       Document 0392
 DOCN  M9590392
 TI    Temporal trends of incident human immunodeficiency virus infection in a
       cohort of injecting drug users in Baltimore, Md.
 DT    9509
 AU    Nelson KE; Vlahov D; Solomon L; Cohn S; Munoz A; Department of
       Epidemiology, School of Hygiene and Public Health,; Johns Hopkins
       University, Baltimore, Md., USA.
 SO    Arch Intern Med. 1995 Jun 26;155(12):1305-11. Unique Identifier :
       AIDSLINE MED/95297892
 AB    OBJECTIVE: To measure the temporal trends in the incidence of infection
       with human immunodeficiency virus in a cohort of injecting drug users in
       Baltimore, Md, between 1988 and 1992. DESIGN: Study subjects were
       screened for antibodies to human immunodeficiency virus by enzyme-linked
       immunosorbent assay and confirmed with Western blot. They were followed
       up at 6-month intervals with repeated serologic screening and
       comprehensive interviews for human immunodeficiency virus risk factors.
       SETTING: Special study clinic. PARTICIPANTS: A cohort of 2960
       participants were recruited and screened between February 1988 and March
       1989. Recruitment criteria included an age of 18 years or older, a
       history of illicit drug injection since 1978, and the absence of the
       acquired immunodeficiency syndrome; subjects were subsequently tested
       for human immunodeficiency virus antibodies. Most subjects (85%) were
       not receiving methadone treatment at baseline and were recruited by word
       of mouth. MAIN OUTCOME MEASURE: Human immunodeficiency virus
       seroconversion. RESULTS: Of the 2247 seronegative participants at
       baseline, 1532 were followed up, and 188 (12.3%) had seroconverted by
       December 1992. The incidence of human immunodeficiency virus infection
       over time among users declined somewhat, especially among women; the
       overall incidence was 1.90 per 100 person-semesters, or 3.80% annually.
       The incidence, adjusted for gender, was higher in younger (< 35 years)
       than older (> or = 35 years) subjects (relative incidence, 1.75; 95%
       confidence interval, 1.29 to 2.38) and in women compared with men,
       adjusted for age (relative incidence, 1.29; 95% confidence interval,
       0.95 to 1.80). The relative incidence among active compared with
       inactive drug users adjusted for age and gender was 1.58 (95% confidence
       interval, 1.06 to 2.35). CONCLUSIONS: Although the incidence of human
       immunodeficiency virus infection in this cohort of injecting drug users
       in Baltimore declined somewhat during the 4 years of follow-up,
       especially among women, the persistent annual incidence of nearly 4%
       during 3 1/2 to 4 1/2 years of observation suggests the need for
       additional strategies for prevention of infection, especially among
       those who continue injecting drugs. Newer methods of prevention, such as
       provision of sterile injection equipment, an effective human
       immunodeficiency virus vaccine, and wider availability of effective
       treatment or prevention of drug addiction, are urgently needed in these
       high-risk populations.
 DE    Adult  Age Distribution  Baltimore/EPIDEMIOLOGY  Cohort Studies  Female
       Human  HIV Infections/ETIOLOGY  HIV Seropositivity/*EPIDEMIOLOGY
       Incidence  Male  Questionnaires  Sex Distribution  Substance Abuse,
       Intravenous/*COMPLICATIONS  Support, U.S. Gov't, P.H.S.  JOURNAL ARTICLE

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

