This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Spittal, P. M.
Right arrow Articles by Schechter, M. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Spittal, P. M.
Right arrow Articles by Schechter, M. T.
Related Collections
Right arrow HIV infection, AIDS
Right arrow Drug misuse
CMAJ • April 2, 2002; 166 (7)
© 2002 Canadian Medical Association or its licensors

Research
Recherche

Risk factors for elevated HIV incidence rates among female injection drug users in Vancouver

Patricia M. Spittal*{dagger}, Kevin J.P. Craib*{dagger}, Evan Wood*{dagger}, Nancy Laliberté*, Kathy Li*, Mark W. Tyndall*{dagger}, Michael V. O'Shaughnessy*{ddagger} and Martin T. Schechter*{dagger}

From *the British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, and {dagger}the Department of Health Care and Epidemiology and {ddagger}the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC

Correspondence to: Dr. Martin Schechter, Professor and Head, Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Ave., Vancouver BC V6T 1Z3; fax 604 806-9044; martin.schechter{at}ubc.ca

Background: In 1997, we found a higher prevalence of HIV among female than among male injection drug users in Vancouver. Factors associated with HIV incidence among women in this setting were unknown. In the present study, we sought to compare HIV incidence rates among male and female injection drug users in Vancouver and to compare factors associated with HIV seroconversion.

Methods: This analysis was based on 939 participants recruited between May 1996 and December 2000 who were seronegative at enrolment with at least one follow-up visit completed, and who were studied prospectively until March 2001. Incidence rates were calculated using the Kaplan–Meier method. The Cox proportional hazards regression model was used to identify independent predictors of time to HIV seroconversion.

Results: As of March 2001, seroconversion had occurred in 110 of 939 participants (64 men, 46 women), yielding a cumulative incidence rate of HIV at 48 months of 13.4% (95% confidence interval [CI] 11.0%–15.8%). Incidence was higher among women than among men (16.6% v. 11.7%, p = 0.074). Multivariate analysis of the female participants' practices revealed injecting cocaine once or more per day compared with injecting less than once per day (adjusted relative risk [RR] 2.6, 95% CI 1.4–4.8), requiring help injecting compared with not requiring such assistance (adjusted RR 2.1, 95% CI 1.1–3.8), having unsafe sex with a regular partner compared with not having unsafe sex with a regular partner (adjusted RR 2.9, 95% CI 0.9–9.5) and having an HIV-positive sex partner compared with not having an HIV-positive sex partner (adjusted RR 2.7, 95% CI 1.0–7.7) to be independent predictors of time to HIV seroconversion. Among male participants, injecting cocaine once or more per day compared with injecting less than once per day (adjusted RR 3.3, 95% CI 1.9–5.6), self-reporting identification as an Aboriginal compared with not self-reporting identification as an Aboriginal (adjusted RR 2.5, 95% CI 1.4–4.2) and borrowing needles compared with not borrowing needles (adjusted RR 2.0, 95% CI 1.1–3.4) were independent predictors of HIV infection.

Interpretation: HIV incidence rates among female injection drug users in Vancouver are about 40% higher than those of male injection drug users. Different risk factors for seroconversion for women as opposed to men suggest that sex-specific prevention initiatives are urgently required.




This article has been cited by other articles:


Home page
 CMAJHome page
K. DeBeck, T. Kerr, K. Li, B. Fischer, J. Buxton, J. Montaner, and E. Wood
Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs
Can. Med. Assoc. J., October 27, 2009; 181(9): 585 - 589.
[Abstract] [Full Text] [PDF]

Home page
 J Public Health (Oxf)Home page
M.-J.S. Milloy, T. Kerr, R. Zhang, M. Tyndall, J. Montaner, and E. Wood
Inability to access addiction treatment and risk of HIV infection among injection drug users recruited from a supervised injection facility
J Public Health, September 23, 2009; (2009) fdp089v1.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
S. Y. Shaw, L. Shah, A. M. Jolly, and J. L. Wylie
Identifying Heterogeneity Among Injection Drug Users: A Cluster Analysis Approach
Am J Public Health, August 1, 2008; 98(8): 1430 - 1437.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
E. Wood, M. W. Tyndall, Z. Qui, R. Zhang, J. S. G. Montaner, and T. Kerr
Service Uptake and Characteristics of Injection Drug Users Utilizing North America's First Medically Supervised Safer Injecting Facility
Am J Public Health, May 1, 2006; 96(5): 770 - 773.
[Abstract] [Full Text] [PDF]

Home page
 Sex. Transm. Infect.Home page
P Kyrychenko and V Polonets
High HIV risk profile among female commercial sex workers in Vinnitsa, Ukraine
Sex Transm Inf, April 1, 2005; 81(2): 187 - 188.
[Full Text] [PDF]

Home page
 Int J EpidemiolHome page
E. Wood, K. Li, C. L Miller, R. S Hogg, J. S G Montaner, M. T Schechter, and T. Kerr
Baseline self-perceived risk of HIV infection independently predicts the rate of HIV seroconversion in a prospective cohort of injection drug users
Int. J. Epidemiol., February 1, 2005; 34(1): 152 - 158.
[Abstract] [Full Text] [PDF]

Home page
 Sex. Transm. Infect.Home page
L M Kuyper, T M Lampinen, K Li, P M Spittal, R S Hogg, M T Schechter, and E Wood
Factors associated with sex trade involvement among male participants in a prospective study of injection drug users
Sex Transm Inf, December 1, 2004; 80(6): 531 - 535.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
T. Kerr, E. Wood, D. Small, A. Palepu, and M. W. Tyndall
Potential use of safer injecting facilities among injection drug users in Vancouver's Downtown Eastside
Can. Med. Assoc. J., October 14, 2003; 169(8): 759 - 763.
[Abstract] [Full Text]

Home page
 CMAJHome page
E. Wood, J. S.G. Montaner, B. Yip, M. W. Tyndall, M. T. Schechter, M. V. O'Shaughnessy, and R. S. Hogg
Adherence and plasma HIV RNA responses to highly active antiretroviral therapy among HIV-1 infected injection drug users
Can. Med. Assoc. J., September 30, 2003; 169(7): 656 - 661.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
N. Glick
Vide VIDUS
Can. Med. Assoc. J., August 5, 2003; 169(3): 187 - 188.
[Full Text] [PDF]

Home page
 CMAJHome page
K. J.P. Craib, P. M. Spittal, E. Wood, N. Laliberte, R. S. Hogg, K. Li, K. Heath, M. W. Tyndall, M. V. O'Shaughnessy, and M. T. Schechter
Risk factors for elevated HIV incidence among Aboriginal injection drug users in Vancouver
Can. Med. Assoc. J., January 7, 2003; 168(1): 19 - 24.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
R. S. Remis
HIV incidence among injection drug users in Vancouver
Can. Med. Assoc. J., April 1, 2002; 166(7): 908 - 909.
[Full Text] [PDF]