Injection-related risk behaviors in young urban and suburban injection drug users in Chicago (1997-1999)

We compared injection-related risk practices between urban and suburban inj ection drug users (IDUs) in a large cross-sectional sample of young IDUs. F rom 1997 to 1999, we recruited 700 active IDUs aged 18 to 30 years in Chica go and its suburbs. A suburban residence was reported by 38% of participant s. Participants were interviewed at four urban locations and screened for H IV and hepatitis C virus antibodies. Receptive sharing of syringes and othe r paraphernalia by urban and suburban IDUs in the preceding 6 months was co mpared using univariable and multivariable models. Sharing injection paraph ernalia in the total sample was high, with 50% of participants reporting re ceptive syringe sharing and 70% reporting sharing cotton, cookers, and/or r inse water. After adjusting for demographic characteristics, injection sett ings, frequency, and duration of injection as well as ease of acquiring new syringes, suburban IDUs were significantly more likely than urban IDUs to share syringes (adjusted odds ratio = 1.7; 95% confidence interval: 1.1-2.5 ); however, the likelihood of sharing cotton, cookers, or rinse water was r oughly equal. Despite overall higher risk profiles among suburban IDUs, HIV and hepatitis C prevalence levels were significantly lower than among urba n participants. Current high levels of injection risk behaviors in suburban groups represent a potential for rapid dissemination of infection.