IV Drug Abuse

“The study was conducted with non-governmental organizations (NGOs) in three locations with high concentrations of IDU [intravenous drug users]: Kiev, Odessa and Makeevka/ Donetsk [in the Ukraine]…891 individuals were recruited…In order to provide a valid assessment of variables associated with HIV status, we omitted from further analyses the 113 participants who were aware that they were HIV positive prior to entering the study [leaving 778]…those who were HIV positive were significantly older and had been injecting longer than those who were HIV negative…Females were more likely to be HIV positive as were those who had been arrested. Having had syphilis, hepatitis B or hepatitis C was associated with HIV infection. Sedative/opiate mixture was the only drug type predictive of HIV. Daily injecting was associated with being HIV positive, as was front/back loading with a dealer. Using a previously used syringe was not associated with HIV infection. With regard to sexual risk behaviors, those who were abstinent were more likely to be HIV positive than those who were sexually active. Those who had an HIV-positive sex partner, however, were twice as likely to be HIV positive themselves as those who did not have an HIV-positive partner or who did not know the status of their partner…we were somewhat surprised to find that using a used needle was not related to HIV status.”

“The strongest predictor of anaemia was frequency of injecting drugs. Less than half the study population (41%) injected more than 10 times per month, whereas 84% of the people in this group had anaemia”

“the mean duration of drug use preceding the first registered admission [to this Swiss hospital] was 6.7 years [unconfirmed HIV-negative], 7.1 years [confirmed negative] and 11.3 years [HIV-positive]”

“More than 15% of the HIV-1-seropositive [IV-drug-using] individuals had plasma vitamin A levels less than 1.05 micromol/L, a level consistent with vitamin A deficiency.”

“CD4 cell counts and percentages were obtained from 1,246 HIV-seronegative [IV drug using] subjects…9 had at least one CD4 cell count of <300 cells/microliter or a CD4[:CD8 ratio] <20%...4 subjects had CD4 counts <300 cells/microliter or CD4 < 20% for two points in time, meeting the current surveillance definition for ICL [HIV-free AIDS]...We also examined the data for the 21 subjects who had one CD4 count between 300 and 500 cells/microliter and for whom there was at least one follow-up data collection. None of these subjects progressed to a CD4 cell count of <300 cells/microliter or a CD4<20% at any follow-up visit. Five of these 21 subjects later seroconverted for HIV [indicating that low CD4 cell counts preceded infection, and could not have been caused by HIV]”

“Human immunodeficiency virus (HIV) prevalence was studied in an unselected group of 216 female and transsexual prostitutes…All 128 females who did not admit to drug abuse were seronegative; 2 of the 52 females (3.8%) who admitted to intravenous drug abuse were seropositive.”

“Intravenous drug abusers appear to be at special risk of acquiring tuberculosis, and a high rate of infection in this group was reported well before AIDS began.”

“The best single predictor of seropositivity at the start of the follow-up period was the frequency of drug injection 2 to 5 years prior”