WASHINGTON, DC—Injection drug users (IDUs) continue to represent a substantial proportion of new HIV diagnoses, a recent CDC study confirmed.

Since the peak of the HIV epidemic in the late 1980s, HIV incidence among IDUs has decreased by nearly 80%. However, studies continue to show that IDUs are infected with HIV at high rates. Data from 34 states between 2004 and 2007 showed that 13% of persons who received a diagnosis of HIV were IDUs, according to CDC’s Nov 27th Morbidity and Mortality Weekly Report. “It confirms for us that HIV among IDUs is still a problem, and they still make up a significant proportion of new diagnoses,” said Dr Luke Shouse, a medical epidemiologist at CDC who authored the report.

Blacks or African Americans accounted for 58% of HIV-infected IDUs, whites for 21%, Hispanics or Latinos for 19%, American Indians or Alaska Natives for 0.6%, Asians for 0.4%, and Native Hawaiians or Other Pacific Islanders for 0.1%. “The higher number of HIV infections among blacks or African Americans is consistent with reports that [they] are more likely to inject drugs than whites, and have higher rates of HIV infection overall,” the study stated. The study also found that the majority of HIV-infected IDUs (62%) were males. By age group, the highest percentage of HIV diagnoses among IDUs (33%) was among persons aged 35 to 44 years.

Reaching IDUs

The report stated that recent evidence suggests many IDUs continue to engage in high-risk behaviors, such as sharing syringes and having unprotected sex. Reaching this population with HIV prevention messages and care can be challenging. “By the very nature that they are injection drug users, that behavior is illegal and it makes it a hidden population in many ways,” Shouse told U.S. Medicine. Consequently, HIV prevention programs should be enhanced to target IDUs, especially black or African American IDUs, and should always include HIV testing as a component of the prevention program.

The CDC advises routine HIV screening of adults, adolescents, and pregnant women in health care settings, and retesting at least annually for all persons at high risk for HIV. “One of our big things has been to try and increase HIV testing as a routine part of care provided in all health care settings and include substance abuse clinics,” said Shouse.

It is important that clinicians administer routine testing for HIV because if patients are not aware that they are infected, they may fail to take precautions to prevent transmission to others. This recent study found that 40% of the infected IDUs received their HIV diagnosis within a year of their AIDS diagnosis, which means that they received an HIV diagnosis late in the course of the infection.

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