HIV SEROPREVALENCE AMONG STREET-RECRUITED INJECTION-DRUG AND CRACK COCAINE USERS IN 16 US MUNICIPALITIES

Objectives. This study determined human immunodeficiency virus (HIV) s eroprevalence and factors associated with HIV infection among street-r ecruited injection drug users and crack cocaine smokers. Methods. An a nalysis was performed on HIV serologies and risk behaviors of 6402 inj ection drug users and 3383 crack smokers in 16 US municipalities in 19 92 and 1993. Results. HIV seroprevalence was 12.7% among injection dru g users and 7.5% among crack smokers. Most high-seroprevalence municip alities (>25%) were located along the eastern seaboard of the United S tates. In high-seroprevalence municipalities, but not in others, HIV s eroprevalence was higher for injection drug users than for crack smoke rs. Among injection drug users, cocaine injection, use of speedballs ( cocaine or amphetamines with heroin), and sexual risk behaviors were i ndependently associated with HIV infection. Among crack smokers, sexua l risk behaviors were associated with HIV infection. Conclusions. Inje ction drug users and crack smokers are at high risk for HIV infection.