Behavioral risk factors of human immunodeficiency virus infection among intravenous drug users and implications for preventive interventions.

Risk behaviors for HIV infection in relation to drug and sexual activities among 262 intravenous drug users (IVDUs) from methadone clinics in New York City were investigated using a structured questionnaire in 1986. The overall seroprevalence rate was 60.1 per cent. Intravenous heroin and cocaine users were found to be significantly more likely to be HIV positive than those who used heroin and cocaine intranasally. Among female IVDUs, excluding prostitutes (defined by self-report of sex for money or drugs), the HIV positive participants reported higher numbers of sex partners than those participants who were HIV negative. The female IVDUs who reported prostitution during the last 12 months were less likely to be HIV positive than those who did not. All males who reported passive anal and oral sex without using condoms during the last 12 months were found to be HIV positive. All female prostitutes who reported use of condoms during the last 12 months were found to be HIV negative. Interventions in methadone maintenance programs should focus on the IVDUs who are still using heroin, cocaine, and marijuana; sexually active females; and those IVDUs not using condoms (particularly among prostitutes).