CHANGES IN THE WAY OF HEROIN ADMINISTRATI ON AND THE FREQUENCY OF INFECTION BY THE HUMAN-IMMUNODEFICIENCY-VIRUS

BACKGROUND: Self administration of drugs by different intravenous rout es may induce a reduction in the organic complications of drug addicti on (DA). The aim of this study was to evaluate the changes in the way of drug administration in a series of DA individuals in the province o f Cadiz, Spain, and the evolution of the frequency of infection by the human immunodeficiency virus (HIV) in these patients. METHODS: The re ports of all the drug users from the province of Cadiz admitted to the Detoxication Unit of the Hospital Punta de Europa in Algeciras, from January, 1989 to July, 1993 were reviewed. At the time of admission ma ny data were evaluated, fundamentally the main route of drug administr ation, and anti-HIV seropositivity. RESULTS: Seven hundred ten drug us ers were included in the study. Ninety-seven percent used mainly heroi n. The route of drug administration on admission was intravenous in 56 .1%, pulmonary in 39.7%, inhalatory in 3.2% and oral in 0.8%. Forty-on e point seven percent patients were seropositive for HIV. The frequenc y of the use of the intravenous route throughout the semesters analyze d was I/89: 85.7%, II/89: 89.6%, I/90: 80%, II/90: 80.8%, I/91: 59.8%, II/91: 50%, I/92: 44.9%, II/92: 39%, I/93: 34.3% (p < 0.00001). The u se of the respiratory route significantly increased. The percentage of anti HIV positivity in the drug users evaluated was 67.4, 80.8, 56.4, 46.9, 40.7, 34.1, 30.6, 36.3, 23.2% (p < 0.00001), respectively for t he same periods. The decrease in the use of the intravenous route and the reduction in anti HIV seropositivity demonstrated a correlation co efficient of 0.91 with a confidence interval from 0.62 to 0.98 (p < 0. 05). CONCLUSIONS: The decrease, over time, in the use of the intraveno us route for heroin administration in the collective analyzed was sign ificantly associated with a decrease in HIV infection in these patient s.