Prevalence of HIV and hepatitis B and self-reported injection risk behavior during detention among street-recruited injection drug users in Los Angeles County, 1994–1996

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Abstract
Aims. To describe injection risk behaviors while in detention in a sample of injection drug users (IDUs) in Los Angeles County. Design and setting. Cross-sectional, interviewer-administered, face-to-face risk survey, and serological screening for HIV and hepatitis B conducted at four street locations in Los Angeles County between 1994 and 1996. All interviews were conducted in a non-institutionalized setting. Measurements. Ascertainment of self-reported risk behavior during detention and screening for HIV and hepatitis B surface antigen (HBsAg) and antibody to the core (HBcAb) seromarkers. Participants. Six hundred and forty-two participants were street-recruited during the study period. Seventy-one per cent of the sample was male, the median age was 43 years, 61% were African-American, 27% were Latino, 8% were white and 36% considered themselves homeless. Findings. Overall HIV prevalence was 3.0%; 3.1% tested positive for the hepatitis B surface antigen marker (HBsAg), and 80.3% for antibody to hepatitis B core antigen (HBcAb). After adjustment for length of injection drug use and recency of release from detention, HIV seroreactivity was significantly associated with history of detention due to possession of IDU paraphernalia (OR = 1.9). The presence of the hepatitis B HBcAb seromarker was associated with injection drug use while in detention, (OR = 1.7), and having been ever arrested for possession of IDU paraphernalia (OR = 1.8). Conclusions. IDU detainees constitute a high risk group for blood-borne infections. Comprehensive prevention and health promotion efforts in the community need to include correctional facilities.

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