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HIV prevalence highest in London injecting drug users with no treatment or previous testing history.

Donoghoe MC, Stimson GV; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: 163 (abstract no. PuC 8062).

Centre for Research on Drugs and Health Behaviour, University of London, England.

OBJECTIVES: To examine differences in anti-HIV status in London injecting drug users (IDUs) according to treatment and testing history. METHODS: Between June and November 1990, 534 IDUs surveyed in London using structured questionnaire as part of WHO collaborative study of HIV prevalence and risk behaviour. Multi-site sampling recruited IDUs in treatment agencies (117/534 22%) and in settings outside of treatment (417/534 78%) by trained fieldworkers with access to IDUs through social networks. Samples comprised: IDUs currently receiving treatment (311/528 58.9%), previously receiving treatment but not currently (73/528 13.8%) and never received treatment (144/528 27%). Treatment status not known for six subjects (6/534 1%). Subjects donated saliva specimen for anonymous testing for anti-HIV antibodies (GACRIA/GACELISA). Forty-three (43/534 8%) refused or produced sample insufficient for analysis. RESULTS: Of 491 analyzable samples, 63 HIV positive (63/491 12.8%, 95% CI: 9.85%-15.75%). Rates significantly higher for IDUs never in treatment (27/131 20.6%, 95% CI:13.67%-27.53%) than currently in treatment (29/286 10.1%, 95% CI:6.61%-13.59%, chi 2p less than .005). Those previously in treatment (7/68 10.3%, 95% CI:3.08%-17.52%) had lower rates, but not significantly so (chi 2p = .067). Under half (242/532 45.5%) previously tested for HIV. Rates of previous testing significantly lower in IDUs never in treatment (37/144 25.7%) than currently (173/310 55.8%, X2 p less than .0001) or previously (30/73 41.1%, X2 p = .02) in treatment. Self-reported HIV rates lower (22/216 10.2%) than those from saliva (63/491 12.8%) and lower in the never in treatment group (3/33 9.1%) than currently (16/155 10.3%) or previously (3/26 11.5%) in treatment. Differences not significant. Of 63 subjects testing HIV positive by saliva, only 24 (24/64 38%) previously tested. Of 27 subjects never in treatment and testing HIV positive by saliva, only five (5/27 18.5%) previously tested. CONCLUSIONS: HIV prevalence significantly higher in IDUs never in treatment. This group has lowest uptake of HIV testing and self-reported rates of HIV infection. Prevalence rates based on samples recruited in treatment settings or out of treatment but with a previous treatment history will underestimate prevalence of HIV infection in general IDU populations. Greater efforts needed to reach out-of-treatment drug injectors.

Publication Types:
  • Meeting Abstracts
Keywords:
  • AIDS Vaccines
  • Acquired Immunodeficiency Syndrome
  • Data Collection
  • HIV
  • HIV Antibodies
  • HIV Infections
  • HIV Seropositivity
  • HIV Seroprevalence
  • London
  • Prevalence
  • Research Design
  • Risk-Taking
  • Saliva
  • history
  • methods
  • therapy
Other ID:
  • 92403744
UI: 102201458

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