HIV prevalence and risk behaviour in young drug users in Amsterdam.

Abstract

To assess the HIV prevalence and risk behaviour among regular young drug users (YDU) in Amsterdam. Subjects were 282 YDU (using heroin, cocaine, methadone and/or amphetamines at least 3 days/week) aged 30 years or less who participated in a cross-sectional survey in Amsterdam in 1998. Participants were recruited both directly (41%) through healthcare institutions, and indirectly (59%) by referrals from YDU already enrolled. A comparison sample of YDU from the Amsterdam Cohort Study recruited between 1985 and 1989 was used to describe trends in HIV prevalence and risk behaviour. Mean age was 25 years, 22% were women, 39% had at least once injected drugs, and 22% currently injected in 1998. Cocaine was more often used regularly (70%) than heroin (42%). Of the 282 YDU, 21 (7.4%) were infected with HIV. Among those who had injected drugs, HIV prevalence was 16.2%. Among those who had never injected, the prevalence of HIV infection was 1.8%. A history of injecting declined from 83% in 1985-1989 to 56% in 1998. Compared with 1985-1989, the lack of a recent steady partner appeared to be an important risk factor for a positive HIV status among injectors in 1998, whereas borrowing of used needles/syringes was no longer a risk factor. The use of cocaine among YDU is very popular in Amsterdam. A strong decrease in injecting behaviour has taken place, but among those who inject, risk behaviour is still considerable, and HIV infection is still widespread. Preventative activities should be expanded, specifically among YDU.