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CDC: IDUs in the United States continue to engage in sexual and drug-use behaviors that increase their risk for HIV infection
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"Ten percent of participants were aged <30 years, 49% were aged 30-49 years, and 41% were aged ≥50 years......A substantial percentage of participants reported each of three injection behaviors related to acquisition risk for HIV and other bloodborne viruses: receptive sharing of syringes (35%), receptive sharing of other injection equipment (58%), and receptive sharing of syringes to divide drugs (35%) (Table 4).......Many participants reported having unprotected sex with opposite-sex partners during the past 12 months: 70% of men and 73% of women had unprotected vaginal sex, and 25% of men and 21% of women had unprotected anal sex".
In Table 4, the youngest age group in the study 18-29 had the highest prevalence of risky behaviors including receptive sharing of syringes: 52%, vs 42% for the age group 30-39, 36% for 40-49, 29% for 50-59 & 20% for >60.
"Although most participants had been tested for HIV infection previously, less than half had been tested in the past year as recommended by CDC. In addition, many participants had not been vaccinated against hepatitis A and B as recommended by CDC."
HIV Infection and Risk, Prevention, and Testing Behaviors Among Injecting Drug Users - National HIV Behavioral Surveillance System, 20 U.S. Cities, 2009
The National HIV Behavioral Surveillance System (NHBS) collects human immunodeficiency virus (HIV) prevalence and risk behavior data from three populations at high risk for HIV infection: men who have sex with men, injecting drug users, and heterosexual adults at increased risk for HIV infection. This report summarizes data from the second collection cycle of NHBS in 2009.
"The most commonly injected drugs during the past 12 months among these participants were heroin (90%), speedball (heroin and cocaine combined) (58%), and cocaine or crack (49%). Large percentages of participants reported receptive sharing of syringes (35%); receptive sharing of other injection equipment, such as cookers, cotton, or water (58%); and receptive sharing of syringes to divide drugs (35%). Many participants reported having unprotected sex with opposite-sex partners during the past 12 months: 70% of men and 73% of women had unprotected vaginal sex, and 25% of men and 21% of women had unprotected anal sex......
.......A combination of unsafe injection- and sex-related behaviors during the past 12 months was commonly reported; 41% of participants who reported unprotected vaginal sex with one or more opposite-sex partners, and 53% of participants who reported unprotected anal sex with one or more opposite-sex partners also reported receptive sharing of syringes. More women than men reported having sex in exchange for money or drugs (31% and 18%, respectively). Among men, 10% had oral or anal sex with one or more male partners during the past 12 months......
.....Many participants (74%) reported noninjection drug use during the past 12 months, and 41% reported binge drinking during the past 30 days. A large percentage of participants (74%) had ever been tested for hepatitis C, 41% had received a hepatitis C virus infection diagnosis, and 29% had received a vaccination against hepatitis A virus, hepatitis B virus, or both. Most (88%) had been tested for HIV during their lifetime, and 49% had been tested during the past 12 months. Approximately half of participants received free HIV prevention materials during the past 12 months, including condoms (50%) and sterile syringes (44%) and other injection equipment (41%). One third of participants had been in an alcohol or a drug treatment program, and 21% had participated in an individual- or a group-level HIV behavioral intervention.'"
HEPATITIS
Having ever received HCV testing (i.e., told that they had HCV infection or had ever been tested for HCV infection) was reported by 74% of participants, and 41% reported having received a diagnosis of HCV infection (Table 12). Lifetime HCV testing increased with age and was reported in higher percentages among participants who were white, American Indian/Alaska Native, and other races/ethnicities than by those who were black or Hispanic or Latino. Variation in diagnoses of HCV infection by age and race/ethnicity were similar to those reported for lifetime HCV testing. The percentage of participants reporting an HCV infection diagnosis increased with age, ranging from 26% among participants aged 18-29 years to 53% among participants aged ≥60 years. Diagnosis of HCV infection varied by race/ethnicity, with American Indian/Alaska Native (55%), white (47%), and other (46%) participants reporting the highest percentages. Participants who reported most frequently injecting heroin or heroin and cocaine (injected separately with the same frequency or together as speedball) during the past 12 months had higher percentages of HCV infection diagnoses (42% and 43%, respectively) than those who most frequently injected cocaine/crack and methamphetamine (30% and 30%, respectively). Diagnosis of HCV infection was higher among participants who engaged in receptive sharing of syringes, of other injection equipment, and of syringes to divide drugs during the past 12 months (44%, 44%, and 45%, respectively) than among those who did not engage in these receptive sharing behaviors (39%, 36%, and 38%, respectively) (Table 12). Overall, 29% of participants reported receiving at least 1 dose of HAV vaccine, HBV vaccine, or both.
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