HIV Risk Behaviors Among Community-Recruited Older People Who Inject Drugs (PWID) Prescreening for HPTN 094 in...

Older people who inject drugs (PWID) remain at risk for HIV, yet little is known about HIV risk behavior in this population. We investigated the prevalence and correlates of HIV risk behaviors among older PWID in Washington, DC. We conducted a cross-sectional analysis of self-reported survey data collected between June 2022 and June 2023 from adults recruited through community-based outreach at known drug use hotspots. Respondents who reported injection drug use in the past three months and were aged > 50 were included. We used simple and multivariable logistic regression to determine correlates of HIV risk behaviors in the last three months. Among 260 older PWID, 42% reported at least one HIV risk behavior in the past three months. Benzodiazepine injection was associated with condomless sex (OR = 5.61, 95% CI 1.36-23.06). Reporting an overdose in the last three months (aOR = 3.18, 95% CI 1.08-9.36) and other opioid injection (aOR = 4.61, 95% CI 1.04-20.40) were associated with sharing syringes/needles. Experiencing homelessness (aOR = 2.20, 95% CI 1.17-4.13), reporting an overdose (aOR = 2.57, 95% CI 1.18-5.61), and benzodiazepine injection (aOR = 6.72, 95% CI 1.49-30.24) were associated with sharing other injection equipment. Our findings suggest that older PWID in Washington, DC engage in HIV risk behaviors, particularly those experiencing homelessness, recent overdose, and injecting certain substances. Age-specific substance use treatment and HIV prevention programs are needed to address HIV risk in this population.