International Journal of Epidemiology, Vol 28, 335-340, Copyright © 1999 by International Epidemiological Association
I Hernandez-Aguado, MJ Avino, S Perez-Hoyos, J Gonzalez-Aracil, I Ruiz-Perez, A Torrella, M Garcia de la Hera, F Belda, E Fernandez, C Santos, J Trullen and A Fenosa
BACKGROUND: Evaluation of acquired immunodeficiency syndrome (AIDS)
prevention strategies requires an on-going follow up of the frequency of
human immunodeficiency virus (HIV-1) infection. The aim of this study was
to examine the trends in prevalence and incidence of HIV-1 infection among
injecting drug users (IDU) during the period 1987-1996. METHODS:
Transversal and cohort studies were designed which included a consecutive
sample of 7132 IDU who attended three AIDS Prevention and Information
Centres in the Region of Valencia (Spain) and voluntarily asked to be
tested for HIV antibodies. The prevalence was estimated for each year based
on the serological status of HIV-1 when the patient first visited the
centre. The annual incidence rates were calculated based on the
seronegative patients in which a new determination of HIV- 1 was done. In
order to control the possible effects on the estimations of age, sex and
duration of addiction of the people studied, Poisson and logistic
regression models were adjusted. RESULTS: Prevalence and incidence rates of
HIV-1 infection showed parallel trends over time. The overall prevalence
found was 43.6% (95% confidence intervals [CI]: 42.4-44.7%). Of the 4023
seronegative individuals, 1746 were followed up over the whole of the study
period. The incidence rate observed was 6.85 x 100 persons/year (95% CI :
6.04-7.66). The prevalence figures show a decrease, which is most marked
from 1990 onwards and then they tend to stabilize over the past few years.
The incidence rates increase slightly up to 1991 (9.8 x 100 persons/year),
and then begin to decrease. CONCLUSION: Trends of prevalence of HIV-1
infection approximate trends of subjacent incidence rate. Despite decrease
in HIV- 1 infection frequency observed over 10 years, both the prevalence
and incidence figures continue to be high in absolute terms. It is
necessary to intensify and adapt preventive measures to each subgroup at
risk of infection and in the case of heterosexual transmission ensure that
the failure observed in the case of IDU is not repeated.
ARTICLES
Human immunodeficiency virus (HIV) infection in parenteral drug users: evolution of the epidemic over 10 years. Valencian Epidemiology and Prevention of HIV Disease Study Group
Miguel Hernandez University, San Juan, Alicante, Spain.
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