Cocaine injection and ethnicity in parenteral drug users during the early years of the human immunodeficiency virus (hiv) epidemic in new york city

Parenteral drug users have a high prevalence of infection with human immunodeficiency virus (HIV), the etiologic agent of acquired immune deficiency syndrome (AIDS). New York City has had a prolonged and extensive epidemic of HIV infection and AIDS. In this study, we analyze, in relation to antibody to HIV (anti‐HIV), available data from sera from parenteral drug users collected in New York City during 1978 through 1983 in the course of studies of liver disease. Among parenteral users of both heroin and cocaine, 30 (52%) of 58 had anti‐HIV, compared with six (13%) of 48 injectors of heroin only (P < 0.0001). Only two (11%) of 18 white patients were HIV‐infected, compared with 34 (39%) of 88 black or Hispanic patients (P = 0.03). No other factors studied were linked to anti‐HIV. In a multiple logistic regression, anti‐HIV was significantly more common in parenteral users of both cocaine and heroin (P < 0.0001), black patients (P = 0.02), and Hispanic patients (P = 0.049). We conclude that parenteral users of both cocaine and heroin as well as black and Hispanic patients were disproportionately HIV‐infected during the early years of the HIV epidemic. Use of cocaine and heroin as well as ethnicity were independently linked to anti‐HIV. Measures to prevent or treat drug use, HIV infection, and other medical problems while addressing the specific needs of cocaine users and black and Hispanic patients are urgently needed.