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Behavioral Survey Data: HIV and Persons Who Inject Drugs

Tuesday, March 10, 2020


The latest national survey of self-reported behavior among a sampling of HIV among persons who inject drugs (PWID) confirms areas of improvement as documented in national surveillance reports, like lower HIV prevalence, although challenges remain in various areas. The survey, HIV Infection Risk, Prevention, and Testing Behaviors Among Persons Who Inject Drugs, National HIV Behavioral Surveillance Injection Drug Use 23 U.S. Cities, 2018, is the latest in the series on PWID self-reported behaviors.

Insights are best assessed in relation to HIV surveillance reports, like those summarized in CDC's HIV and People Who Inject Drugs. The 2018 behavioral surveillance report and the 2015 behavioral surveillance report also provide a helpful point of comparison.

Below are select highlights from the 2018 report:

  • HIV prevalence among PWID is higher among those who are older, black, and Hispanic. However, HIV surveillance data document a 31% decline in HIV diagnoses among PWID, from 2010-2016.
  • Significant proportions of the surveyed individuals were tested in the prior year (around 55%) while 90% had ever been tested, with ever-tested rates increasing by rising age. 
  • Self-reported condomless sex, sharing of syringes and injection drug equipment, and diagnoses with bacterial sexually transmitted infections (chlamydia, gonorrhea, or syphilis) have variably improved over time, compared to earlier behavioral survey reports, but remain areas of concern.
  • Around 80% of PWID had been tested for hepatitis C.
  • Over half of PWIDs (53%) reported having receiving syringes from Syringe Service Programs (SSPs).
  • Only 26% of HIV-negative PWID said they were aware of PrEP while only 1% reported being on PrEP, although rates were higher in select cities.

  • About 70% of HIV-positive PWID said they were currently on antiretroviral regimens, with rates being highest among black and Hispanic individuals compared to white HIV-positive PWID. 

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