HIV-INFECTION AMONG VICTIMS OF ACCIDENTAL FATAL DRUG OVERDOSES IN NEW-YORK-CITY

Aims. To determine the factors associated with HIV seroprevalence rate s for victims of drug overdoses. Design. Descriptive epidemiologic sur vey of a complete 3-year sample of accidental fatal drug overdoses. Se tting. New York City (population 7 322 564). Participants. All people over 15 years of age (n = 2159) who died of accidental fatal drug over doses during 1991-93. Measurements. Using medical examiner data and lo gistic regression analyses were conducted to examine the association b etween HIV seroprevalence and gender, race, age and type of drug overd ose. Findings. There were 646 (29.9%) victims who were HIV positive. W omen (37.5%) were more likely than men (27.9%) to be HIV positive. Afr ican-Americans (39.4%) had a higher rate of HIV infection than Latinos (27.5%), whites (19.2%) or Asians (8.3%). Victims residing in communi ties with higher levels of poverty had higher rates of HIV infection b ut poverty did not account for the high rates of HIV infection among A frican-Americans. The highest rates of HIV infection were found among victims aged 35-44 years (38.8%) and 45-54 years (33.7%). Dying from a n opiate overdose was associated with a 2.4 times increase in the like lihood of being HIV positive. Conclusion. If opiate abuse continues to rise in the United States, HIV infection will increase in the next fe w years. Women who abuse drugs participate in risky sexual practices a nd are more likely than men to develop HIV infection from receptive se x as well as sharing of needles. Harm reduction programs should addres s risky sex as well as needle programs. There should be further study of why African-Americans who died of drug overdoses have the highest r ates of HIV infection.