Human Immunodeficiency Virus Infection in Diabetic Intravenous Drug Users

Objective.—To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. Design.—Cross-sectional survey in a cohort of IV drug users. Setting.—Community-based study clinic. Subjects.—The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. Outcome Measures.—The HIV seroprevalence among IV drug users with and without a history of diabetes. Results.—Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P =.03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. Conclusion.—Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.