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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2005 Sep;82(3):434–445. doi: 10.1093/jurban/jti088

HIV among injection drug users in large US metropolitan areas, 1998

Samuel R Friedman 1,2,, Spencer Lieb 3, Barbara Tempalski 4, Hannah Cooper 5,6, Marie Keem 4, Risa Friedman 4, Peter L Flom 7
PMCID: PMC3456049  PMID: 16014877

Abstract

This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metropolitan areas to facilitate social and policy analyses of HIV epidemics. HIV prevalence rates among IDUs in these metropolitan areas were calculated by taking the mean of two estimates: (1) estimates based on regression adjustments to Centers for Disease Control and Prevention (CDC) Voluntary HIV Counseling and Testing data and (2) estimates based on the ratio of the number of injectors living with HIV to the number of injectors living in the metropolitan area. The validity of the resulting estimates was assessed. HIV prevalence rates varied from 2 to 28% (median 5.9%; interquartile range 4.0–10.2%). These HIV prevalence rates correlated with similar estimates calculated for 1992 and with two theoretically related phenomena: laws against over-the-counter purchase of syringes and income inequality. Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates, predictors and consequences of HIV prevalence rates among drug injectors in metropolitan areas and for assessing and targeting the service needs for drug injectors.

Keywords: Epidemic modeling, HIV prevalence estimates, Injection drug users, Local epidemics, Structural analysis

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