HIV infection among injection drug users (IDUs) in San Francisco is strongly associated with sexual behavior, with men who have sex with men (MSM) and women who trade sex for money much more likely to become infected than other IDUs, according to a study by UCSF researchers.
The study published in the May 5, 2001 issue of The Lancet, looked at data collected about IDUs in San Francisco from 1986 through 1998. Researchers found that over this time period, MSMs were 8.8 times more likely and women who reported trading sex for money were 5.1 times more likely than other IDUs in San Francisco to become infected with the HIV virus.
"We have had success here in San Francisco with keeping the incidence of HIV among IDUs low by reducing needle-related risks for HIV with programs like drug treatment and needle exchange. This study establishes that sexual behaviors also pose a significant risk to IDUs for transmission of HIV," said the study's lead author, Alex Kral, PhD, assistant adjunct professor at UCSF's Urban Health Study which is part of the Institute for Health Policy Studies and Department of Family and Community Medicine.
"There has been a tendency for IDU prevention programming to be needle obsessed, and here in San Francisco that has worked to a certain degree. Now, we need to focus new energy on sexual risk reduction among IDUs, while continuing current programs that address needle-borne risks," added Kral.
The data for the study was collected from 1,192 participants of the Urban Health Study, a study of street-recruited IDUs conducted in San Francisco from 1986 through 1998. The UCSF Urban Health Study was the first and is the longest running study of IDUs recruited from the streets and not from drug treatment centers.
Study co-investigators are Ricky N. Bluthenthal, PhD, associate sociologist with the Health Program and Drug Policy Research Center at Rand and assistant professor at Charles R. Drew University of Medicine and Science; Jennifer Lorvick, staff research associate, Lauren Gee, MPH, senior statistician, and Brian R. Edlin, MD, associate adjunct Professor and director, all of them at UCSF's Urban Health Study; and Peter Bacchetti, PhD, adjunct professor in UCSF's Department of Epidemiology and Biostatistics.
The research was supported by grants from the National Institute on Drug Abuse, the University of California's Universitywide AIDS Research Program and the San Francisco Department of Public Health.