing of noninjecting drug-use equipment.
authors.affiliation: Institute for International Research on Youth at Risk, National Development and Research Institutes, Inc., New York, NY 10010, USA. neaigus@ndri.org
authors.forename: Alan
authors.initials: A
authors.lastname: Neaigus
authors.forename: V Anna
authors.initials: VA
authors.lastname: Gyarmathy
authors.forename: Mingfang
authors.initials: M
authors.lastname: Zhao
authors.forename: Maureen
authors.initials: M
authors.lastname: Miller
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006678:HIV / Q000276:immunology / Q000302:isolation & purification; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D006679:HIV Seropositivity / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D006515:Hepatitis B virus / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D009519:New York City / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*