Prevalence of HIV-1 among recent arrestees in Los Angeles County, California: serial cross-sectional study, 1991-1995.

Injection drug users (IDU), crack smokers, and commercial sex workers engage in illegal activities that place them at risk for HIV infection. The marginalized nature of these groups often limits use of customary sampling methods to assess HIV prevalence. We tested urine samples of recent arrestees to evaluate HIV prevalence of at-risk populations that are difficult to access using standard surveillance methods. We tested for HIV-1 antibodies in urine specimens of recent Los Angeles County (California, U.S.A.) arrestees as part of the Drug Use Forecasting (DUF) Program funded by the U. S. National Institute of Justice. Data are presented for 5 years of a serial cross-sectional study of arrestees. Results from 1991 through 1995 indicate a slight HIV prevalence increase among crack smokers (from 4% to 6%). Prevalence estimates were relatively stable for IDU (6%), male (3%) and female arrestees (3%), arrestees who share needles (9%), and commercial sex workers (6%). HIV status was independently associated with injection drug use, crack smoking, and ever having exchanged sex for money or drugs. Prevalence of HIV among arrestee subgroups may reflect prevalence in the community. However the benefit of using the DUF sample must be weighed against bias introduced from using nonrandom samples to estimate prevalence.

HIV risk behaviors among women in methadone maintenance treatment.

This article reports on the HIV risk behaviors of a sample of 158 women heroin addicts admitted into the Los Angeles Enhanced Methadone Maintenance Project. Risk behaviors for HIV were associated with age, lack of education, ethnicity, relationship with a drug user, HIV status, and higher scores on measures of illegal activity, suicidality, depression, polydrug use, and alcohol use. Significant reductions in number of male sex partners and needle-sharing partners were reported at follow-up, although frequency of condom use was unchanged. Methadone maintenance programs need to screen women for risk factors and assist them in developing new behavioral skills in order to implement a harm reduction approach to treatment.

Ethnic differences in HIV risk behaviors, self-perceptions, and treatment outcomes among women in methadone maintenance treatment.

This study examined the HIV risk profiles of White, African-American, and Latina women enrolled in the UCLA Enhanced Methadone Maintenance Project, a NIDA-funded research demonstration project with the goal of reducing risk of HIV infection and/or transmission. Each group demonstrated distinct patterns associated with family relationships, sources of income, sexual and injection behaviors, and self-perceptions, although they were similar in their employment, drug use, mental health, and criminal behavior histories. In general, Latinas were more likely to report familial influences and to display evidence of low self-esteem and self-efficacy, inconsistent condom use, and high-risk injection behavior. White women reported the highest levels of regular condom use at follow-up; however, they were the least likely to report safer injection practices. African-American women expressed the highest levels self-esteem, yet they reported more alcohol use at intake and crack cocaine use both before and after treatment entry. They showed the greatest gains in adopting safer injection practices and were the least likely to report multiple sex partners after treatment entry. These findings can be used to improve the potential of methadone maintenance treatment for HIV risk reduction for women and to aid in developing culturally sensitive treatment protocols.