Death, AIDS morbidity, and HIV seroprevalence in New York City intravenous drug abusers

Drug treatment programs represent a point of access to intravenous drug abusers and, as such, may also be useful in monitoring health status indicators among this population. Such a surveillance project was established in 1985 among drug treatment clinics in New York City to monitor the human immunodeficiency virus (HIV) epidemic. HIV seroprevalence was 54% (255/469) in 1985, 61% (159/262) in 1986, and 60% (133/222) in 1987. Of the 2500 cumulative enrollees in these clinics each year, 4 patients met the Centers for Disease Control acquired immunodeficiency syndrome (AIDS) surveillance definition in 1985, 37 in 1986, and 37 in 1987. There were 25 AIDS-related deaths in 1985, 8 in 1986, and 16 in 1987. These results suggest that by including drug treatment programs in a rational surveillance system, we may be able to monitor the HIV epidemic more closely. The public health significance of such a surveillance program is magnified given the association between intravenous drug abuse-associated AIDS and the prevalence of AIDS among women, children, and ethnic/racial minorities.