A perfect storm: Crack cocaine, HSV-2, and HIV among non-injecting drug users in New York City

Don C. Des Jarlais, Courtney McKnight, Kamyar Arasteh, Jonathan Feelemyer, David C. Perlman, Holly Hagan, Emily F. Dauria, Hannah L.F. Cooper

Research output: Contribution to journalArticle

Abstract

Prevalence of human immunodeficiency virus (HIV) infection has reached 16% among non-injecting drug users (NIDU) in New York City, an unusually high prevalence for a predominantly heterosexual population that does not inject drugs. Using a long-term study (1983-2011, >7,000 subjects) among persons entering the Beth Israel drug-treatment programs in New York City, we identified factors that contributed to this high prevalence: a preexisting HIV epidemic among injectors, a crack cocaine epidemic, mixing between injectors and crack users, policy responses not centered on public health, and herpes-simplex virus 2 facilitating HIV transmission. Implications for avoiding high prevalence among NIDU in other areas are discussed.

Original languageEnglish (US)
Pages (from-to)783-792
Number of pages10
JournalSubstance Use and Misuse
Volume49
Issue number7
DOIs
StatePublished - Jun 2014

Keywords

  • Crack cocaine
  • HIV
  • HSV-2
  • Non-injecting drug users

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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