RISK BEHAVIOR AND HIV SEROPREVALENCE AMONG INJECTING DRUG-USERS IN RIO-DE-JANEIRO, BRAZIL

Objective: To characterize HIV seroprevalence and risk behavior among injecting drug users (IDUs) in Rio de Janeiro, Brazil, between 1990 an d 1996. Design: We report data from three separate cross-sectional sam ples of IDUs in Rio de janeiro: the World Health Organization (WHO) sa mple (n = 479), the Proviva sample (n = 138) and the Brasil sample (n = 110). These data provide the most comprehensive view available, to d ate, of this understudied population in Rio. Methods: Demographic char acteristics, HIV/AIDS risk behavior and HIV seroprevalence were compar ed across the three samples and combined analyses were performed to de termine the factors associated with injecting risk behavior, sexual ri sk behavior and HIV seropositivity. Results: The overall HIV seropreva lence among IDUs was 25%. Two encouraging findings of the present anal ysis were the lower levels of needle-sharing among participants recrui ted in the latest years (1995-1996) and the lower HIV seroprevalence i n the Proviva sample composed mainly of less educated, poorer IDUs liv ing in deprived neighborhoods. No trends toward safer behavior were fo und for sexual risk, younger age being the principal factor associated with high risk. Conclusions: Levels of needle-sharing and sexual risk among IDUs in Rio remain high, demonstrating the urgent need to incre ase the limited preventive measures undertaken so far. Seroprevalence levels for HIV remain significantly lower in the most deprived sample, arguing for the fundamental importance of prompt and effective preven tion strategies to keep infection rates from rising among the poorest and largest strata of Rio's IDUs.