HIV among drug users in regional towns near the initial focus of the Dutch epidemic

In Europe, most HIV seroprevalence studies of injecting drug users (IDU) have been conducted in large cities and found high levels of infection. Few studies have reported on the spread of HIV to IDU in less urbanized regions or to non-IDU. HIV infection in non-IDU indicates sexual transmission, which is potentially a threat for the general population. In Amsterdam, the seroprevalence among IDU has been about 30% since 1986, whereas a seroprevalence of 5% was found in non-IDU from Surinam or the Antilles [5-7]. In this study we describe the spread of HIV and the levels of risk behaviour among IDU and non-IDU in regional towns near Amsterdam. In conclusion, our results indicate that the spread of HIV from drug users in Amsterdam to these peripheral towns has been very limited. Therefore, the risk of further spread to the general population seems minimal outside Amsterdam.