Observations on the Stabilization of HIV Seroprevalence Among Injecting Drug Users

Abstract

HIV seroprevalence among injecting drug users (IDUs) has stabilized in a large number of cities, including New York,¹ Stockholm,² Vienna,³ Amsterdam,⁴ San Francisco,⁵ and Innsbruck.⁶ This stabilization has occurred at very different levels of HIV seroprevalence, from the 50% in New York to the 12% in San Francisco. The precise reasons why the stabilization has occurred at such differing levels have yet to be determined, but probably include: the extent to which HIV had already spread among the local group of IDUs (prior to large-scale AIDS risk reduction); and the extent to which the local legal, geographic, and social organization of the “community” of IDUs facilitates the multi-person use of injection equipment. Stabilization of HIV seroprevalence among IDUs in various cities has now occurred often enough that it can be considered a “normal” outcome of an HIV epidemic among IDUs.