Combined HIV Prevention, the New York City Condom Distribution Program, and the Evolution of Safer Sex Behavior Among Persons Who Inject Drugs in New York City
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Examine long term sexual risk behaviors among persons who inject drugs (PWID) in New York City following implementation of “combined” prevention programming, including condom social marketing. Quantitative interviews and human immunodeficiency virus (HIV) testing were conducted among PWID entering Beth Israel Medical Center drug treatment programs 1990–2012. Data were analyzed by four time periods corresponding to the cumulative implementation of HIV prevention interventions. 7,132 subjects were recruited from 1990 to 2012; little change in sexual behavior occurred among HIV seronegative subjects, while HIV seropositive subjects reported significant decreases in being sexually active and significant increases in consistent condom use. HIV transmission risk (being HIV positive and engaging in unprotected sex) declined from 14 % in 1990–1995 to 2 % in 2007–2012 for primary sexual partners and from 6 to 1 % for casual partners. Cumulative implementation of combined prevention programming for PWID was associated with substantial decreases in sexual risk behavior among HIV seropositives.
KeywordsCondom/condom promotion Combined prevention HIV Heterosexual transmission Persons who inject drugs Harm reduction
This work was grant funded by 5R01DA003574.
Conflict of interest
The authors disclose no financial conflicts of interest.
- 1.World Health Organization UNODC, Joint United Nations Programme on HIV/AIDS. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva: 2008.Google Scholar
- 2.Sendziuk P. Harm reduction and HIV-prevention among injecting drug users in Australia: an international comparison. Can Bull Med Hist/Bulletin canadien d’histoire de la médecine. 2007;24(1):113–29.Google Scholar
- 4.Van den Berg C, Smit C, Van Brussel G, Coutinho R, Prins M. Full participation in harm reduction programmes is associated with decreased risk for human immunodeficiency virus and hepatitis C virus: evidence from the Amsterdam Cohort Studies among drug users. Addiction. 2007;102(9):1454–62.CrossRefGoogle Scholar
- 5.de Vos AS, van der Helm JJ, Prins M, Kretzschmar MEE. Decline in incidence of HIV and hepatitis C virus infection among injecting drug users in Amsterdam: evidence for harm reduction? Paper presented at: International AIDS Conference 2012; Washington D.C.Google Scholar
- 7.Montaner J, Lima VD, Yip B, Day I, et al. Expanded HAART coverage is associated with decreased HIV/AIDS morbidity and HIV new diagnoses: an update on the ‘treatment as prevention’ experience in British Columbia, Canada. Paper presented at: International AIDS Conference 2012; Washington D.C.Google Scholar
- 11.Newman RG, Cates MS. Methadone treatment in narcotic addiction: program management, findings, and prospects for the future. New York: Academic Press; 1977.Google Scholar
- 19.New York City Department of Health and Mental Hygiene. HIV Surveillance & Epidemiology Program—HIV/AIDS Annual Surveillance Statistics. New York City: NYCDOHMH;1982–2013.Google Scholar
- 25.Des Jarlais DC, McKnight CM, Arasteh K, et al. Use of the “NYC Condom” among people who use drugs. J Urban Health. (in press).Google Scholar
- 29.Stata 12 [computer program]. College Station, Texas 2012.Google Scholar