AIDS and Behavior

, Volume 22, Issue 4, pp 1383–1394 | Cite as

Continued Transmission of HIV Among Young Adults Who Inject Drugs in San Francisco: Still Room for Improvement

  • Ali Mirzazadeh
  • Jennifer L. Evans
  • Judith A. Hahn
  • Jennifer Jain
  • Alya Briceno
  • Stephen Shiboski
  • Paula J. Lum
  • Christopher Bentsen
  • Geoff Davis
  • Kathy Shriver
  • Melanie Dimapasoc
  • Mars Stone
  • Michael P. Busch
  • Kimberly Page
Original Paper


We measured HIV incidence rate, trend and risk factors in 564 HIV-negative young people (< 30 years) who inject drugs (PWID) in San Francisco between 2000 and 2014. HIV incidence was 0.93/100 person-years (PY; 95% CI 0.50, 1.73). Incidence varied between 0.62/100 PY in 2000–2002 and 1.06/100 PY in 2012–2014 (P for trend = 1.0). HIV incidence varied significantly (P < 0.01) by race/ethnicity: among Hispanics it was 8.19/100 PY (95% CI 3.41, 19.68), African-Americans 4.59/100 PY (95% CI 1.15, 18.37), and Whites 0.26/100 PY (95% CI 0.06, 1.03). Male participants who reported sex with men (MSM) had higher HIV incidence (2.63/100 PY; 95% CI 1.31, 5.25) compared to males who did not report MSM (0.50/100 PY; 95% CI 0.12, 1.99) (P = 0.01). Despite an overall stable HIV incidence trend, incidence was elevated among African-American and Hispanic PWID, and men who have sex with men. Addressing prevention needs in these key populations is critical for the goal of eliminating HIV transmission.


HIV Incidence Epidemiology Drug users Injection Young adults Cohort studies San Francisco 


Medimos la tasa de incidencia y factores de tendencia y de riesgo del VIH en 564 jóvenes (menores de 30 años) VIH-negativos que se inyectan drogas en San Francisco entre el 2000 y el 2014. La incidencia de VIH fue de 0.93/100 personas-años (IC 95%: 0.50, 1.73). La incidencia varió entre 0.62/100 personas-años entre el 2000 y el 2002 y 1.06/100 personas-años entre el 2012 y el 2014 (P de tendencia = 1.0). La incidencia del VIH varió significativamente (p < 0.001) por raza/etnicidad: entre Hispanos fue de 8.19/100 personas-años (IC 95%: 3.41, 19.68), Afroamericanos 4.59/100 personas-años (IC 95%: 1.15, 18.37), y Blancos 0.26/100 personas-años (IC 95%: 0.06, 1.03). Los participantes masculinos que reportaron sexo con hombres tuvieron la mayor incidencia de VIH (2.63/100 personas-años; IC 95%: 1.31, 5.25) en comparación con participantes masculinos que no reportaron sexo con hombres (0.50/100 personas-años; IC 95%: 0.12, 1.99) (P = 0.01). A pesar de una tendencia de incidencia de VIH universalmente estable, la incidencia fue elevada entre personas (que se inyectan) Afroamericanas e Hispanas, y entre hombres que tienen sexo con hombres. Dirigir necesidades de prevención en estas poblaciones clave es vital para la meta de eliminar la transmisión del VIH.



The authors thank Dr. Meghan Morris for her contributions to this study. We also recognize the important contribution of San Francisco Department of Public Health, Berkeley Free Clinic, Homeless Youth Alliance, San Francisco Community Clinic Consortium Street Outreach Services, and San Francisco AIDS Foundation. This paper is dedicated to the memory of Joep Lange, whose brilliance and passion to HIV prevention will be forever missed.


This study was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01DA016017 (KP), NIHK24 under Award Number AA022586 (JAH) and NIMH R25 under Award Number MH064712 (AM). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2017_1988_MOESM1_ESM.docx (126 kb)
Supplementary material 1 (DOCX 127 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Ali Mirzazadeh
    • 1
  • Jennifer L. Evans
    • 1
  • Judith A. Hahn
    • 1
    • 2
  • Jennifer Jain
    • 3
  • Alya Briceno
    • 1
  • Stephen Shiboski
    • 4
  • Paula J. Lum
    • 2
  • Christopher Bentsen
    • 5
  • Geoff Davis
    • 5
  • Kathy Shriver
    • 5
  • Melanie Dimapasoc
    • 6
  • Mars Stone
    • 6
  • Michael P. Busch
    • 6
    • 7
  • Kimberly Page
    • 8
  1. 1.Department of Epidemiology and Biostatistics, Institute for Global Health SciencesUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of Medicine, San Francisco General HospitalUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of Global Public Health and Infectious DiseaseSchool of Medicine, University of California, San DiegoSan DiegoUSA
  4. 4.Division of HIV, Infectious Disease, and Global Medicine, Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  5. 5.Bio-Rad LaboratoriesRedmondUSA
  6. 6.Blood Systems Research InstituteSan FranciscoUSA
  7. 7.Department of Laboratory MedicineUniversity of California, San FranciscoSan FranciscoUSA
  8. 8.Epidemiology, Biostatistics and Preventive Medicine, Department of Internal MedicineUniversity of New Mexico Health Sciences CenterAlbuquerqueUSA

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