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Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study.
CMAJ. 1993 Oct 01; 149(7):945-51.CMAJ

Abstract

OBJECTIVE

To determine the prevalence of antibodies to HIV-1 and risk factors for HIV-1 infection among injection drug users.

DESIGN

Questionnaire survey. A venous blood sample was taken for HIV-1 antibody testing.

SETTING

Montreal and Toronto.

PARTICIPANTS

A total of 810 subjects who had used injection drugs in the previous 6 months recruited mainly from treatment centres and from the street in Montreal (425 subjects) and from treatment centres in Toronto (385 subjects) between September 1988 and September 1990. The overall participation rate was 82%.

OUTCOME MEASURES

HIV-1 seropositivity, sociodemographic and behavioural risk factors for HIV-1 infection.

RESULTS

The overall seroprevalence rate of HIV-1 infection was 4.8% (95% confidence limits [CL] 3.5 and 6.5). In Montreal the rate was 8.2% (95% CL 6.0 and 11.2), and in Toronto 1.0% (95% CL 0.4 and 2.6) (p < 0.001). Seropositive subjects were significantly older (p = 0.041) and were more likely to have a history of imprisonment (p = 0.006) than seronegative subjects. In univariate analysis seropositivity was associated with the following behaviours: more frequent cocaine use (p < 0.001), injecting drugs in "shooting galleries" (p = 0.002), sharing equipment with a person known to be HIV-1 seropositive (p = 0.006), "booting" fresh blood (p = 0.004), homosexual or bisexual orientation (p = 0.006), engaging in prostitution (p < 0.001) and, for men, number of male sexual partners in the previous 6 months (p = 0.007). In multivariate analysis the determinants of HIV-1 seropositivity were Montreal as the city of recruitment (odds ratio [OR] 6.7, 95% CL 2.32 and 19.42), engaging in prostitution (OR 2.13, 95% CL 1.01 and 4.75), a history of imprisonment (OR 3.51, 95% CL 1.33 and 9.29) and sharing equipment with a person known to be HIV-1 seropositive (OR 4.43, 95% CL 1.43 and 13.74).

CONCLUSIONS

Our findings show that HIV-1 is circulating among injection drug users in Montreal and Toronto and that both drug use and sexual behaviours are implicated in the transmission of infection in the populations studied. Adapted preventive programs should be developed to prevent further spread of HIV-1 infection in this population.

Authors+Show Affiliations

Centre de recherche clinique André-Viallet, Hôpital Saint-Luc, Montreal, Que.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8402423

Citation

Lamothe, F, et al. "Seroprevalence of and Risk Factors for HIV-1 Infection in Injection Drug Users in Montreal and Toronto: a Collaborative Study." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 149, no. 7, 1993, pp. 945-51.
Lamothe F, Bruneau J, Coates R, et al. Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study. CMAJ. 1993;149(7):945-51.
Lamothe, F., Bruneau, J., Coates, R., Rankin, J. G., Soto, J., Arshinoff, R., Brabant, M., Vincelette, J., & Fauvel, M. (1993). Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 149(7), 945-51.
Lamothe F, et al. Seroprevalence of and Risk Factors for HIV-1 Infection in Injection Drug Users in Montreal and Toronto: a Collaborative Study. CMAJ. 1993 Oct 1;149(7):945-51. PubMed PMID: 8402423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study. AU - Lamothe,F, AU - Bruneau,J, AU - Coates,R, AU - Rankin,J G, AU - Soto,J, AU - Arshinoff,R, AU - Brabant,M, AU - Vincelette,J, AU - Fauvel,M, PY - 1993/10/1/pubmed PY - 1993/10/1/medline PY - 1993/10/1/entrez SP - 945 EP - 51 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 149 IS - 7 N2 - OBJECTIVE: To determine the prevalence of antibodies to HIV-1 and risk factors for HIV-1 infection among injection drug users. DESIGN: Questionnaire survey. A venous blood sample was taken for HIV-1 antibody testing. SETTING: Montreal and Toronto. PARTICIPANTS: A total of 810 subjects who had used injection drugs in the previous 6 months recruited mainly from treatment centres and from the street in Montreal (425 subjects) and from treatment centres in Toronto (385 subjects) between September 1988 and September 1990. The overall participation rate was 82%. OUTCOME MEASURES: HIV-1 seropositivity, sociodemographic and behavioural risk factors for HIV-1 infection. RESULTS: The overall seroprevalence rate of HIV-1 infection was 4.8% (95% confidence limits [CL] 3.5 and 6.5). In Montreal the rate was 8.2% (95% CL 6.0 and 11.2), and in Toronto 1.0% (95% CL 0.4 and 2.6) (p < 0.001). Seropositive subjects were significantly older (p = 0.041) and were more likely to have a history of imprisonment (p = 0.006) than seronegative subjects. In univariate analysis seropositivity was associated with the following behaviours: more frequent cocaine use (p < 0.001), injecting drugs in "shooting galleries" (p = 0.002), sharing equipment with a person known to be HIV-1 seropositive (p = 0.006), "booting" fresh blood (p = 0.004), homosexual or bisexual orientation (p = 0.006), engaging in prostitution (p < 0.001) and, for men, number of male sexual partners in the previous 6 months (p = 0.007). In multivariate analysis the determinants of HIV-1 seropositivity were Montreal as the city of recruitment (odds ratio [OR] 6.7, 95% CL 2.32 and 19.42), engaging in prostitution (OR 2.13, 95% CL 1.01 and 4.75), a history of imprisonment (OR 3.51, 95% CL 1.33 and 9.29) and sharing equipment with a person known to be HIV-1 seropositive (OR 4.43, 95% CL 1.43 and 13.74). CONCLUSIONS: Our findings show that HIV-1 is circulating among injection drug users in Montreal and Toronto and that both drug use and sexual behaviours are implicated in the transmission of infection in the populations studied. Adapted preventive programs should be developed to prevent further spread of HIV-1 infection in this population. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/8402423/Seroprevalence_of_and_risk_factors_for_HIV_1_infection_in_injection_drug_users_in_Montreal_and_Toronto:_a_collaborative_study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=8402423.ui DB - PRIME DP - Unbound Medicine ER -