Intravenous drug users and Aids: risk behaviors

FRANÇAIS :
345 consommateurs de drogue par voie intraveineuse sont interrogés sur leur conduite, en matière d'usage (partage de seringues, pratiques d'aseptie des seringues, "shooting gallery"...) et de sexualité (abstinence, utilisation ou non de préservatifs, prostitution, partenaires multiples). La moitié pratiquent au moins une injection par jour, et près des deux tiers partagent les seringues. La séropositivité est corrélée avec la fréquence des injections, le partage des seringues, l'absence de nettoyage des aiguilles, la fréquentation des "shooting galleries", le nombre de partenaires. Seulement 4% des toxicomanes par voie intraveineuse ont des pratiques sûres en matière d'usage de drogue, et en matière de sexualité. Ce constat quoique faible, est deux fois plus fréquent à Baltimore où un programme d'information est mis en route depuis deux ans, ce qui laisse supposer un effet patent.
ENGLISH :
Risk-taking behaviors were studied in this assessment of 345 intravenous drug users from Baltimore, El Paso, and Denver. Over 50% reported injecting drugs daily and 70% shared needles with others, averaging 6.3 partners. In addition, 86% had shared a "cooker" and nearly 50% injected in a "shooting gallery". Two-thirds of the total sample never used a condom, while only 6% always used this form of protection. On the other end of this risk continuum were those subjects who did not share needles or always cleaned their needles with an effective agent, had no sexual relations or always used a condom. However, in an analysis of total risk, it was found that only 14 subjects (4%) practiced safe needle use and safe sex. Despite these findings, some encouraging results were seen. In an analysis of risk according to location, Baltimore subjects were significantly less at risk according to number of risk behavior than in El Paso or Denver. Street outreach to modity risk behaviors among IVDUs began in Baltimore approximately 2 years prior to funding in El Paso and Denver. These results suggest that there may be a potential to moderate risk through intervention.