Similarities and differences by race/ethnicity in changes of HIV seroprevalence and related behaviors among drug injectors in New York City, 1991-1996

Objective: To measure differences and similarities in the prevalence of HIV infection and of related risk and protective behaviors among New York City black, white, and Hispanic drug injectors during a period of decreasing HI V prevalence. Methods: Drug injectors were interviewed at a drug detoxification clinic an d a research storefront in New York City from 1990 to 1996. All subjects ha d injected drugs within the last six months. Phlebotomy for HIV testing was conducted after pretest counseling. Analysis compares the first half (peri od) of this recruitment interval with the second half. Results: HIV seroprevalence declined among each racial/ethnic group. In eac h period, white drug injectors were significantly less likely to be infecte d than either blacks or Hispanics. Similar declines were found in separate analyses by gender, length of time since first injection, and by recruitmen t site. After adjustment for changes in sample composition over time, black s and Hispanics remained significantly more likely to be infected than whit es. Interactions indicate that the decline may be greatest among Hispanics and slowest among blacks. A wide variety of risk behaviors declined in each racial/ethnic group and syringe exchange use increased in each group. Few respondents reported injecting with members of a different racial group at their last injection event. Conclusions: HIV prevalence and risk behaviors seem to be falling among eac h racial/ethnic group of drug injectors. Black and Hispanic injectors conti nue to be more likely to be infected. Declining prevalence among whites pos es some risk of politically based decisions to reduce prevention efforts. O verall, these results show that risk reduction can be successful among all racial/ethnic groups of drug injectors and suggest that continued risk redu ction programs may be able to attain further declines in infection rates in each group.