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Author Notes:

Alan Neaigus, PhD, MCRP, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York City, NY 10032. Email: an2118@columbia.edu

The authors would like to acknowledge and thank the following people: Sarah Braunstein, PhD, MPH, Demetre Daskalakis, MD, MPH, Jay Varma, MD, and James Hadler, MD, of the NYC Department of Health and Mental Hygiene (DOHMH) and Kent Sepkowitz, MD, who reviewed earlier drafts of the article. Also, we would like to acknowledge and thank: Denise Paone, EdD, and Emily Winkelstein, MSW, of the Bureau of Alcohol and Drug Use Prevention, Care, and Treatment at the NYC DOHMH, who provided information on the Peer-Delivered Syringe Exchange program in NYC; Christopher S. Murrill, PhD, MPH, who is now with the CDC, for directing the 2005 cycle of NHBS in NYC; Maria C. B. Mendoza of the CDC, who provided guidance on time trend analysis; and Elizabeth DiNenno, PhD, Amy Drake, MPH, Amy Lansky, PhD, MPH, Isa Miles, ScD, Dita Broz, PhD, MPH, Alexandra Oster, MD, and Gabriela Paz-Bailey, MD, MSc, PhD, of the CDC, who contributed to the NHBS study design locally and nationally and provided guidance for the implementation of the study in NYC. The study would not have been possible without the efforts of the NYC NHBS field staff and the study participants who consented to be in the study.

The authors have no conflicts of interest to disclose.

Subjects:

Research Funding:

This research was funded by a cooperative agreement between the New York City Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention, Grant #U62/CCU223595-03-1.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • HIV
  • hepatitis C
  • people who inject drugs
  • risk behaviors
  • trends
  • New York City
  • HEPATITIS-C
  • SEXUAL TRANSMISSION
  • PREPARATION EQUIPMENT
  • UNITED-STATES
  • USERS
  • VIRUS
  • SEROPREVALENCE
  • SEROCONVERSION
  • METAANALYSIS
  • EPIDEMIC

Trends in HIV and HCV Risk Behaviors and Prevalent Infection Among People Who Inject Drugs in New York City, 2005-2012

Tools:

Journal Title:

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES

Volume:

Volume 75, Number Suppl 3

Publisher:

, Pages S325-S332

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: We assess trends in HIV and hepatitis C virus (HCV) risk behaviors and prevalent infection among people who inject drugs (PWID) in New York City (NYC). Methods: PWID in NYC were sampled using respondent-driven sampling in 2005, 2009, and 2012 (serial cross sections) for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance study. Participants were interviewed about their current (≤12 months) risk behaviors and tested for HIV and HCV. The crude and adjusted risk ratio (RR) and 95% confidence interval (95% CI) for linear time trends were estimated using generalized estimating equations regression with a modified Poisson model. Results: The sample comprised 500, 514, and 525 participants in 2005, 2009, and 2012, respectively. Significant (P< 0.05) linear trends in risk behaviors included a decline in unsafe syringe sources (60.8%, 31.3%, 46.7%; RR = 0.86, 95% CI: 0.81 to 0.92), an increase in all syringes from syringe exchanges or pharmacies (35.4%, 67.5%, 50.3%; RR = 1.15, 95% CI: 1.09 to 1.22), and an increase in condomless vaginal or anal sex (53.6%, 71.2%, 70.3%; RR = 1.14, 95% CI: 1.09 to 1.19). Receptive syringe sharing (21.4%, 27.0%, 25.1%), sharing drug preparation equipment (45.4%, 43.4%, 46.7%), and having ≥2 sex partners (51.2%, 44.0%, 50.7%) were stable. Although HIV seroprevalence declined (18.1%, 12.5%, 12.2%), HCV seroprevalence was high (68.2%, 75.8%, 67.1%). In multivariate analysis, adjusting for sample characteristics significantly associated with time, linear time trends remained significant, and the decline in HIV seroprevalence gained significance (adjusted RR = 0.76, 95% CI: 0.64 to 0.91, P = 0.003). Conclusions: This trend analysis suggests declining HIV prevalence among NYC PWID. However, HCV seroprevalence was high and risk behaviors were considerable. Longitudinal surveillance of HIV and HCV risk behaviors and infections is needed to monitor trends and for ongoing data-informed prevention among PWID.
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