Risk Factors for Elevated HIV Incidence Among Aboriginal Injection Drug Users in Vancouver
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Author(s):
Craib, K. J. |
Spittal, P. M. |
Wood, Evan |
Laliberte, N. |
Hogg, R. S. |
Li, K. |
Heath, K. Tyndall, M. W. |
O'Shaughnessy, M. V. |
Schechter, M. T.
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Description:
Background: Because of established links between entrenched poverty and risk of HIV infection, there have long been warnings that HIV/AIDS will disproportionately affect Aboriginal people in Canada. We compared HIV incidence rates among Aboriginal and non-Aboriginal injection drug users (IDUs) in Vancouver and studied factors associated with HIV seroconversion among Aboriginal participants. Methods: This analysis was based on 941 participants (230 Aboriginal
people) recruited between May 1996 and December 2000 who were seronegative at enrolment and had completed
at least one follow-up visit. Incidence rates were calculated using the Kaplan-Meier method. The Cox proportional hazards regression model was used to identify independent predictors of time to HIV seroconversion among female and male Aboriginal IDUs. Results: As of May 31, 2001, seroconversion had occurred in 112 (11.9%) of the participants, yielding a cumulative incidence of HIV infection at 42 months of 12.7% (95% confidence interval [CI] 10.3%–15.1%). The cumulative incidence at 42 months was significantly higher among the Aboriginal participants than among the non-Aboriginal participants (21.1% v. 10.7%, p < 0.001). This elevation in risk was present in both female and male Aboriginal IDUs. Among the female Aboriginal IDUs, frequent speedball (combined cocaine and heroin) injection (adjusted relative risk [RR] 3.1; 95% CI 1.4–7.1) and going on binges of injection drug use (adjusted RR 2.3; 95% CI 1.0–5.2) were found to be independent predictors of HIV seroconversion. Among the male Aboriginal IDUs, the independent predictors of seroconversion were frequent speedball injection (adjusted RR 2.9; 95% CI 1.0–8.5) and frequent cocaine injection (adjusted RR 2.5; 95% CI 1.0–6.5). (abstract from the article)
Type of Resource:
Journal
Publication Date:
2003
Volume:
168
Issue:
1
Pages:
19-24
Location:
Vancouver