Is Injection Serosorting Occurring Among HIV-Positive Injection Drug Users? Comparison by Injection Partner's HIV Status

"Research needs to build evidence for the roles that HIV status of injection partners may or may not play in injection risk behaviors of injection drug users (IDUs)," the authors wrote in introducing the current study. Using baseline data from a randomized controlled study (INSPIRE) in Baltimore, Miami, New York, and San Francisco, 2001-2005, the team categorized 759 primarily heterosexual HIV-positive IDUs into four groups based on the HIV serostatus of injection partners.

Of the sample, 32 percent injected exclusively with HIV-positive partners in the previous three months, and more than 60 percent had risky injection practices with these partners. Among the rest, 49 percent injected with any partners of unknown serostatus; 11 percent reported both HIV-positive and –negative partners but no partners of unknown serostatus; and 8 percent injected exclusively with HIV-negative partners.

The group with mixed status partners reported riskier injection behavior. Risk among those with partners of unknown serostatus appeared driven by the greater number of injecting partners. No major group differences were noted for sociodemographic and psychosocial factors.

"Our analysis suggests that serosorting appeared to be occurring among some, but not an overwhelming majority of HIV-positive IDUs, and knowledge of HIV status of all injection partners per se did not appear to be as important as knowledge of sexual partner's HIV status in its association with risk behavior."

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