Benzodiazepine Use is an Independent Risk Factor for HIV Infection Among People with Injection Drug Use

People who inject drugs (PWID) are at risk for contracting HIV, and benzodiazepine use is an established risk factor for hazardous behaviors associated with HIV transmission. However, no direct association between benzodiazepine use and HIV infection has previously been demonstrated among this population. Researchers prospectively tracked a cohort of 1682 HIV-negative PWID to determine whether self-reported benzodiazepine use was directly associated with HIV seroconversion.

• At baseline, 501 participants reported benzodiazepine use; of these, 99% reported the mode of use to be non-injection.
• Among the overall population, 176 seroconverted for an incidence density of 1.5 cases per 100 person-years.
• Participants who reported benzodiazepine use at baseline were more likely to seroconvert over the course of the study period.
• Multivariable models controlling for age, ancestry, and at least daily injection cocaine use demonstrated that benzodiazepine use was independently and positively associated with an elevated risk of HIV seroconversion (adjusted rate ratio, 1.50).

Comments:

These findings emphasize not only the need for targeted HIV prevention programs for this population, but also the importance of prescriber education regarding the limited proven clinical benefits and known risks of benzodiazepines.

Seonaid Nolan, MD

Reference:

Ickowicz S, Hayashi K, Dong H, et al. Benzodiazepine use as an independent risk factor for HIV infection in a Canadian setting. Drug Alcohol Depend. 2015;155:190–194.