Muzzio E, Benetucci J, Redini L, Hellinger J, Jordan M, Naveira J, Segura M, Gabriel D, Sheehan H, Tang AM, Weissenbacher M. Infectious consequences in injecting and non-injecting polysubstance drug users in Buenos Aires, Argentina. 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention incorporating the 19th ASHM Conference, July 22-25, 2007, Sydney, Australia. Abstract #CDB459.
Objectives: Similar to crack cocaine in the US, smoked coca paste is cheap, potent, highly addictive and a growing threat to Argentina. This study reports patterns of drug use and infectious consequences.
Methods: We conducted a cross-sectional study to identify patterns of drug use, health and metabolic status among current and former drug users in Buenos Aires. Participants were enrolled from two sites: the Hospital Muniz (a reference center for infectious diseases) and CENARESO (a drug treatment center). Each subject completed a physical exam, a guided questionnaire, and a fasting blood draw.
Results: Of the 207 participants, 27 (13%) were female and 69 (33%) had HIV. HIV-positive participants were significantly older (34.7 vs. 29.0 years; p < 0.0001) and more likely to be Amerindios (36% vs. 20%; p=0.01) than HIV-negative participants. Among the 86 (42%) who reported ever injecting drugs, 21 (24%) remained injectors, 57 (66%) transitioned to non-injection drugs only, and 8 (9%) were clean in the six months prior to the survey. Current injectors injected cocaine (71%) or ketamine (29%), and were also actively snorting (81%) cocaine; smoking coca paste (67%), marijuana (67%) and tobacco (90%); taking sedatives (86%); and drinking alcohol (86%). Use of amphetamines, Ecstasy and poppers were less common and none reported heroin use. Injectors had significantly (p < 0.001) higher rates of HIV (57% vs. 16%), Hepatitis C (62% vs. 7%), and exposure to Hepatitis B (62% vs.19%) than non-injectors.
Conclusions: This study documents high rates of continued drug use in HIV+ and HIV-negative groups actively engaged in health care. Non-injection cocaine use is common and many former injectors are switching to non-injection drugs. The frequency and significance of injectors moving toward non-injection drugs warrants further study. High rates of HBV susceptibility in both injectors and non-injectors warrant vaccination for these high-risk groups.
