A COMPARISON OF THE PREVALENCE OF HIV-INFECTION AND INJECTING RISK BEHAVIOR IN URBAN AND RURAL SAMPLES IN SCOTLAND

Aims. To compare the prevalence of HIV infection and injecting risk be haviour: among injecting drug users from urban and rural areas. Design s. Two samples of injecting drug users were recruited using a multi-si te sampling strategy. Respondents were first interviewed by trained in terviewers then specimens of saliva were collected for anonymous testi ng for antibodies to HIV. Setting. Respondents were recruited from dru g treatment services and street sites. Participants. Respondents were eligible for inclusion in the study if they had ''ever'' injected a dr ug and were currently using drugs. Measurements. Measurements taken in cluded self-reported patterns of drug use and injecting risk behaviour . Specimens of saliva were tested for the presence of HIV infection us ing GACELISA with reactive specimens confirmed by Western blot analysi s. Findings. Our data indicate that there are two separate populations which are geographically discrete but broadly similar in profile and current injecting risk behaviour. The prevalence of HIV infection amon g IDUs from Dundee city was found to be 26.8% (95% CI, 20.2%-33.0%) co mpared with 3.7% (95% CI, 0.13%-15.8%) for IDUs from rural Tayside. Th is marked difference in prevalence of HIV infection we attribute to a high level of injecting risk among urban IDUs between 1980 and.1984, l imited migration from the urban epicentre of infection and a reluctanc e among rural IDUs to share with IDUs outside their immediate social a nd kinship networks. Conclusions. Although current levels of injecting risk behaviour are similar in our urban and rural samples, rural IDUs may be less likely to contract HIV from their fellow injectors becaus e of the lower prevalence of HIV infection and more closed sharing net works within the rural population. The implications of this for the de velopment and expansion of drug services ave considered.