INTRODUCTION OF HIV INTO DRUG INJECTOR NETWORKS OUTSIDE AIDS EPICENTERS

Injection drug users (IDUs) continue to be at risk for HIV infection d espite high levels of knowledge about how human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) is transmitted. Yet, a mong not-in-treatment injection drug users, the chances of becoming in fected with HIV vary substantially. Information regarding the factors that facilitate the introduction of HIV into networks of drug injector s in low HIV seroprevalence cities is urgently needed. This study exam ines the factors related to HIV seroprevalence in a large (n=9492), mu lti-site sample of IDUs recruited in 11 low seroprevalence cities. Uni variate and multivariate associations between drug injection and sexua l behaviours and travel to an AIDS epicentre were examined. Results sh ow that, next to male-to-male sexual contact, having sex at least twic e in an AIDS epicentre was the strongest predictor of HIV infection. A lso associated with higher odds of being HIV-positive were racial/ethn ic characteristics, daily drug injection, and injecting drugs in an AI DS epicentre. These results confirm that travelling to an AIDS epicent re and having sex or injecting drugs play a large role in the introduc tion of HIV into drug injector networks in low seroprevalence cities.