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Is Injection Serosorting Occurring among HIV-Positive Injection Drug Users? Comparison by Injection Partner’s HIV Status

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Abstract

Research needs to build evidence for the roles that HIV status of injection partners may or may not play in injection risk behaviors of injection drug users (IDUs). Using baseline data collected from a randomized controlled study (INSPIRE) conducted in four cities (Baltimore, Miami, New York, and San Francisco) from 2001 to 2005, we categorized 759 primarily heterosexual HIV-positive IDUs into four groups based on HIV serostatus of drug injection partners. Thirty-two percent of the sample injected exclusively with HIV-positive partners in the past 3 months and more than 60% had risky injection behavior with these partners. Eight percent injected exclusively with HIV-negative partners and 49% injected with any unknown status partners. The remaining 11% reported having both HIV-positive and -negative injection partners, but no partners of unknown HIV status. Riskier injection behavior was found among the group with mixed status partners. The risk among the group with any unknown status partners appeared to be driven by the greater number of injection partners. No major group differences were observed in socio-demographic and psychosocial factors. Our analysis suggests that serosorting appeared to be occurring among some, but not an overwhelming majority of HIV-positive IDUs, and knowledge of HIV status of all injection partners per se did not appear to be as important as knowledge of sexual partner’s HIV status in its association with risk behavior.

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Acknowledgments

The INSPIRE Team includes the following people: Carl Latkin, Amy Knowlton, and Karin Tobin (Baltimore); Lisa Metsch, Eduardo Valverde, James Wilkinson, and Martina DeVarona (Miami); Mary Latka, Dave Vlahov, Phillip Coffin, Marc Gourevitch, Julia Arnsten, and Robert Gern (New York); Cynthia Gomez, Kelly Knight, Carol Dawson Rose, Starley Shade, and Sonja Mackenzie (San Francisco); David Purcell, Yuko Mizuno, Scott Santibanez, Richard Garfein, and Ann O’Leary (Centers for Disease Control and Prevention [CDC]); Lois Eldred, Kathleen Handley (Health Resources and Services Administration). We would also like to acknowledge the following people for their contributions to this research: Susan Sherman, Roeina Marvin, Joanne Jenkins, Donny Gann, and Tonya Johnson (Baltimore); Clyde McCoy, Rob Malow, Wei Zhao, Lauren Gooden, Sam Comerford, Virginia Locascio, Curtis Delford, Laurel Hall, Henry Boza, Cheryl Riles, Faye Yeomans (Miami); George Fesser, Carol Gerran, Diane Thornton (New York); Caryn Pelegrino, Barbara Garcia, Jeff Moore, Erin Rowley, Debra Allen, Dinah Iglesia-Usog, Gilda Mendez, Paula Lum, and Greg Austin (San Francisco); Gladys Ibanez, Hae-Young Kim, Toni McWhorter, Jan Moore, Lynn Paxton, and John Williamson (CDC); Lee Lam, Jeanne Urban, Stephen Soroka, Zilma Rey, Astrid Ortiz, Sheila Bashirian, Marjorie Hubbard, Karen Tao, Bharat Parekh, Thomas Spira (CDC Laboratory). This study was supported by the Centers for Disease Control and Prevention and the Health Resources and Services Administration.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Yuko Mizuno & David W. Purcell

  2. 1600 Clifton Road, NE Mail Stop E37, Atlanta, GA, 30333, USA

    Yuko Mizuno

  3. Department of Epidemiology and Public Health, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, R-669, Miami, FL, 33136, USA

    Lisa R. Metsch

  4. Health Equity Institute, San Francisco State University, 1600 Holloway Avenue, SP406, San Francisco, CA, 94132, USA

    Cynthia A. Gomez

  5. Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway Avenue, Room 286, Baltimore, MD, 21205, USA

    Amy R. Knowlton

  6. Aurum Institute for Health Research, Postnet Suite 300, Private Bag X30500, Houghton, 2041, Johannesburg, South Africa

    Mary H. Latka

Authors
  1. Yuko Mizuno
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  2. David W. Purcell
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  3. Lisa R. Metsch
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  4. Cynthia A. Gomez
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  5. Amy R. Knowlton
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  6. Mary H. Latka
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Corresponding author

Correspondence to Yuko Mizuno.

Additional information

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention

This study was supported by the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). The funding was a cooperative agreement, and thus CDC and HRSA provided significant input in study design, analysis, and interpretation of data.

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Mizuno, Y., Purcell, D.W., Metsch, L.R. et al. Is Injection Serosorting Occurring among HIV-Positive Injection Drug Users? Comparison by Injection Partner’s HIV Status. J Urban Health 88, 1031–1043 (2011). https://doi.org/10.1007/s11524-011-9578-1

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  • DOI: https://doi.org/10.1007/s11524-011-9578-1

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