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Dual HIV Risk: Receptive Syringe Sharing and Unprotected Sex Among HIV-Negative Injection Drug Users in New York City

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Abstract

HIV-negative injection drug users (IDUs) who engage in both receptive syringe sharing and unprotected sex (“dual HIV risk”) are at high risk of HIV infection. In a cross-sectional study conducted in New York City in 2009, active IDUs aged ≥18 years were recruited using respondent-driven sampling, interviewed, and tested for HIV. Participants who tested HIV-negative and did not self-report as positive were analyzed (N = 439). Adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) were estimated using multinomial logistic regression. The sample was: 77.7 % male; 54.4 % Hispanic, 36.9 % white, and 8.7 % African-American/black. Dual risk was engaged in by 26.2 %, receptive syringe sharing only by 3.2 %, unprotected sex only by 49.4 %, and neither by 21.2 %. Variables independently associated with engaging in dual risk versus neither included Hispanic ethnicity (vs. white) (aOR = 2.0, 95 % CI = 1.0–4.0), married or cohabiting (aOR = 6.3, 95 % CI = 2.5–15.9), homelessness (aOR = 3.4, 95 % CI = 1.6–7.1), ≥2 sex partners (aOR = 8.7, 95 % CI = 4.4–17.3), ≥2 injecting partners (aOR = 2.9, 95 % CI = 1.5–5.8), and using only sterile syringe sources (protective) (aOR = 0.5, 95 % CI = 0.2–0.9). A majority of IDUs engaged in HIV risk behaviors, and a quarter in dual risk. Interventions among IDUs should simultaneously promote the consistent use of sterile syringes and of condoms.

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Acknowledgments

The authors would like to acknowledge Colin Shepard, MD, Deborah Dowell, MD, MPH, and Jay Varma, MD, of the New York City Department of Health and Mental Hygiene, and Kent Sepkowitz, MD, for critical comments on the intellectual content in earlier drafts of the paper. We would like to thank Isa Miles, Sc.D., Elizabeth DiNenno, PhD., and Alexa Oster, MD, MPH of the CDC for contributing to the NHBS study design nationally and to local implementation, and the New York City NHBS field staff for their efforts in data collection, as well as the study participants who consented to be in the study. This work was funded by a cooperative agreement between the New York City Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention (Grant # 5U62PS000964-02).

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Authors and Affiliations

  1. HIV/AIDS Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th Street, 22nd Floor, New York, NY, 11101-4132, USA

    Alan Neaigus & Kathleen H. Reilly

  2. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Samuel M. Jenness

  3. College of Nursing, New York University, New York, NY, USA

    Holly Hagan

  4. Department of Anthropology, John Jay College of Criminal Justice, New York, NY, USA

    Travis Wendel

  5. The New School for Social Research, New York, NY, USA

    Camila Gelpi-Acosta

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  1. Alan Neaigus
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Correspondence to Alan Neaigus.

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Neaigus, A., Reilly, K.H., Jenness, S.M. et al. Dual HIV Risk: Receptive Syringe Sharing and Unprotected Sex Among HIV-Negative Injection Drug Users in New York City. AIDS Behav 17, 2501–2509 (2013). https://doi.org/10.1007/s10461-013-0496-y

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