| Titre : | Sexual transmission of HIV-1 among injection drug users in San Francisco, USA : risk-factor analysis. (2001) |
| Auteurs : | Alex-H KRAL ; Peter BACCHETTI ; Ricky-N BLUTHENTHAL ; Brian-R EDLIN ; Lauren GEE ; Jennifer LORVICK |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 357, n° 9266, 2001) |
| Pagination : | 1397-1401 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; VIH ; Rétrovirus ; Virus ; Toxicomanie ; Examen sérologique ; Facteur risque ; Epidémiologie ; Comportement sexuel ; Etats Unis ; Amérique ; Toxicomane ; Homme ; Immunopathologie ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xDG7v9. Diffusion soumise à autorisation]. Background Many new HIV-1 infections in the USA occur in injection drug users (IDUs). HIV-1 seroconversion of IDUs is mainly associated with injection-related risk factors. Harm-reduction programmes concentrate on injection-risk behaviour. We aimed to establish whether injection or sexual risk factors, or both, were associated with HIV-1 antibody seroconversion of street-recruited IDUs in San Francisco, from 1986 to 1998. Methods IDUs were enrolled every 6 months from four community sites. We did a nested case-control study comparing 58 respondents who seroconverted between visits with 1134 controls who remained seronegative. Controls were matched with cases by sex and date. Adjusted odds ratios and 95% Cl were calculated for men and women by use of conditional logistic regression. Findings Men who had sex with men were 8.8 times as likely to seroconvert (95% Cl 3.7-20.5) as heterosexual men. Women who reported having traded sex for money in the past year were 5.1 times as likely as others to seroconvert (95% CI 1.9-13.7). Women younger than 40 years were more likely to seroconvert than those 40 years or older (2-8 [1.05-7.6]), and women who reported having a steady sex-partner who injected drugs were less likely to seroconvert than other women (0.32 [0.11-0.92]). Interpretation HIV-1 seroconversion of street-recruited IDUs in San Francisco is strongly associated with sexual behaviour. HIV-1 risk might be reduced by incorporation of innovative sexual-risk-reduction strategies into harm-reduction programmes. |
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