Using Retrospective Behavioral Data to Determine HIV Risk Factors among Street-Recruited Drug Injectors

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Abstract
This paper investigates whether the time period during which retrospective behavioral data are collected affects the results of studies of HIV risk factors. In particular, we address the concern that questionnaires probing behaviors in the recent past may not isolate the risk behaviors involved at the time of actual HIV infection. During 1987 and 1988, 278 street-recruited injecting drug users (IDUs) in New York City were interviewed about their sexual behaviors, medical history, drug-injection behaviors in the prior ten years, and specific needle-use behaviors during 1985–86 and thereafter. Among the 278 subjects, 52% were HIV-seropositive. In univariate analysis, serostatus was significantly related to: a) total drug-injection frequency during 1983–84 and 1985–86; b) mean monthly total drug-injection frequency during 1977 to 1987; c) cocaine injection frequencies during 1983–84 and 1985–86, and during the last thirty days; and d) injecting in shooting galleries and using previously used cookers during 1985–86. Significant predictors of seroprevalence in stepwise logistic regression were total drug and cocaine injection frequencies during 1983–84, years of injection, residence in the Bronx, not being Hispanic and history of any sexually transmitted disease. The data confirm previous reports on behavioral risk factors for HIV serostatus. Re-analysis using drug-injection frequency data for different time periods indicates that in the context of an “older” HIV epidemic like that in New York City, analysis of risk factors may be less sensitive to time periods than had previously been feared, although it may be true that data for behaviors in “the last thirty days” cover a sufficiently atypical period as to produce misleading results.