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Drug injectors' have become the second largest HIV transmission category in Argentina and Brazil, as is the case in many pattern I countries, making up more than one-quarter of all AIDS cases reported by HIV seroprevalence data suggest that the expanding proportion of AIDS cases attributable to drug injection stems from an absolute increase in the number of AIDS cases among drug injectors, and is not merely reflective of a decline in the proportion of cases reported in other transmission categories. Results of a review of studies in Argentina and Brazil indicate that HIV seroprevalence is increasing rapidly, contrary to the situation in some pattern I countries in which HIV seroprevalence among drug injectors is either stably high or increasing only slightly. Also contrary to most pattern I countries, cocaine rather than heroin is the injected drug of choice in Argentina and Brazil. Given that injectors of cocaine are more likely to be HIV infected than are heroin injectors, differences in the type of drug injected between countries may have distinct epidemiological consequences on the spread of HIV. A similar increase from 1. To complement existing information, data searches were conducted and personal communications from current researchers were collected for a total of 24 documents from Argentina and 18 from Brazil. The median sample size was 68 in Brazil and in Argentina; most studies were from outpatient facilities, males constituted more than two-thirds of the sample in half of the studies, and the median age when reported was between 16 and 29 years old. Analysis of data from selected studies showed that HIV seroprevalence among drug injectors in both countries has increased rapidly, with the greatest increase occurring in Brazil. This rapid increase may also be influenced by the fact that cocaine, rather than heroin, is the drug of choice. Cocaine injection involves drawing blood into the syringe before injection and also more frequent injections. The level of seroprevalence among drug injectors varies among different subpopulations. Sexually transmitted disease clinic attenders who are IV drug users show rates of 6. Street children in Rio de Janeiro who use IV drugs 68 of surveyed had a rate of The risk factors associated with HIV infection among drug injectors are socioeconomic status and injecting and sex practices. Overall, these data suggest that there is an absolute increase in the number of AIDs cases among drug injectors rather than a decline in the proportion of cases reported in other transmission categories. Drug injector transmission poses a threat to the sex partners and offspring of injectors and provides a bridge to the heterosexual infection of women. While there is no obvious quick solution to the problem of IV drug use, there are programs which can slow the spread of HIV among injectors. It is urgent to control sexual transmission and drug injection transmission of HIV in these countries. Abstract Drug injectors' have become the second largest HIV transmission category in Argentina and Brazil, as is the case in many pattern I countries, making up more than one-quarter of all AIDS cases reported by Publication types Editorial. Substances Cocaine.

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