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Substance Abuse, Sexual Behaviors, HIV/STD/HCV Testing, and Prevention Service Utilization among Injection Drug Users in  Dallas, Texas, 2005-2006   Shane U. Sheu, MPH,  Sonia Arbona, PhD,  Erin Elbel,  Doug Kershaw,  Praveen R. Pannala, MD, MPH Sharon K. Melville, MD, MPH Texas Department of State Health Services  May 25, 2010
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Background
Persons Living with HIV/AIDS and New HIV/AIDS Cases, Texas, 2002-2008 Data Source: Texas HIV/AIDS Reporting System (HARS); 2002-2008
Proportion of AIDS Cases by Transmission Category, Texas, 1990-2008 ,[object Object],[object Object]
National HIV Behavioral Surveillance System Sites Atlanta Ft. Lauderdale Miami San Juan New Orleans Dallas Houston San Diego Los Angeles Las Vegas San Francisco Seattle Denver St. Louis Chicago Detroit Boston New Haven Nassau New York City Newark Philadelphia Baltimore Washington, DC Norfolk ,[object Object],[object Object],[object Object],[object Object],Source: Centers for Disease Control and Prevention
Methods
NHBS Overall Strategy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respondent Driven Sampling Recruitment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NHBS IDU1 Eligibility Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object]
Dallas NHBS IDU1 Overview ,[object Object],[object Object],[object Object],[object Object]
Implementing RDS at Multiple Sites for NHBS IDU1 Dallas
Statistical Analysis ,[object Object],[object Object]
Results
NHBS IDU1 Demographic Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Demographic Characteristics continue ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Recruitment Network of Participants by Race and Ethnicity White - homophily 0.401 Race and ethnicity Afr Am - homophily 0.545 Hispanic - homophily 0.330 Am Indian/Alaska Native - homophily  -1 Multiracial - homophily 0.032 -  Most participants recruited were African American -  Four seeds recruited  the majority of the  participants Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data
NHBS IDU1 Prevalence Estimates of Unprotected Sex   Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Prevalence Estimates of Using Drugs or Alcohol before or during Sex  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Prevalence Estimates of Testing Behaviors  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Prevalence Estimates of Prevention Service Utilization  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Unprotected Sex  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 69.3% 30.7% Not using drug or alcohol before or during sex  (n=75) <.0001 19.7% 80.3% Using drug or alcohol before or during sex  (n=522)  2  P value Sex with condom Sex without condom
NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Sharing Injection Equipment  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 33.8% 66.2% Not using drug or alcohol before or during sex  (n=74) 0.01 21.1% 78.9% Using drug or alcohol before or during sex  (n=522)  2  P value Not sharing injection equipment Sharing injection equipment
NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Syringe Sharing  Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 71.2% 28.8% Not using drug or alcohol before or during sex  (n=73) <.0001 45.1% 54.9% Using drug or alcohol before or during sex  (n=521)  2  P value No syringe sharing Syringe Sharing
NHBS IDU1 Other Factors Found Not to be Statistically Significant with Participants Using Drugs or Alcohol before or during Sex  0.32 Used free kits 0.53 Talked to counselor one on one about HIV prevention in the past 12 months 0.81 Participated in group session about HIV prevention in the past 12 months 0.85 Received free kits in the past 12 months 0.90 Received free condoms in the past 12 months 0.69 Received sterile needles in past 12 months 0.72 Used free new sterile needles 0.38 Tested to check for syphilis in the past 12 months 0.67 Ever tested for HCV 0.29 Ever tested for HIV P-value Factors
Results Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Data Limitations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]
Implications for Programs, Policy, and Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Implications for Programs, Policy, and Research ,[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acknowledgements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Questions? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Substance Abuse, Sexual Behaviors, HIV/STD/HIV

  • 1. Substance Abuse, Sexual Behaviors, HIV/STD/HCV Testing, and Prevention Service Utilization among Injection Drug Users in Dallas, Texas, 2005-2006 Shane U. Sheu, MPH, Sonia Arbona, PhD, Erin Elbel, Doug Kershaw, Praveen R. Pannala, MD, MPH Sharon K. Melville, MD, MPH Texas Department of State Health Services May 25, 2010
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  • 4. Persons Living with HIV/AIDS and New HIV/AIDS Cases, Texas, 2002-2008 Data Source: Texas HIV/AIDS Reporting System (HARS); 2002-2008
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  • 12. Implementing RDS at Multiple Sites for NHBS IDU1 Dallas
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  • 17. NHBS IDU1 Recruitment Network of Participants by Race and Ethnicity White - homophily 0.401 Race and ethnicity Afr Am - homophily 0.545 Hispanic - homophily 0.330 Am Indian/Alaska Native - homophily -1 Multiracial - homophily 0.032 - Most participants recruited were African American - Four seeds recruited the majority of the participants Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data
  • 18. NHBS IDU1 Prevalence Estimates of Unprotected Sex Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
  • 19. NHBS IDU1 Prevalence Estimates of Using Drugs or Alcohol before or during Sex Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
  • 20. NHBS IDU1 Prevalence Estimates of Testing Behaviors Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
  • 21. NHBS IDU1 Prevalence Estimates of Prevention Service Utilization Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597
  • 22. NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Unprotected Sex Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 69.3% 30.7% Not using drug or alcohol before or during sex (n=75) <.0001 19.7% 80.3% Using drug or alcohol before or during sex (n=522)  2 P value Sex with condom Sex without condom
  • 23. NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Sharing Injection Equipment Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 33.8% 66.2% Not using drug or alcohol before or during sex (n=74) 0.01 21.1% 78.9% Using drug or alcohol before or during sex (n=522)  2 P value Not sharing injection equipment Sharing injection equipment
  • 24. NHBS IDU1 Participants Using Drugs or Alcohol before or during Sex by Syringe Sharing Data Source: Texas National HIV Behavioral Surveillance- 2005-2006, IDU1 Data N=597 71.2% 28.8% Not using drug or alcohol before or during sex (n=73) <.0001 45.1% 54.9% Using drug or alcohol before or during sex (n=521)  2 P value No syringe sharing Syringe Sharing
  • 25. NHBS IDU1 Other Factors Found Not to be Statistically Significant with Participants Using Drugs or Alcohol before or during Sex 0.32 Used free kits 0.53 Talked to counselor one on one about HIV prevention in the past 12 months 0.81 Participated in group session about HIV prevention in the past 12 months 0.85 Received free kits in the past 12 months 0.90 Received free condoms in the past 12 months 0.69 Received sterile needles in past 12 months 0.72 Used free new sterile needles 0.38 Tested to check for syphilis in the past 12 months 0.67 Ever tested for HCV 0.29 Ever tested for HIV P-value Factors
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