Lack of legal income is strongly associated with an increased risk of AIDS and death in HIV-infected injecting drug users.

The aim of the study was to analyze the impact of soci-economic status in addition to other risk factors in the progression of HIV disease in a cohort of injecting drug users (IDUs) with a mean follow-up of two years. Between 1989 and 1992, 124 HIV-infected IDUs were recruited in a primary care outpatient clinic providing free consultations and free access to therapy. The main outcome measures were death and AIDs-defining events. The proportion of current daily injectors at entry in the study and at the end of follow-up was 67.7% and 57.2%, respectively. The proportion of individuals on maintenance opioid therapy at entry in the study and at the end of follow-up was 0 and 12.1%, respectively. CD4 cell counts below 200 x 10(6)/L at baseline, positive p24 antigenemia at baseline, the lack of legal income and occasional drug use at entry were risk factors for clinical progression and death. When adjusted in a multivariate analysis, the absence of legal income remained associated with death and occurrence of an AIDS-defining event with a relative risk of 5.2 (1.5-18.1) (p = 0.004). Lack of legal income is a strong risk factor for progression of HIV disease in IDUs, that is independent of CD4 cell count and p24 antigenemia.

Evaluation by women consulting in a family planning centre of their risk of HIV infection.

In order to assess women's self-perception of their risk of infection by HIV, research was performed among 654 women who had consulted in a family planning centre in the Paris region. Of the 452 (69%) women who took part in this research, 77% considered themselves as 'not at risk of carrying the AIDS virus', 11% as 'at risk' and 12% did not give a specific answer. The most important risk factors noted by the patient and the doctor were found to be the number of partners, the use of syringes and the non- or faulty use of condoms. Estimates of the risk of infection by physicians had a high correlation with those of the women, although there were wide differences between the opinions of the six doctors involved. In one case out of three the doctors were unable to decide whether or not their patient was at risk. The evident difficulties experienced by these physicians show an urgent need for the development of specific medical training programmes. The seroprevalence of 2.4% of HIV infection among the women studied, and 1.1% of those who consulted during the study period, confirm the importance of carrying out specific studies on women consulting in family planning centres.