       Document 0059
 DOCN  M9610059
 TI    Risk factors for human immunodeficiency virus seroconversion among
       out-of-treatment drug injectors in high and low seroprevalence cities.
       The National AIDS Research Consortium.
 DT    9601
 AU    Friedman SR; Jose B; Deren S; Des Jarlais DC; Neaigus A; National
       Development and Research Institutes, Inc., New York, NY; 10013, USA.
 SO    Am J Epidemiol. 1995 Oct 15;142(8):864-74. Unique Identifier : AIDSLINE
       MED/96017410
 AB    From 1988 to 1991, 6,882 drug injectors in 15 US cities were interviewed
       and had serum samples collected. The interviews and samples were
       analyzed for determination of significant predictors of human
       immunodeficiency virus (HIV) seroconversion in the 10 low seroprevalence
       cities and the five high seroprevalence cities. The unit of analysis was
       the period of observation between consecutive paired interviews/blood
       samples. In Cox proportional hazards regression, significant predictors
       of seroconversion in the low seroprevalence cities were: not being in
       drug treatment, injecting in outdoor settings or abandoned buildings,
       using crack cocaine weekly or more frequently, engaging in
       woman-to-woman sex, being of non-Latino race/ethnicity, and city
       seroprevalence. Predictors in high seroprevalence cities were: injecting
       with potentially infected syringes, not being in drug treatment, and
       having a sex partner who injected drugs. These findings suggest that HIV
       may be concentrated in sociobehavioral pockets of infection in low
       seroprevalence cities. For reducing HIV transmission, these results
       suggest: 1) in low seroprevalence cities, localized monitoring to detect
       specific emerging sociobehavioral pockets of infection, and quick
       implementation of appropriate targeted interventions if necessary; 2) in
       high seroprevalence cities, relatively more emphasis on locality-wide
       outreach and syringe-exchange projects to reduce risky behavior; and 3)
       in both types of cities, considerable expansion of drug treatment
       programs.
 DE    Adult  Comparative Study  Female  Health Behavior  Human  HIV
       Seropositivity/*BLOOD/EPIDEMIOLOGY/TRANSMISSION  *HIV Seroprevalence
       Male  Predictive Value of Tests  Proportional Hazards Models
       Questionnaires  Risk Factors  Substance Abuse,
       Intravenous/*COMPLICATIONS/PREVENTION & CONTROL  Support, U.S. Gov't,
       P.H.S.  United States/EPIDEMIOLOGY  *Urban Health  JOURNAL ARTICLE
       MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

