Sexual orientation and HIV infection prevalence among young Latino injection drug users in Harlem

Among injection drug users (IDUs), those at highest risk for HIV infection include Latinos, young women, and young men who have sex with men (homosexu al men). We examined how HIV infection prevalence is affected by gender and sexual orientation among young Latino IDUs in New York City. We used basel ine data from a cohort study of young (18-30 years) IDUs in Harlem, New Yor k City, conducted from 1997 through 1999. Participants were asked about dru g use and sexual behaviors, and blood was taken for HIV, hepatitis B, and h epatitis C viral antibody testing. Of 156 participants who self-identified as Latino, 145 (94%) were Puerto Rican. Overall, 101 (65%) were heterosexua l men, 11 (7%) were men who have sex with men (MSM), 32 (20%) were heterose xual women, and 12 (8%) were women who have sex with women (WSW). Of the wh ole cohort, 17 (11%) were HIV positive. HIV infection rates were higher amo ng WSW (42%, p < 0.05), heterosexual women (16%, p < 0.05), and homosexual men (18%, p = 0.09) than heterosexual men (5%). Compared with heterosexual men, homosexual men were significantly (p < 0.05) more likely to have recei ved money or drugs for sex (64% versus 33%), and WSW were significantly mor e likely to have had unprotected sex with an IDU 5 years or more older (50% versus 16%). Multivariate analysis showed being a WSW (adjusted odds ratio [AOR] = 8.68, 95% confidence interval [CI] 1.78-42.26) and having unprotec ted sex with an older IDU (AOR = 7.01, 95% CI 2.23-21.96) to be associated with HIV infection. Sexual transmission may account for many HIV infections among young Latino IDUs. The high prevalence of HIV infection among WSW ma y, in part, be due to their having unprotected sex with older men, but stud ies with larger sample sizes are needed to confirm this.