Journal of Urban Health

, Volume 82, Issue 3, pp 434–445 | Cite as

HIV among injection drug users in large US metropolitan areas, 1998

  • Samuel R. Friedman
  • Spencer Lieb
  • Barbara Tempalski
  • Hannah Cooper
  • Marie Keem
  • Risa Friedman
  • Peter L. Flom


This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metropolitan areas to facilitate social and policy analyses of HIV epidemics. HIV prevalence rates among IDUs in these metropolitan areas were calculated by taking the mean of two estimates: (1) estimates based on regression adjustments to Centers for Disease Control and Prevention (CDC) Voluntary HIV Counseling and Testing data and (2) estimates based on the ratio of the number of injectors living with HIV to the number of injectors living in the metropolitan area. The validity of the resulting estimates was assessed. HIV prevalence rates varied from 2 to 28% (median 5.9%; interquartile range 4.0–10.2%). These HIV prevalence rates correlated with similar estimates calculated for 1992 and with two theoretically related phenomena: laws against over-the-counter purchase of syringes and income inequality. Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates, predictors and consequences of HIV prevalence rates among drug injectors in metropolitan areas and for assessing and targeting the service needs for drug injectors.


Epidemic modeling HIV prevalence estimates Injection drug users Local epidemics Structural analysis 


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Copyright information

© Oxford University Press on behalf of the New York Academy of Medicine 2005

Authors and Affiliations

  • Samuel R. Friedman
    • 1
    • 2
  • Spencer Lieb
    • 3
  • Barbara Tempalski
    • 4
  • Hannah Cooper
    • 5
    • 6
  • Marie Keem
    • 4
  • Risa Friedman
    • 4
  • Peter L. Flom
    • 7
  1. 1.Institute for AIDS ResearchNational Development and Research InstitutesNew York
  2. 2.Department of Epidemiology, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimore
  3. 3.Bureau of HIV/AIDSFlorida Department of HealthTallahassee
  4. 4.National Development and Research Institutes, Inc.New York
  5. 5.Medical and Health Research Association of New York/National Development and Research Institutes, Inc.New York
  6. 6.Columbia Mailman School of Public HealthNew York
  7. 7.Statistics and Data Analysis CoreNational Development and Research Institutes, Inc.New York

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