Human immunodeficiency virus seropositivity in intravenous drug users in Ohio

A seroprevalence survey of 508 intravenous (IV) drug users enrolled in methadone treatment programs in Ohio for evidence of infection with the human immunodeficiency virus (HIV) demonstrated a positivity prevalence of 1.4%. This seropositivity prevalence is low compared with 10% to 72% positive from surveys conducted in the IV drug-using populations of New York, New Jersey, Detroit and San Francisco. Although needle sharing was common (71% since 1983), the number of sharing partners was usually limited and regular. A potential for cross-infection from urban centers with higher seropositivity prevalence was indicated by patterns of travel and needle sharing while traveling to higher risk metropolitan centers such as New York. Hispanics appeared to be at greater risk for HIV infection (OR 17.7, 95% CI 2.4-133.0), as were male IV drug users with gay/bisexual lifestyles (OR 14.1, 95% CI 1.3-153.0). HIV positive individuals were identified in Cleveland (1.6%), Dayton (3.1%), and Columbus (0.8%), but not in the four other Ohio metropolitan areas participating in the survey. Study participants indicated that knowledge of AIDS had changed their IV drug-using habits with 60% reporting that fear of AIDS had caused them to give up IV drugs or needle sharing. Sampling from methadone clinics may underestimate the HIV seropositivity in Ohio's IV drug-using community; however, it appears that relatively few IV drug users in Ohio are currently infected with HIV. The low prevalence of HIV infection in the Ohio IV drug-using community provides the opportunity to intervene in limiting the spread of the virus by educating individuals to reduce or eliminate risk factors for the transmission of the disease.