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Colombia has experienced a significant increase in the incidence of HIV in the past decade attributed to the alarming rise of heroin injection. However, there is limited information about the level of HIV knowledge and the perception of risk among people who inject drugs (PWIDs) in Latin America. Further data is needed to optimally inform HIV prevention efforts in the region. The present study explores the level of HIV knowledge and risk perception, and their potential association with risk practices among PWIDs in Colombia. The survey instrument included the 18-item HIV Knowledge Questionnaire and the Risk Assessment Battery. Among the 190 respondents who completed the survey, approximately half demonstrated a limited knowledge of HIV (51.1%,  n  = 97). Misconceptions regarding the mechanisms of HIV transmission and the usefulness of female condoms were common. Homelessness was associated with limited HIV knowledge ( p  = .006, OR 2.62 IC 95% 1.31–5.25). Lastly, HIV knowledge was associated with safer injection behaviors, but was not related to safe sexual practices. Perceived risk of HIV exposure was not related to the level of HIV knowledge, drug-related, or sexual risk behaviors. Overall, our results indicate that misconceptions about the mechanisms of HIV transmission persist among PWIDs in Colombia, particularly among unstably housed respondents. Further efforts are needed to address social determinants of health, including housing access, among this vulnerable population to reduce the risks of HIV exposure.

HIV knowledge and risk behaviors among people who inject heroin in Colombia