As part of the baseline survey of a prospective study of the natural history of HIV-1 infection among intravenous (IV) drug users, 1,580 current and former IV drug users (IVDUs) were interviewed about their knowledge of AIDS, acquisition and prevention of HIV-1 infection, and risk behaviors. Using the National Center for Health Statistics's AIDS Knowledge and Attitudes Questionnaire, responses are compared to a cross-section of the U.S. population. The results show few differences between current knowledge of routes of transmission, general AIDS knowledge, unlikely sources of infection, and methods of prevention among IVDUs who are at high risk of acquiring HIV-1 and the general public, presumably at very low risk of infection. Analyses of HIV-1 and AIDS knowledge also demonstrated virtually no differences by HIV-1 antibody status or awareness of their serostatus at baseline, with the exception that those aware of their status were less likely to be hopeless in dealing with the problem. While few consistent differences were found between drug use behaviors and knowledge, IVDUs who reported having been in drug treatment were systematically better informed as to routes of transmission and prevention methods. However, those with a history of treatment were also more likely to see themselves at higher risk of acquiring HIV-1 than those who did not have this history. The data demonstrate that basic knowledge about HIV-1 has diffused to the IVDU community. Increasing treatment opportunities would seem to offer one avenue for assisting in behavior change in light of the HIV-1 epidemic these individuals face.
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