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HIV Risk Behaviors Among Community-Recruited Older People Who Inject Drugs (PWID) Prescreening for HPTN 094 in
Sydney Bornstein1, Hannah Yellin2, Blair Altman2
1Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. sbornstein@gwu.edu.
AIDS and Behavior
|April 18, 2026
Summary
Older adults who inject drugs face significant HIV risks. Homelessness, recent overdose, and injecting benzodiazepines are linked to risky behaviors like syringe sharing and unprotected sex.
Area of Science:
- Public Health
- Epidemiology
- Addiction Medicine
Background:
- Older adults who inject drugs (PWID) are a vulnerable population with ongoing risks for HIV transmission.
- Limited research exists on the specific HIV risk behaviors prevalent among older PWID.
Purpose of the Study:
- To investigate the prevalence and correlates of HIV risk behaviors among older PWID in Washington, DC.
- To identify factors associated with increased HIV risk in this demographic.
Main Methods:
- Cross-sectional analysis of self-reported survey data from June 2022 to June 2023.
- Inclusion criteria: adults aged over 50 who reported injection drug use in the past three months.
- Logistic regression models were used to determine correlates of HIV risk behaviors.
Main Results:
- 42% of 260 older PWID reported at least one HIV risk behavior in the past three months.
- Benzodiazepine injection correlated with condomless sex.
- Syringe/needle sharing was associated with recent overdose and other opioid injection.
- Sharing other injection equipment was linked to homelessness, recent overdose, and benzodiazepine injection.
Conclusions:
- Older PWID in Washington, DC, exhibit significant HIV risk behaviors.
- Homelessness, recent overdose, and injecting specific substances (benzodiazepines, other opioids) are key correlates of risk.
- Tailored substance use treatment and HIV prevention programs are crucial for this population.
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