Black Tar Heroin May Save Users From HIV: Report

New research suggests that regional differences in varieties of heroin may explain why injection drug users (IDUs) in the West are much less likely to contract HIV than IDUs in the East. Unlike the powdered heroin that predominates in eastern cities, the black tar heroin common west of the Mississippi clogs them, meaning users are more likely to thoroughly clean syringes, flushing out possibly infected blood. They are also likely to dispose of syringes more frequently. Such behavior may reduce the risk of transmitting HIV through needle sharing.

"This paper shows a possible solution for a public health paradox that has been unsolved for 20 years, i.e., why did western U.S. heroin injectors not get the full brunt of [the] HIV epidemic?" noted study co-author Dr. Daniel H. Ciccarone of the University of California-San Francisco.

Ciccarone and co-author Dr. Philippe Bourgois said Mexican black tar heroin was dominant among western IDUs in the early- to mid-1990s, while powdered heroin from South Asia and South America was more common in the East. New York City and Los Angeles, both with considerable IDU populations, differed greatly in HIV infection rates in the early 1990s: about 41 percent of New York City IDUs were HIV-positive, versus only 4 percent of Los Angeles IDUs.

Aside from being gummy, black tar heroin is heated before use, which researchers think might kill HIV. Injecting black tar heroin leads quickly to venous sclerosis, which makes injecting into veins difficult. This causes IDUs to start injecting into muscle or skin -- injection methods that may be less likely to transmit HIV.

HIV infections among IDUs have begun dropping in many parts of the United States, but Ciccarone warned a possible influx of powdered heroin from Afghanistan and Pakistan may spark an increase in HIV. The study, "Explaining the Geographical Variation of HIV Among Injection Drug Users in the United States," appeared in the journal Substance Use & Misuse (12.31.03;38(14)2049-2063;DOI:10.1081/JA-120025125).

Back to other news for February 11, 2004