Objective:We assessed the prevalence of HIV infection and associated risk behaviors among street-recruited young injection drug users (IDUs) in San Francisco.
Methods:In a cross-sectional study, 304 young (age <30 years) IDUs with a history of injecting in the previous 30 days were interviewed and tested for antibodies to HIV. Analyses assessing independent associations with HIV infection were limited to males only, due to the low number of infections in women.
Results:The prevalence of HIV infection was 5.3% overall but was highly stratified by gender and sexual preference (15.6% among homosexual/bisexual men vs. heterosexual men) and recruitment neighborhood (18% in the Polk Street area). Of 16 HIV infections, 14 (88%) were in males. Factors independently associated with HIV infection in males included sexual preference (homosexual/bisexual vs. heterosexual: adjusted odds ratio [AOR], 7.5; 95% confidence interval [CI], 1.5-36.6), recruitment neighborhood (Polk Street neighborhood vs. other neighborhoods: AOR, 4.8; 95% CI, 1.4-16.7), and duration of residence in San Francisco (≥1 year vs. <1 year: AOR, 11.8; 95% CI, 1.4-95.8).
Conclusions:The prevalence of HIV infection was highest among male IDUs who have sex with men. The strong associations between HIV infection and sexual orientation and HIV infection and recruitment locale suggest that risk may be attributable largely to sexual risk. In addition to successful prevention efforts aimed at reducing needle-associated risk, current intervention models aimed at young IDUs should target high-risk neighborhoods and emphasize sexual risk reduction measures, in particular among men who have sex with men.
Address correspondence and reprint requests to Dr. Kimberly Page Shafer, Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105, USA; e-mail: [email protected]
Current affiliation for K. Ochoa is the Keck School of Medicine, University of Southern California, Los Angeles, CA.
Manuscript received May 15, 2001; accepted August 12, 2002.
© 2002 Lippincott Williams & Wilkins, Inc.