Intravenous drug users and AIDS: Knowledge, attitudes and behaviour in Calabria, Italy

Objective: the aim of this study was to evaluate the knowledge, attitudes and behaviour of Italian intravenous drug users (IVDUs) regarding AIDS. Design: cross-sectional survey. Setting: 4 public drug treatment centres in Calabria, Italy. Participants: 157 IVDUs attending the clinics from March to October 1994 recruited on a voluntary basis. Measurements and results: a self-administered questionnaire consisting of questions on demographics, knowledge about AIDS, injecting and sexual behaviour and attitudes on drug-using and sexual activity was distributed to participants. Stepwise logistic regression was performed. Knowledge was significantly lower in married people (OR=0.22, 95% CI: 0.06-0.76) and in those with a lower income (OR=0.61, 95% CI: 0.38-0.97), while it was higher in IVDUs with a longer history of addiction (OR=1.19, 95% CI: 1.03-1.36). The 'sharing' of injecting equipment was significantly higher as the frequency of injection increased (OR=3.44, 95% CI: 1.17-10.36). The routine use of condoms was significantly lower in married people (OR=O.04, 95% CI: 0.01-0.43) and as the number of partners in the previous year increased (OR=0.39, 95% CI: 0.18- 0.83), while it was significantly more common in those who considered that getting AIDS was a likely event in their lives (OR=3.61, 95% CI: 1.20- 10.84). Knowledge was satisfactory in our population, except for methods of disinfection. The proportion of sharers in the previous 3 months (15.9%) was low. The routine use of condoms was still low, confirming resistance to seeking a safer sexual lifestyle. Conclusions: the results of our study confirm that changing sexually risky behaviour has proven more difficult than changing drug injection risk behaviour. Our findings suggest that an important target for AIDS prevention programmes may be the reduction of frequency of injection and that intervention strategies should shift their emphasis from drug use to sexual behaviour.