HIV prevalence and risk behaviors among new initiates into injection drug use over the age of 40 years old

Injection drug users (IDUs) who have recently initiated an injecting career have high risk behaviors for HIV infection. The average age of an IDUs fir st injection is typically reported as 19-20 years, and some literature has reported 'maturing out' of drug use typically around 40 years old. The purp ose of this study was to discriminate risk behaviors among newer injectors by age of initiation. This cross-sectional study includes volunteers enroll ed using extensive community recruitment techniques in 1988 and 1989 in Bal timore, MD. Of the 722 injection drug users who had initiated injection wit hin the prior six years, 124 were over 35 years old of whom 53 were 40 year s and older. Rates of HIV were lower among those over 40 years (13.2%) than those who were 35-39 years (22.5%) or under 35 pears old (20.9%). The beha vioral characteristics of those aged 35-39 were similar to those under 35 y ears old, but those over 40 years old when compared with less than 39 years reported injecting at least daily less frequently (88.7% vs 76.5%, p = 0.0 42), using a needle from a sterile wrapper (19.0% vs 36.6%, p = 0.006), and injecting with their own works (52.6% vs 28.8%, p = 0.021). This study sho ws that people initiate injection drug use across a wide age range and that needle hygiene practices early after initiation tend to be safer in older compared to younger initiates. (C) 1999 Elsevier Science Ireland Ltd. All r ights reserved.