Journal of Urban Health

, Volume 81, Issue 3, pp 377–400 | Cite as

Estimating numbers of injecting drug users in metropolitan areas for structural analyses of community vulnerability and for assessing relative degrees of service provision for injecting drug users

  • Samuel R. Friedman
  • Barbara Tempalski
  • Hannah Cooper
  • Theresa Perlis
  • Marie Keem
  • Risa Friedman
  • Peter L. Flom
Article

Abstract

This article estimates the population prevalence of current injection drug users (IDUs) in 96 large US metropolitan areas to facilitate structural analyses of its predictors and sequelae and assesses the extent to which drug abuse treatment and human immunodeficiency virus (HIV) counseling and testing are made available to drug injectors in each metropolitan area. We estimated the total number of current IDUs in the United States and then allocated the large metropolitan area total among large metropolitan areas using four different multiplier methods. Mean values were used as best estimates, and their validity and limitations were assessed. Prevalence of drug injectors per 10,000 population varied from 19 to 173 (median 60; interquartile range 42–87). Proportions of drug injectors in treatment varied from 1.0% to 39.3% (median 8.6%); and the ratio of HIV counseling and testing events to the estimated number of IDUs varied from 0.013 to 0.285 (median 0.082). Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates and predictors of the population density of drug injectors in metropolitan areas and for assessing the extent of service delivery to drug injectors. Although service provision levels varied considerably, few if any metropolitan areas seemed to be providing adequate levels of services.

Keywords

Drug abuse treatment HIV counseling and testing Injection drug users Population prevalence estimates Service coverage Structural analysis 

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Copyright information

© The New York Academy of Medicine 2004

Authors and Affiliations

  • Samuel R. Friedman
    • 1
    • 2
  • Barbara Tempalski
    • 1
  • Hannah Cooper
    • 3
  • Theresa Perlis
    • 1
  • Marie Keem
    • 1
  • Risa Friedman
    • 1
  • Peter L. Flom
    • 4
  1. 1.Institute for AIDS ResearchNational Development and Research Institutes, Inc.New York
  2. 2.Department of Epidemiology, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimore
  3. 3.Medical and Health Research Association of New York City Inc. at National Development and Research Institutes, Inc.New York
  4. 4.Statistics and Data Analysis CoreNational Development and Research Institutes, Inc.New York

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