sodium-hypochlorite and Heroin-Dependence

To examine the HIV seroconversion rate, risk factors for seroconversion, and changes in risk behavior over time in intravenous drug users (IVDU) in San Francisco, 1985-1990.. Observational study.. All methadone maintenance and 21-day methadone detoxification programs in San Francisco.. A total of 2351 heterosexual IVDU, of whom 681 were seronegative at first visit and seen at least twice ('repeaters').. HIV seroconversion rates, risk factors for seroconversion, and changes in behavior.. The HIV seroconversion rate in repeaters was 1.9% per person-year (ppy) of follow-up [2.1% in women versus 1.7% in men (not significant); 4% in African Americans versus 1% in whites (P = 0.006); 3.9% ppy in the first third of the study, 1.2% in the second (P = 0.007), and 1.9% in the last (not significant)]. Risk factors for seroconversion were five or more sexual partners per year [hazard ratio (HR) = 2.6; P = 0.02], use of shooting gallery ever (HR = 2.9; P = 0.02), and less than 1 year (lifetime) in methadone maintenance (HR = 2.7; P = 0.02). Self-reported intravenous cocaine use fell from 33 to 15% over 5 years, shooting gallery use fell from 19 to 6%, and the proportion with five or more sexual partners fell from 25 to 10%. Bleach use rose to 75% of needle-sharers.. The 1985-1990 HIV seroconversion rate in IVDU (1.9% ppy) was comparable to that in San Francisco cohorts of homosexual men (1.4% ppy). A decline in HIV seroconversion coincided with changes in risk behavior. Stable attendance of methadone maintenance was highly protective: the seroconversion rate in subjects with 1 year or more in methadone was 12% ppy.

Topics: Adult; Amphetamines; Bias; Cocaine; Cohort Studies; Comorbidity; Disinfection; Equipment Contamination; Ethnicity; Female; Heroin Dependence; HIV Infections; HIV Seropositivity; HIV Seroprevalence; Humans; Injections, Intravenous; Male; Needle Sharing; Risk Factors; San Francisco; Sexual Behavior; Sexual Partners; Sodium Hypochlorite; Substance Abuse Treatment Centers; Substance Abuse, Intravenous; Substance-Related Disorders; Urban Population

Based on a 1988-91 sample of 422 drug-using arrestees in Los Angeles, this study compares the drug-related risk behavior of users whose preferred injection drug is cocaine and users with a preference for heroin or no preference between the two drugs. Cocaine preference is unrelated to the likelihood of needle sharing overall, needle sharing with strangers, needle sharing at shooting galleries, and failure to use bleach as a needle disinfectant. In analyses restricted to users who reported needle sharing, the frequency of sharing is no more closely related to heroin injection frequency than to cocaine injection frequency. These results suggest that local preventive education programs do not need to address distinctive patterns of drug-related risk behavior among injection cocaine users and injection heroin users in Los Angeles.

Topics: Adult; Choice Behavior; Cocaine; Crime; Disinfection; Female; Health Behavior; Health Education; Heroin Dependence; HIV Infections; Humans; Los Angeles; Male; Needle Sharing; Needles; Risk Factors; Risk-Taking; Sampling Studies; Sodium Hypochlorite; Substance Abuse, Intravenous