HIV seropositivity in community-recruited and drug treatment samples of injecting drug users

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ObjectiveTo assess the representativeness of drug use treatment samples for measuring HIV seroprevalence among injecting drug users (IDU) in community settings.DesignSeroprevalence was determined in two cross-sectional, convenience samples including an unlinked survey of IDU entrants to all publicly-funded drug-treatment programs and a survey of community-recruited IDU.MethodsUnconditional logistic regression [odds ratio (OR)] was used to calculate unadjusted and adjusted OR to measure the association between HIV seropositivity and site of recruitment.ResultsBetween 1988 and 1989, 25% of 870 community-recruited IDU were seropositive, compared with 13% of 671 entrants to drug-treatment programs. This twofold risk of HIV seropositivity among community-recruited IDU remained after adjustment for sample differences in gender, race-ethnicity, and age group (adjusted OR, 2.09; 95% confidence interval, 1.58–2.78).ConclusionsThese results suggest the importance of extending HIV surveillance outside of drug-treatment facilities. Active serologic surveillance may be feasible by coupling recent saliva and fingerstick sampling techniques with existing community outreach education efforts.

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