Women, drugs and HIV/AIDS: results of a multicentre European study

Background Ln the light of rising human immunodeficiency virus (HIV) incide nce rates amongst women in Western Europe, a multicentred, cross-sectional study was undertaken to explore the multitude of possible factors associate d with HIV in a population of female injecting drug users (IDU). Methods Face-to-face interviews were conducted with 1198 female IDU recruit ed from a variety of settings in Paris, Madrid, Pome, London and Berlin. Th eir HN status was determined from antibody testing of blood or saliva sampl es or from written confirmation of HIV test results from a physician. A hie rarchical logistic regression model was used to identify direct and indirec t associations between socioeconomic factors, marginalization and risk beha viour with HIV prevalence. Results The HIV prevalence in the sample of female IDU was 27.8% (range: 1. 4% in London and 52.6% in Madrid). Factors independently associated with HI V prevalence in the regression analysis included: age >25 years (OR = 2.0-2 .9), left full-time education before age 14 (OR = 2.4), no fixed address (O R = 2.2), previous imprisonment (OR = 1.4), commercial sex (OR = 1.3), havi ng a regular HIV positive sexual partner (OR = 6.6), ever shared needles (O R = 1.5) and any sexually transmitted disease (STD) infection in the last y ear (OR = 1.7). Conclusions The sexual behaviour and partners of female IDU in Western Euro pe are as important a component in explaining the HIV epidemic in this popu lation as other risk factors, including high-risk drug taking behaviour. Ho meless IDU women may be an important residual risk group warranting future preventive interventions and women with a history of STD should be a partic ular target for health education. Differences in HIV prevalence across citi es are very large and may be related to differences in harm reduction polic ies.