Racial Differences in HIV Infection and Risk Behaviors among Drug Users in a Low Seroprevalence Area

While it is well known that the rate of AIDS and HIV for African Americans is considerably higher than it is for whites, both the reasons for this difference and the extent to which racial differences can be generalized to low seroprevalence areas are less clear. Using data collected from a sample of 1393 out-of-treatment chronic drug users in a low seroprevalence area, we examine differences between HIV serostatus of non-Hispanic African Americans (n=907) and non-Hispanic whites (n=231) who agreed to HIV testing. Our results show a significantly higher seropositive rate among African American current injecting drug users and current crack users who have injected drugs. Differences in seropositive rates among crack users who have never injected drugs are non-significant, although the rate is still higher among African Americans. We also compare needle-risk behaviors, crack use, sexual risk behaviors, and perceptions of HIV risk for African-American and white drug users in our sample. The pattern of differences we find in risk behaviors between African-American drug users and white drug users underlines the important role that crack cocaine may play in HIV infection in the African-American community and the need for more intervention programs designed specifically for heterosexual African-American drug users.