RESUMO
OBJECTIVE: To determine the prevalence of HIV infection and gain insights into the risk behaviour among injecting drug users (IDU) in Heerlen and Maastricht, the Netherlands. DESIGN: Descriptive inventory. METHOD: In 1994, 1996 and 1998/1999 a questionnaire on risk behaviour was obtained from 866 IDUs in Heerlen and Maastricht, and 858 saliva and serum samples were also obtained for testing on HIV antibodies. RESULTS: In the total region of Heerlen and Maastricht, no significant change in HIV prevalence was found (1994: 10%, 1996: 12%, 1998/1999: 14%). However, in Heerlen the HIV prevalence was demonstrated to have increased significantly (1994: 11%, 1996: 16%, 1998/1999: 22%), whereas in Maastricht HIV prevalence was constant (1998/1999: 5%). The percentage of participants that injected drugs in the six months preceding the survey decreased from 80% in 1994 to 63% in 1998/1999. Injection-related risk behaviour slightly decreased: in 1998/1999 14% of the participants had borrowed used syringes or needles in the last 6 months. Additionally, inconsistent condom use with steady and casual sexual partners was reported. Of the participants, 86-89% did not always use condoms with steady partners and 49% with casual partners. DISCUSSION: In view of the increasing HIV prevalence among IDUs in Heerlen, the persistent injecting and sexual risk behaviour and the large number of IDUs who have sexual contact with non-users in Heerlen and Maastricht, there is a substantial risk of HIV transmission both within the IDU community and to the general population.