HIV-infectie en riskant gedrag onder druggebruikers in Arnhem

Abstract

Objectives: 1) To get information about the spread of HIV among drug users in the Netherlands outside Amsterdam and 2) to develop tools for surveillance research among drug users. Methods: In 1991-1992 273 drug users with (protocol 1 ; n=181) and without contact with the methadonepost (protocol 2 ; n=92, 'on the street') were interviewed on their drug using and sexual behaviours and tested by blood (only protocol 1), fingerprick and saliva. To estimate the number of drug users in the population a capture-recapture method was developed. Results: The prevalence of HIV-infection in Arnhem is estimated at 2% (3/139) among intravenous drug users (IDUs) (95%CI 0.4-6.3%) and 0% (0/134) among non-intravenous drug users (95% CI 0.0-2.8%). All testresults were concordant. Of recent injectors (n=86) 42% report recent sharing of needles or syringes. Of all participants 67% report never using a condom in non-commercial sexual contacts. Among recent injectors borrowing needles or syringes was associated with a longer history of injecting drug use, not being tested for HIV previously, and not using needle exchange facilities consistently. Most IDUs can be contacted at the methadone post but IDUs who are not in contact with the methadonepost report more risk behaviour and have different social-demographic characteristics. IDUs who were previously tested for HIV infections report more risk behaviour longer than 6 months ago, but less recent risk behaviour. The number of drug users in Arnhem is estimated to be between 720 and 1380 (95% CI ; point estimate 1050) ; the number of IDUs between 300 and 570 pointestimate 431) ; the number of HIV-infected drug users between 5 and 27 (point estimate 9). Conclusions The spread of HIV among IDUs in Arnhem is limited so far. Risk behaviour, however, is frequent, which which possibly lead to further spread. Therefore, prevention and surveillance among IDUs are of great importance. The saliva test is very suitable for prevalence research among IDUs.<br>