In this fast-tracked article, Dr. Martin Schechter and colleagues warn that HIV incidence is on the rise among female injection drug users (IDUs) in Vancouver and that the increase is being driven by factors different from those found in males.
In 1996, Schechter and colleagues recruited 939 participants (624 men and 315 women) who were HIV negative at enrolment and who completed follow-up study visits and serology tests up to March 2001. During each visit blood samples were drawn and information was collected on patterns of drug use and high-risk behaviours. Over the period, seroconversion occurred in 64 men and 46 women.
The authors found that among the female participants, independent predictors of seroconversion were: injecting cocaine at least once a day, needing help to inject, having unsafe sex and having an HIV-positive partner.
Among male participants, the independent predictors were: injecting cocaine more than once a day, being Aboriginal and borrowing needles. The authors say the findings point to the urgent need for sex-specific prevention initiatives.
In a related commentary, Dr. Robert Remis discusses the public health and social policy implications of the different sets of predictors. He also warns that the study delivers disturbing news about Canada’s Aboriginal population: HIV infection rates for both men and women were about twice as high as in the non-Aboriginal population.
Risk factors for elevated HIV incidence rates among female injection drug users in Vancouver
— P.M. Spittal et al
HIV incidence among injection drug users
— R.S. Remis
Journal
Canadian Medical Association Journal