American Journal of Public Health, Vol 90, Issue 3 352-359, Copyright © 2000 by American Public Health Association

JOURNAL ARTICLE

HIV incidence among injection drug users in New York City, 1992-1997: evidence for a declining epidemic

DC Des Jarlais, M Marmor, P Friedmann, S Titus, E Aviles, S Deren, L Torian, D Glebatis, C Murrill, E Monterroso and SR Friedman
Beth Israel Medical Center, New York, NY 10003, USA.

OBJECTIVES: We assessed recent (1992-1997) HIV incidence in the large HIV epidemic among injection drug users in New York City. METHODS: Data were compiled from 10 separate studies (N = 4979), including 6 cohort studies, 2 "repeat service user" studies, and 2 analyses of voluntary HIV testing and counseling services within drug treatment programs. RESULTS: In the 10 studies, 52 seroconversions were found in 6344 person-years at risk. The observed incidence rates among the 10 studies were all within a narrow range, from 0 per 100 person-years at risk to 2.96 per 100 person-years at risk. In 9 of the 10 studies, the observed incidence rate was less than 2 per 100 person-years at risk. The weighted average incidence rate was 0.7 per 100 person-years at risk. CONCLUSIONS: The recent incidence rate in New York City is quite low for a high-seroprevalence population of injection drug users. The very large HIV epidemic among injection drug users in New York City appears to have entered a "declining phase," characterized by low incidence and declining prevalence. The data suggest that very large high-seroprevalence HIV epidemics may be "reversed."

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