title: A perfect storm: crack cocaine, HSV-2, and HIV among non-injecting drug users in New York City.
abstract: Prevalence of human immunodeficiency virus (HIV) infection has reached 16% among non-injecting drug users (NIDU) in New York City, an unusually high prevalence for a predominantly heterosexual population that does not inject drugs. Using a long-term study (1983-2011, >7,000 subjects) among persons entering the Beth Israel drug-treatment programs in New York City, we identified factors that contributed to this high prevalence: a preexisting HIV epidemic among injectors, a crack cocaine epidemic, mixing between injectors and crack users, policy responses not centered on public health, and herpes-simplex virus 2 facilitating HIV transmission. Implications for avoiding high prevalence among NIDU in other areas are discussed.
authors: 1Beth Israel Medical Center, Baron Edmond de Rothschild Chemical Dependency Institute, New York, USA.
authors: Don C
authors: DC
authors: Des Jarlais
authors: Courtney
authors: C
authors: McKnight
authors: Kamyar
authors: K
authors: Arasteh
authors: Jonathan
authors: J
authors: Feelemyer
authors: David C
authors: DC
authors: Perlman
authors: Holly
authors: H
authors: Hagan
authors: Emily F
authors: EF
authors: Dauria
authors: Hannah L F
authors: HL
authors: Cooper
mesh_terms: D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D060085:Coinfection / Q000453:epidemiology* / Q000276:immunology; D016578:Crack Cocaine; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006291:Health Policy; D006561:Herpes Simplex / Q000453:epidemiology* / Q000276:immunology; D018258:Herpesvirus 2, Human; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
chemical_list: D016578:Crack Cocaine