Elevados índices de incidencia de VIH entre los participantes indigenas en un estudio de cohorte de usuarios de drogas inyectables en Vancouver, Canadá

Elevated HIV incidence rates among aboriginal participants in a cohort study of injection drug users in Vancouver, Canada

K J P Craib, P M Spittal, K Li, K Heath, N Laliberte, M Tyndall, M V O’Shaughnessy, M T Schechter
BC Centre for Excellence in HIV/AIDS, Vancouver, Canada

Objectives: To compare cumulative HIV incidence rates among aboriginal and non-aboriginal participants in a cohort of injection drug users (IDUs).
Methods: This analysis was based on 941 participants who were recruited between 05/96 and 12/00, HIV-negative at enrolment, and completed at least one follow-up visit. Cumulative incidence rates were calculated using Kaplan-Meier methods and compared via the log-rank test. Cox regression analysis using time-dependent covariates was used to identify independent predictors of time to HIV seroconversion.
Results: The mean duration of follow-up was similar between aboriginal and non-aboriginal participants (37 vs. 38 months; p=0.769). Aboriginal participants were significantly younger (33 vs. 35 years; p=0.017). As of 12/01, 44 of 230 aboriginal participants had seroconverted, compared to 68 of 711 non-aboriginals. After 44 months, the cumulative incidence rate was significantly higher among aboriginal participants (19.9% vs. 10.2%; p<0.001). Cumulative incidence was significantly higher among male aboriginals compared to male non-aboriginals (19.4% vs. 9.2%; p=0.007). Cumulative incidence was significantly higher among female aboriginal participants compared to female non-aboriginals (20.2% vs. 9.4%; p=0.007). Multivariate analysis of aboriginal participants revealed frequent injection of cocaine (ARR= 2.2; 95% CI: 1.1,4.2) and speedballs (ARR=2.5; 95% CI: 1.3, 5.0) to be independent predictors of time to HIV seroconversion. Among non-aboriginals, frequent cocaine injection (ARR=3.3; 95% CI: 1.9, 5.6), borrowing needles (ARR=1.8; 95% CI: 1.1, 3.1) and not being married (ARR=2.2; 95% CI: 1.0, 4.6) were independent predictors.
Conclusions: In the VIDUS cohort, HIV incidence was 95 percent higher among aboriginal participants. These findings have implications for indigenous populations worldwide. Harm reduction strategies addressing the HIV/AIDS concerns unique to this population are urgently required.

The XIV International AIDS Conference
Abstract no. MoPeC3537


Suggested Citation
“K J P Craib, et al. Elevated HIV incidence rates among aboriginal participants in a cohort study of injection drug users in Vancouver, Canada. Poster Exhibition: The XIV International AIDS Conference: Abstract no. MoPeC3537”

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