Changing profiles of injecting drug users with AIDS in a Hispanic population

Aims To describe and assess the changing trends in socio-demographic, risk, clinical and immunological parameters in male intravenous drug users (IDU) with AIDS. Design, setting and participants Baseline description by year of entry of 610 male IDU with AIDS who entered into a cohort study in Bayamon, Puerto Rico, from 1992 to 2000. Study participants were evaluated at in-patient health-care facilities in the University Hospital Ramon Ruiz Arnau or in the ambulatory immunology clinic facilities. Findings The median age at which subjects entered the study and the proportion of patients with an educational level lower than a high school degree increased from 1992 to 2000. Upward trends were also observed in the practice of injecting non-prescription drugs during the last 12-month period, the practice of needle sharing and the use of a combination of heroin and cocaine ('speedballs'). Higher proportions of subjects were also diagnosed with wasting syndrome and bacterial pneumonia. The median CD4 count recorded at entry decreased over the course of the study. Conclusions Puerto Rican male IDU diagnosed with AIDS are arriving at health-care facilities in the latest stages of the disease. Better and early interventions with different health care approaches need to be developed.