Historique
Article de Périodique
What happened to the HIV epidemic among non-injecting drug users in New York City? (2017)
Auteur(s) :
DES JARLAIS, D. C. ;
ARASTEH, K. ;
McKNIGHT, C. ;
FEELEMYER, J. ;
CAMPBELL, A. N. C. ;
TROSS, S. ;
COOPER, H. L. F. ;
HAGAN, H. ;
PERLMAN, D. C.
Année
2017
Page(s) :
290-298
Langue(s) :
Anglais
Refs biblio. :
45
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus géographique
ETATS-UNIS
Thésaurus mots-clés
VIH
;
PREVALENCE
;
VOIE D'ADMINISTRATION
;
COCAINE
;
HEROINE
;
ETUDE CLINIQUE
;
CRACK
;
CONDUITE A RISQUE
Note générale :
Commentary: Robust public health policies as a way forward in the HIV epidemic. Whitehead N.E., p. 299-300.
Résumé :
Background and aims: HIV has reached high prevalence in many non-injecting drug user (NIDU) populations. The aims of this study were to (1) examine the trend in HIV prevalence among non-injecting cocaine and heroin NIDUs in New York City, (2) identify factors potentially associated with the trend and (3) estimate HIV incidence among NIDUs.
Design: Serial-cross sectional surveys of people entering drug treatment programs. People were permitted to participate only once per year, but could participate in multiple years.
Setting: Mount Sinai Beth Israel drug treatment programs in New York City, USA.
Participants: We recruited 3298 non-injecting cocaine and heroin users from 2005 to 2014. Participants were 78.7% male, 6.1% white, 25.7% Hispanic and 65.8% African American. Smoking crack cocaine was the most common non-injecting drug practice.
Measures: Trend tests were used to examine HIV prevalence, demographics, drug use, sexual behavior and use of antiretroviral treatment (ART) by calendar year; ?2 and multivariable logistic regression were used to compare 2005-10 versus 2011-14.
Findings: HIV prevalence declined approximately 1% per year (P < 0.001), with a decline from 16% in 2005-10 to 8% in 2011-14 (P < 0.001). The percentages of participants smoking crack and having multiple sexual partners declined and the percentage of HIV-positive people on ART increased. HIV incidence among repeat participants was 1.2 per 1000 person-years (95% confidence interval = 0.03/1000-7/1000).
Conclusions: HIV prevalence has declined and a high percentage of HIV-positive non-injecting drug users (NIDUs) are receiving antiretroviral treatment, suggesting an end to the HIV epidemic among NIDUs in New York City. These results can be considered a proof of concept that it is possible to control non-injecting drug use related sexual transmission HIV epidemics.
Design: Serial-cross sectional surveys of people entering drug treatment programs. People were permitted to participate only once per year, but could participate in multiple years.
Setting: Mount Sinai Beth Israel drug treatment programs in New York City, USA.
Participants: We recruited 3298 non-injecting cocaine and heroin users from 2005 to 2014. Participants were 78.7% male, 6.1% white, 25.7% Hispanic and 65.8% African American. Smoking crack cocaine was the most common non-injecting drug practice.
Measures: Trend tests were used to examine HIV prevalence, demographics, drug use, sexual behavior and use of antiretroviral treatment (ART) by calendar year; ?2 and multivariable logistic regression were used to compare 2005-10 versus 2011-14.
Findings: HIV prevalence declined approximately 1% per year (P < 0.001), with a decline from 16% in 2005-10 to 8% in 2011-14 (P < 0.001). The percentages of participants smoking crack and having multiple sexual partners declined and the percentage of HIV-positive people on ART increased. HIV incidence among repeat participants was 1.2 per 1000 person-years (95% confidence interval = 0.03/1000-7/1000).
Conclusions: HIV prevalence has declined and a high percentage of HIV-positive non-injecting drug users (NIDUs) are receiving antiretroviral treatment, suggesting an end to the HIV epidemic among NIDUs in New York City. These results can be considered a proof of concept that it is possible to control non-injecting drug use related sexual transmission HIV epidemics.
Affiliation :
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Cote :
Abonnement