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Richard E. Chaisson, MD; Peter Bacchetti, PhD; Dennis Osmond, MA; Barbara Brodie, RN, FNP; Merle A. Sande, MD; Andrew R. Moss, PhD

JAMA. 1989;261(4):561-565.

Abstract
We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.

(JAMA 1989;261:561-565)

Author Affiliations
From the Medical Service, San Francisco General Hospital (Drs Chaisson and Sande and Ms Brodie), and the Departments of Medicine (Drs Chaisson and Sande and Ms Brodie) and Epidemiology and International Health (Drs Bacchetti and Moss and Mr Osmond), University of California, San Francisco. Dr Chaisson is now with The Johns Hopkins University School of Medicine, Baltimore.

Footnotes
Reprint requests to AIDS Service, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, 1830 E Monument St, Room 7401, Baltimore, MD 21205 (Dr Chaisson).

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