Human immunodeficiency virus seroprevalence in female intravenous drug users: the puzzle of black women's risk.

This study of 155 female i.v. drug users found that black women had higher HIV seroprevalence than white women (21% compared to 7%, respectively, odds ratio = 3.59, 95% CI 1.28-9.98). To attempt to explain why black female i.v. drug users were more likely to test HIV antibody positive, the ethnic distribution of a series of risk factors associated with HIV seropositivity, such as needle sharing, high risk sexual behavior and history of sexually transmitted disease, was examined. Either there was no significant difference between the two groups or white i.v. drug users were more likely than blacks to engage in specific risk behaviors. Although this study failed to identify risk factors associated with higher HIV seropositivity in black female i.v. drug users, it did uncover important trends in the data. These trends are analyzed in terms of observed or possible social and cultural differences between black and white women. It is suggested that these underlying social and cultural differences may hold the key to black female i.v. drug users' greater risk of HIV infection.