TATTOOS IN PERSONS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - NEW INSIGHTS INTO AN OLD ART

We studied the epidemiology of tattoos in persons with human immunodef iciency virus (HIV) infection and assessed their attitudes and those o f their health care providers regarding tattoos by personal interviews , a standardized questionnaire, and medical chart review. The setting was an outpatient HIV clinic at Boston City Hospital, an inner city mu nicipal hospital. Over a 4-month period, we studied 73 tattoos in 29 H IV-infected individuals of whom 69% were male, 45% were nonwhite, 79% reported prior or active injection drug use, and 66% obtained their in itial tattoo during adolescence. Although 79% had serologic markers of hepatitis B infection and 21% had serologic evidence of hepatitis C i nfection, only 4% of the participants reported a prior knowledge of he alth risks associated with tattooing. Of the 73 tattooing experiences studied, 38% involved the use of illicit drugs or alcohol, and 77% wer e obtained illegally, often during incarceration. Tattoos in this inne r city population of HIV-infected patients were usually obtained durin g adolescence, often illegally, frequently under the influence of alco hol or illicit drugs, and almost always without appreciation of associ ated health risks. Tattoos may be a marker of psychosocial issues and asymptomatic bloodborne infections and should trigger a discussion of possible risk factors and prevention strategies by the health care pro vider.