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American Journal of Epidemiology Vol. 135, No. 3: 225-233
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Parenteral and Sexual Transmission of Human Immunodeficiency Virus in Intravenous Drug Users: A Study of Seroconversion
1Consigfio Nazronale delte Rcerche, Istituto di Tecnol-ogte Biomediche Avanzate, Reparto di Epidemiologia e Informatica Medica Milan, Italy
2Istituto di Rfcovero e Cura a Carattere Scientifico Ospedale Maggiore di Milano, Laboratorio Epidemiologico Mian, Italy
3G. H. Sergievsky Center, Columbia University New York, NY
4Clinica Neurotogica Mondino Pavia, Italy
5Clinca delle Malafbe Infettive, Universita degfi Studi di Milano Milan, Italy
To evaluate the role of parenteral and sexual transmission of human immunodeficiency virus, we studied seronegative intravenous drug users recruited from 25 drug dependence treatment centers in northern Italy. All attending intravenous drug users were asked for their consent and screened for antibodies to human immunodeficiency virus; those who were seronegative were enrolled, interviewed about their habits, and invited to follow-up visits. Between 1987 and 1989, 1,195 seronegative intravenous drug users were enrolled, 635 were followed up (mean duration, 11.9 months), and 35 seroconversions were observed. The incidence rate ratios were 3.3 (95% confidence interval (Cl) 1.4–7.5) for subjects aged <20 years, 2.4 (95% Cl 1.2%4.7) for <2 years of intravenous drug use, 2.2 (95% Cl 0.9–5.5) for syringe sharing, and 1.0 for subjects with a sexual partner who had tested positive for human immunodeficiency virus. A case-control approach, using logistic regression and adjusting for sex, age, area, and prevalence, showed odds ratios of 13.2 (95% Cl 3.1–56.8) for frequent syringe sharing and 4.0 (95%; Cl 1.5–10.4) for sexual contacts with seropositive partners; frequent use of condoms was associated with a reduction in risk that did not reach statistical significance. Parenteral transmission is the most important route of infection with the human immunodeficiency virus among intravenous drug users, and sexual transmission plays a relevant, additive role. Am J Epidemiol 1992;135:225–33.
confounding factors (epidemiology); epidemiotogic methods; HIV; HIV/transmission; incidence; risk factors; substance use disorders
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