title: Heroin Use and Injection Risk Behaviors in Colombia: Implications for HIV/AIDS Prevention.
abstract: BACKGROUND
  Heroin production in Colombia has increased dramatically in recent decades, and some studies point to an increase in local heroin use since the mid-1990s. Despite this rapid increase, little is known about the effects of these activities on heroin injection within Colombia. One of the biggest concerns surrounding heroin injection is the potential spread of HIV through drug user networks.
  
  
  OBJECTIVE
  This article examines injection risk behaviors among heroin injectors in the Colombian cities of Medellín and Pereira to explore the implications for possible increased HIV transmission within this group.
  
  
  METHODS
  A cross-sectional study used respondent-driving sampling to recruit a sample of 540 people who inject drugs (PWID) over 18 years of age (Medellín: n = 242, Pereira: n = 298). Structured interviews with each participant were conducted using the World Health Organization Drug Injection Study Phase II Survey. An HIV test was also administered.
  
  
  RESULTS
  Information regarding the socio-demographics, injection drug use, HIV risk and transmission behaviors, injection risk management, and HIV knowledge and prevalence of participants are reported. The study identified many young, newly initiated injectors who engage in risky injection practices. The study also found that HIV prevalence is fairly low among participants (2.7%).
  
  
  CONCLUSIONS
  Findings indicate a potential risk for the spread of HIV among PWID in Colombia given their widespread sharing practices, high rate of new injector initiation, and unsafe syringe cleaning practices. Colombia has a possibly time-limited opportunity to prevent an HIV epidemic by implementing harm reduction interventions among young, newly initiated PWID.
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Mateu-Gelabert
authors.affiliation: b University of Central Florida , Orlando , Florida , USA.
authors.forename: Shana
authors.initials: S
authors.lastname: Harris
authors.affiliation: c Universidad CES , Medellín , Colombia.
authors.forename: Dedsy
authors.initials: D
authors.lastname: Berbesi
authors.affiliation: c Universidad CES , Medellín , Colombia.
authors.forename: Ángela María
authors.initials: ÁM
authors.lastname: Segura Cardona
authors.affiliation: c Universidad CES , Medellín , Colombia.
authors.forename: Liliana Patricia
authors.initials: LP
authors.lastname: Montoya Vélez
authors.affiliation: d University of the Andes , Bogotá , Colombia.
authors.forename: Inés Elvira
authors.initials: IE
authors.lastname: Mejía Motta
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Jessell
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Honoria
authors.initials: H
authors.lastname: Guarino
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D000293:Adolescent; D000328:Adult; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data*; D015995:Prevalence; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Colombia; HIV prevention; HIV/AIDS; harm reduction; heroin; injection risk behaviors