HIV seroprevalence surveys in drug treatment centers

Abstract

Sharing of equipment used to inject illicit drugs intravenously is a risk factor for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). Systematic surveillance of HIV infection among intravenous drug users (IVDUs) in the United States is essential to monitor the HIV epidemic and to target and evaluate prevention programs for IVDUs and their partners. The most accessible segment of the largely covert population of IVDUs are those in drug treatment programs. In collaboration with State and local health departments and drug abuse treatment agencies, the Centers for Disease Control is conducting blinded (serologic test results not linked to identifiable persons) and nonblinded (in which clients voluntarily agree to participate) surveys of IVDUs entering drug treatment in 39 U.S. metropolitan areas. The same protocol is used in all participating drug treatment centers. Blinded surveys will be carried out annually to determine HIV seroprevalence rates in eligible IVDUs entering drug treatment and to monitor trends over time. Each year, nonblinded surveys of IVDUs entering drug treatment will assess self-reported drug use and sexual behaviors to help design educational interventions and to detect changes in behavior over time. This sentinel surveillance system, using a standardized methodology, will provide the best national and regional data available on the seroprevalence of HIV among IVDUs and the relationships of drug use, sexual behaviors, and HIV serologic status of IVDUs.