Transmmission and Recreational Drug Use

“The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%.”

“In [two] studies, HIV prevalence was nearly identical among current injectors (injected in the last 6 months) and heroin and cocaine users who had never injected: 13% among current injectors and 12% among never-injectors in the drug treatment program study, and 15% among current injectors and 17% among never injectors in the respondent driven sampling storefront study. The 95% CIs [statistical confidence intervals] overlapped in all gender and race/ethnicity subgroup comparisons of HIV prevalence in both studies. Conclusions: The very large HIV epidemic among drug users in New York City appears to be entering a new phase, in which sexual transmission is of increasing importance [they couldn't possibly consider that their theory that HIV is a transmissible virus is bankrupt]”

“The HIV incidence among drug users in the ACS has declined since 1985. Accompanied by a reduction in injecting drug use and needle sharing, this decline occurred despite continued sexual risk behaviour.”

“Overall HIV infection remains rare among IDUs in the UK, however there is evidence of ongoing and possibly increased transmission. The prevalence of HIV among IDUs has remained substantially higher in London than the rest of the country…By the end of 2003 there had been a total of 4,093 HIV diagnoses reported in the UK where infection had probably been acquired through injecting drug use. These account for 6.5% of all the diagnoses reported (62,998) in the UK, 4.9% (2,824 of 58,040) of the reported infections in England, 33%[!] (1,210 of 3,699) in Scotland, 4.5% (40 of 890) in Wales, and 2.7% (8 of 291) in Northern Ireland…35. The annual number of new HIV diagnoses among IDUs in recent years has been low and constant (table 1), at an annual average of 103 reports during the period 1998 to 2003. So far, 107 HIV diagnoses, where infection was thought to have been acquired by injecting drug use, have been reported in the UK for 2003…HIV infection remains comparatively rare among IDUs in the UK, with around one in 100 infected, and the majority of those with HIV would appear to have had their infection diagnosed.”

“Syringes supplied by SEPs [syringe exchange programs] account for fewer than 2% of those needed to meet the standard of 1 syringe per injection.…syringes with either 2 or 20 microliters of blood [containing HIV-negative blood mixed with the supernatant of an HIV culture to simulate 0.1 to 5 infectious units per microliter] stored at 4C yielded viable HIV-1 even at 42 days of storage, the longest duration tested. At the other extreme, at 37C, syringes with either 2 or 20 microliters of blood failed to yield viable HIV-1 if stored for 7 days or longer. At 22C [room temperature], viable HIV-1 was recovered from some syringes with approximately 2 and 20 microliters of blood for up to 21 and 42 days, respectively. At both 27C and 32C, viable HIV-1 was receovered from some syringes with approximately 2 and 20 microliters of blood for 1 and 7 days, respectively.”

“Of 694 subjects [IV drug users in Vancouver], the 15-month cumulative HIV incidence [number of people changing from HIV-negative to HIV-positive] was significantly elevated in frequent NEP attendees (11.8 ± 1.7 versus 6.2 ± 1.5%).”

“[Table 5 shows that the risk of an IV drug user becoming HIV-positive is 10.2 to 22.9 times greater among consistent needle exchange program users versus non-users. Frequent users were 2.2 to 3.9 times more likely and infrequent users had about the same risk as non-users.]”

“The adjusted HR [hazard ratio] for seroconversion [becoming HIV-positive] associated with five or more sexual partners in the previous year was significantly elevated (HR=3.4 [i.e. 3.4 times higher than the average rate]). Current intravenous cocaine use (HR 2.5) and (marginally) crack [cocaine] use (HR=3.2) were associated with risk of seroconversion, but intravenous heroin and amphetamine use were not…Sharing needles and bleach use were not associated with seroconversion…When we examined the principal risk factors separately by sex, the HR associated with crack use, number of sexual partners and intravenous cocaine use were very large among female subjects”

“Human immunodeficiency virus (HIV) prevalence was studied in an unselected group of 216 female and transsexual prostitutes…All 128 females who did not admit to drug abuse were seronegative; 2 of the 52 females (3.8%) who admitted to intravenous drug abuse were seropositive.”

“Of the 4911 consecutive patients [attending a Baltimore city clinic for sexually transmitted diseases] from whom serum was obtained, 256 (5.2%) were seropositive for HIV…seroprevalence was significantly higher among men who acknowledged using parenteral [injection] drugs since 1978, as compared to those who did not. HIV antibody prevalence was also higher among men who acknowledged having sexual relations with a parenteral drug user…HIV antibody was present in 2.7% of men who did not report any previous high-risk behavior…HIV seroprevalence rates were significantly higher among women who acknowledged using parenteral [injection] drugs since 1978…[and those] who had sexual relations with men who used parenteral drugs or men who were bisexual…HIV antibody was present in 1.8% of women who did not report any previous high-risk behavior…among women under 25 years of age, 68.2% of those who were seropositive did not acknowledge any high-risk behavior”