HIV-INFECTION AMONG NON-INJECTING DRUG-USERS ENTERING DRUG-TREATMENT, UNITED-STATES, 1989-1992

Objective: To describe HIV seroprevalence among non-injecting drug users (non-IDU) entering sentinel drug treatment centers in the United States. Design: Anonymous, blinded (unlinked) HIV seroprevalence surveys. Setting: Sixty-eight sentinel drug treatment centers in 37 United States metropolitan areas. Participants: Consecutive sample of clients admitted to sentinel drug treatment centers from January 1989 through December 1992. Of 84 617 clients, 37 633 (44.5%) had used illicit drugs but reported no injecting drug use since 1978. Main outcome measures: Center-specific, metropolitan area-specific, and national median HIV seroprevalence rates. Results: National median center-specific HIV seroprevalence among non-IDU was 3.2% (range, 0-15.2%). Rates varied widely by geographic area. Median rates were highest in the northeast (5.6%; range, 0-15.2%), intermediate in the south (3.4%; range, 0.6-8.0%), and generally lower throughout the rest of the country: midwest (1.3%; range, 0-3.1%) and west (1.8%; range, 0-14.5%). When stratified by treatment center, there were few statistically significant differences in seroprevalence among African Americans, Hispanics and whites. The median rate was 3.4% among men and 2.7% among women. Rates among non-IDU were lower than among IDU attending the same drug treatment centers, but consistently higher than among heterosexual patients attending sexually transmitted disease clinics in the same metropolitan areas. Conclusions: HIV seroprevalence among non-IDU entering drug treatment is high in many metropolitan areas. HIV prevention and education efforts in drug treatment centers should target sexual as well as drug-use risk reduction for all clients.