HIV RISK-FACTORS AMONG INJECTING DRUG-USERS IN 5 US CITIES

Objectives: To examine factors associated with HIV infection in inject ing drug users (IDU), the independent and interactive effects of poten tial risk factors, and geographic differences in risk factors. Methods : IDU entering methadone treatment in New York City, Asbury Park and T renton in New jersey, Baltimore and Chicago between February 1987 and December 1991 were interviewed using a standard questionnaire and test ed for HIV antibodies (n = 4584). Associations of HIV serostatus with race/ethnicity, other demographic characteristics, and injecting and s exual risk behaviors were assessed by logistic regression analyses. Re sults: African Americans were at increased risk for HIV in four of the five cities, and Puerto Ricans in two cities. Injection in shooting g alleries and 'speedball' injection emerged as behavioral variables hig hly associated with HIV, although interaction of these variables indic ates that each variable contributes to HIV risk only in the absence of the other behavior. Conclusions: Geographic differences in HIV risk f actors and the interaction of 'speedball' and shooting gallery use sug gest that multiple HIV risk models are needed that reflect seroprevale nce rates, variation in risk behaviors, and the social context of risk behaviors. Increased risk among racial/ethnic minorities independent of risk behaviors, suggests the need to examine further potential soci al and environmental factors, such as the social networks in which inj ecting and sexual behaviors occur, HIV seroprevalence within these net works, and the locales in which risk behaviors occur.