Prevalence and Incidence of HIV and Sexual Risk Behaviors in Crack Users in the San Salvador Metropolitan Area, El Salvador

Objective: It is in order to estimate the prevalence and incidence of HIV, the frequency of sexual risk behaviors, and perceptions of available resources to prevent and treat HIV among crack users in the San Salvador Metropolitan Area. Methods: We conducted a survey of 420 crack users by using respondent-driven sampling to measure demographic characteristics, the quantity and frequency of drug use, history of STIs, including HIV, and experiences with organizations which provide prevention and treatment of HIV. Each participant offered a free and voluntary HIV test and was asked permission to share the results of the test with the study. Bernoullian modeling was used to estimate the prevalence and incidence of HIV among heterosexual males in this population. Results: The estimated prevalence was 7% (95% CI: 2.3% -9.8%) among participants who agreed to take the test and share the results, and 4.9% (95% CI: 2.8% -7.8%) assuming that those who did not take the test or share results were seronegative. Participants reported a high frequency of sexual risk behaviors. In addition, participants were reported to have little knowledge of organizations to prevent or treat HIV/AIDS; 58% had never taken an HIV test prior to survey administration. Conclusions: Crack users in San Salvador are at high risk for HIV acquisition. HIV prevention interventions are urgently needed, especially interventions increasing access to HIV testing and prevention.