HIV PREVALENCE AND RISK BEHAVIOR IN NEEDLE EXCHANGE ATTENDERS - A NATIONAL STUDY

Objective: To determine whether needle and syringe exchange programs r epresent feasible sites to describe the prevalence of HIV and related risk behaviour among injecting drug users. Design: Cross-sectional sur vey. Setting: 21 needle and syringe exchange programs in all Australia n jurisdictions. Participants: All persons attending the needle and sy ringe exchange programs over one week in March 1995 were eligible to p articipate in the study once. Intervention: Needle and syringe exchang e attenders were asked to complete a brief, self-administered question naire and provide a finger-prick blood sample.Main outcome measures: P revalence of HIV antibody, drug injecting and sexual behaviour, and su rvey cost. Results: Completed questionnaires with blood samples suitab le for testing were provided by 1005 (42%) of 2373 individuals who att ended the needle and syringe exchange programs during the survey week. Women were more likely than men to participate in the survey but ther e was no difference in the response rate by age group. The HIV prevale nce was 2.1% and was significantly higher in men who described themsel ves as homosexual, compared to men who described themselves as heteros exual (22.5% v. 0.7%; P<0.001). Thirty-one per cent of respondents rep orted using a syringe after someone else in the preceding month. Concl usion: Cross-sectional surveys of needle exchange clients offer a prac tical method for monitoring risk behaviour and seroprevalence of blood borne viral infections.