| High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: results of a cohort study. | |
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MedLine Citation:
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PMID: 9420522 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Needle exchange programs (NEPs) are designed to prevent human immunodeficiency virus (HIV) transmission among injection drug users. Although most studies report beneficial effects in terms of behavior modification, a direct assessment of the effectiveness of NEPs in preventing HIV infection has been lacking. A cohort study was conducted to assess the association between risk behaviors and HIV seroprevalence and seroincidence among injection drug users in Montreal, Canada. The association between NEP use and HIV infection was examined in three risk assessment scenarios using intensive covariate adjustment for empirical confounders: a cross-sectional analysis of NEP use at entry as a determinant of seroprevalence, a cohort analysis of NEP use at entry as a predictor of subsequent seroconversion, and a nested case-control analysis of NEP participation during follow-up as a predictor of seroconversion. From September 1988 to January 1995, 1,599 subjects were enrolled with a baseline seroprevalence of 10.7%. The mean follow-up period was 21.7 months. The adjusted odds ratio for HIV seroprevalence in injection drug users reporting recent NEP use was 2.2 (95% confidence interval 1.5-3.2). In the cohort study, there were 89 incident cases of HIV infection with a cumulative probability of HIV seroconversion of 33% for NEP users and 13% for nonusers (p < 0.0001). In the nested case-control study, consistent NEP use was associated with HIV seroconversion during follow-up (odds ratio = 10.5, 95% confidence interval 2.7-41.0). Risk elevations for HIV infection associated with NEP attendance were substantial and consistent in all three risk assessment scenarios in our cohort of injection drug users, despite extensive adjustment for confounders. In summary, in Montreal, NEP users appear to have higher seroconversion rates then NEP nonusers. |
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Authors:
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J Bruneau; F Lamothe; E Franco; N Lachance; M Désy; J Soto; J Vincelette |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of epidemiology Volume: 146 ISSN: 0002-9262 ISO Abbreviation: Am. J. Epidemiol. Publication Date: 1997 Dec |
Date Detail:
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Created Date: 1998-01-22 Completed Date: 1998-01-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7910653 Medline TA: Am J Epidemiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 994-1002 Citation Subset: IM; X |
Affiliation:
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Department of Psychiatry, University of Montreal, Quebec, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Case-Control Studies Cohort Studies Female HIV Infections / epidemiology*, etiology, prevention & control HIV Seroprevalence* Humans Incidence Male Needle-Exchange Programs / statistics & numerical data* Odds Ratio Quebec / epidemiology Regression Analysis Risk Factors Risk-Taking Substance Abuse, Intravenous* / complications |
| Comments/Corrections | |
Comment In:
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Am J Epidemiol. 2000 Jan 15;151(2):207-8
[PMID:
10645825
]
Am J Epidemiol. 1998 Oct 1;148(7):713-4; author reply 716-7 [PMID: 9778178 ] Am J Epidemiol. 1999 Aug 1;150(3):325-6 [PMID: 10430240 ] Am J Epidemiol. 1997 Dec 15;146(12):1003-6; discussion 1007-10 [PMID: 9420523 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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