A4a Gender and Age Patterns in HSV-2 and HIV Among Non-Injecting Drug Users

Tuesday, March 9, 2010: 10:15 AM
International Ballroom A/B/C/D (M2) (Omni Hotel)
Don Des Jarlais, PhD1, Kamyar Arasteh, PhD1, Courtney McKnight, MPH1, David Perlman, MD2, Holly Hagan, PhD3, Salaam Semaan, DrPH4 and Samuel Friedman, PhD5, 1Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY, 2Department of Medicine, Beth Israel Medical Center, New York, NY, 3College of Nursing, New York University, New York, NY, 4National Center for HIV/AIDS, viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 5AIDS Research, National Development and Research Institutes, Inc, New York, NY

Background: Herpes simplex virus 2 (HSV-2) infection biologically facilitates acquisition and transmission of HIV.

Objectives: To examine prevalence of and associations between herpes simplex virus type 2 (HSV-2) and HIV among never-injecting heroin and cocaine users in New York

Methods: Subjects were recruited from patients entering the Beth Israel drug detoxification program. Informed consent was obtained, a structured questionnaire including demographics, drug use history and sexual risk behavior, was administered and a blood sample was collected for HIV and HSV-2 antibody testing. Only persons who reported that they had never injected illicit drugs were included in the analyses.

Results: 1418 subjects who had never (lifetime) injected drugs (NIDUs) were recruited from 2005 through 2009. Subjects were primarily male (76%) and African-American (67%) or Hispanic (25%), reported recent crack cocaine use (74%), and had a mean age of 42 years. The prevalence of both viruses was high: for HSV-2, 61% among the total sample, 53% among non-MSM male NIDUs, 85% among female NIDUs, and 72% among MSM NIDUs; for HIV, 16% among the total sample, 15% among non-MSM males, 20% among females and 46% among MSM. HSV-2 was associated with HIV, (OR = 3.2, 95% CI 2.3 to 4.5), and the strength of the association increased with increasing age of the subjects. The association was particularly strong among females (OR = 7.1, 95% CI 1.7 to 30.0).

Conclusions: Rates of HIV and HSV-2 infection and the association between the two viruses among non-injecting drug users in New York City are comparable to rates in sub-Saharan Africa.

Implications for Programs, Policy, and/or Research: Additional interventions to reduce HIV transmission among NIDUs are urgently needed, as well as platforms for providing services to NIDUs and better methods for tracking HIV infection among NIDUs.

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