RISK-FACTORS FOR HIV-1 SEROPREVALENCE AMONG DRUG INJECTORS IN THE COCAINE-USING ENVIRONMENT OF RIO-DE-JANEIRO

To determine risk factors for HIV-1 among drug injectors in Rio de Jan eiro, where cocaine is the dominant drug of injection, subjects were r ecruited using the criteria and interview instrument of the World Heal th Organization's Cross-National Study of HIV infection and risk behav iour in injecting drug users. HIV antibody test results were derived b oth from serum tests and from self-reports of previous tests (document ed evidence of self-reported seropositivity was required). The analyti cal sample consists of 123 subjects, recruited both at drug abuse trea tment sites and at street locations. Of 27 subjects with both serologi cal and self-reported antibody status data, 20 reported previous negat ive tests; of these three had positive sera and may have seroconverted . Seven subjects reporting prior positive serostatus all tested positi ve. For the 123 subjects, seroprevalene was 34%. Independent significa nt risk factors in multivariate logistic regression with backwards eli mination are: years of injection greater than 5; being a male who has had sex with men in the previous 5 years; and not having taken deliber ate steps to protect oneself against AIDS. These findings indicate tha t homosexual/bisexual male drug injectors may be a bridge group throug h which HIV is entering drug-injecting networks in Rio de Janeiro. Eff orts by drug injectors to reduce their risk of infection seem to have protective effects. This underscores the importance of HIV prevention efforts aimed at drug injectors.