Reports on HIV/AIDS: 1990

APRIL 27, 1990, MMWR, Vol. 39, No. 16, pp. 273-276
Risk Behaviors for HIV Transmission among Intravenous-Drug Users
Not in Drug Treatment - United States, 1987-1989
A major limitation to preventing transmission of human immunodeficiency virus
(HIV) among intravenous-drug users (IVDUs) has been that most information about
IVDUs' drug use and sexual behavior has been derived from studies of the most
accessible subgroup (i.e., persons in drug-treatment programs) and therefore may
not be representative of all IVDUs (1,2). Such data have been particularly limited for
IVDUs not in drug treatment. This report provides preliminary data from September
1987 through December 1989 about IVDUs not in drug-treatment programs. The data
are derived from the National AIDS Outreach Demonstration Research Project, which
was initiated in 1987 by the National Institute on Drug Abuse (NIDA) and directed at
IVDUs not in drug-treatment programs and their sex partners.
Objectives of the NIDA project included 1) collection of information on drug use
and sexual behaviors of IVDUs not in treatment, 2) assessment of knowledge about
HIV transmission and acquired immunodeficiency syndrome (AIDS) among IVDUs
and their sex partners, and 3) communication of information regarding HIV transmission and AIDS to IVDUs and their sex partners.
From September 1987 to October 1988, outreach demonstration programs were
established in 63 sites in 45 cities in the United States and Puerto Rico. IVDUs were
recruited from hospital emergency rooms and inpatient settings, jails and prisons,
public housing projects, community-based organizations, sexually transmitted disease clinics, and neighborhoods frequented by IVDUs.
Persons recruited for the program must have injected drugs during the 6 months
before recruitment and not have been enrolled in a formal drug-treatment program
during the 30 days before the intake interview. At recruitment and at 6-month
follow-up intervals, trained interviewers used a standardized questionnaire to collect
detailed information from participants about knowledge and behaviors related to
drug use and sexual activity.
For 16,998 IVDUs not in treatment, preliminary data were obtained on their
geographic distribution, demographics, employment status, drug use, and sexual
activity. Of these, 5091 (30%) were recruited in the Northeast, 5028 (30%) in the
Southeast, 4017 (24%) in the West, 2135 (13%) in the Midwest, and 727 (4%) in Puerto
Rico.
Of the 16,998 IVDUs for whom data were obtained, 13,595 (80%) were between the
ages of 25 and 44 years; 12,678 (75%) were male; 8585 (51%) were black, and 4498
(26%) were Hispanic; 9077 (53%) were unemployed, and 2620 (15%) worked
occasionally; and 6722 (40%) had never been in drug treatment. In addition, 14,067
(83%) reported having been in jail or prison at some time; of these, 11,392 (81%) had
never participated in formal drug treatment while incarcerated.
During the 6 months before the intake interview, 16,712 (98%) of IVDUs had
injected cocaine or heroin either alone, sequentially, or mixed; 5824 (34%) predominantly injected heroin, 5310 (31%) predominantly injected cocaine, and 5578 (33%)
predominantly injected combinations of heroin and cocaine. Two hundred eighty-six
(2%) reported injecting amphetamines or other drugs but not heroin or cocaine. Ten
thousand seventy-seven (59%) reported injecting drugs daily. In addition, 13,249
(78%) IVDUs reported sharing drug-injection equipment with another IVDU, and 3454
(20%) reported sharing with strangers (Table 1).

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