March 1, 2012
New Report: HIV Infection and HIV-Associated Behaviors
among Injecting Drug Users – 20 Cities, United States,
2009
Injection Drug Users (IDUs) in the United States (U.S.)
are at increased risk of acquiring human
immunodeficiency virus (HIV) infection. Despite a recent
reduction in the number of HIV infections attributed to
injecting drug use in the U.S., IDUs remain a
substantial proportion of those becoming infected with
HIV. In 2009, 9% of new HIV infections in the U.S.
occurred among IDUs.
To monitor HIV-associated behaviors and HIV prevalence
among IDUs, CDC’s National HIV Behavioral Surveillance
System (NHBS) conducts interviews and HIV testing in
selected metropolitan statistical areas (MSAs). NHBS is
a behavioral surveillance system used to monitor
prevalence and trends in 1) HIV-related risk behaviors,
2) HIV testing, and 3) use of HIV prevention services
among populations at high risk for acquiring HIV,
including MSM, injection-drug users, and heterosexuals
at increased risk for HIV infection. Data are collected
in annual cycles from one risk group per year so that
each group is surveyed once every 3 years. This report
summarizes data from 10,073 IDUs interviewed and tested
in 20 MSAs in 2009 as part of NHBS.
The report shares increased evidence of risk behaviors
for persons at high risk for HIV infection. Of IDUs
recruited in 20 U.S. cities, 9% tested positive for HIV,
of whom 45% were unaware of their infection. Among those
at risk of acquiring HIV infection, 34% reported sharing
syringes and 69% reported having unprotected vaginal sex
in the past 12 months. Less than half the IDUs reported
having been tested for HIV (49%) or participating in a
behavioral intervention (19%) during the same time
period. HIV infection among IDUs in the U.S. remains a
significant challenge. Although incidence data show that
HIV incidence among IDUs is low, these data suggest that
risk behaviors and lack of awareness of infection remain
high.
Given the prevalence of drug and sexual risk behaviors
among IDUs, efforts should be made to provide HIV
prevention for IDUs – such as increased access to HIV
testing, sterile syringes, and condoms. Multiple reviews
find that Syringe Exchange Programs (SEPs) can reduce
needle sharing among IDUs, resulting in positive
behavior change that can reduce HIV transmission. The
reviews also note that SEPs do not result in negative
consequences such as increases in injection frequency,
in injection drug use, or in unsafe disposal of needles
in the community. SEPs can also provide a positive
pathway to prevention for substance abusing persons.
Proven prevention strategies remain critical for those
at high risk for HIV, such as individuals with multiple
sex partners, those in relationships with HIV-positive
individuals and IDUs.
Read the
full report.
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