ABSTRACT
Background & objectives: Female sex workers (FSWs) who inject drugs (FSW-IDs) have a higher risk of HIV infection and transmission. Understanding the socio-demographic characteristics and other risk behaviours among FSW-IDs will help in strengthening targeted interventions for HIV prevention and management. In the present study, the HIV prevalence, associated socio-demographic characteristics and risk behaviours among FSWs who injected drugs (FSW-IDs) and those who did not ID (FSW-NIDs) was determined in India. Methods: The national cross-sectional, community-based, integrated biological and behavioural surveillance was conducted in 2014-2015 at 73 randomly selected FSW domains across 28 States and Union Territories in India. The sample size was fixed at 400 for each domain, and a probability-based sampling method was followed. The data were analyzed by logistic regression methods. Results: Data from 27,007 FSWs were included in the analysis, of which 802 (3%) were FSW-IDs. HIV prevalence among FSW-IDs was significantly higher than that in FSW-NIDs (4.5 vs. 1.9%). Univariate analysis showed that factors significantly associated with higher HIV prevalence among FSW-IDs were older age, sex work as the only source of income, dissolved marriage, living with a sex worker, urban locality of sex work and consumption of alcohol or oral drugs. In multivariable analysis, factors such as older age of FSW-IDs (35 yr and above), having a dissolved marriage and sex work being the only source of income were observed to be independently and significantly associated with higher HIV prevalence. Interpretation & conclusions: Scaling up the HIV preventive interventions for FSW-IDs, such as facilitating awareness and improved access to needle and syringe exchange programme (NSEP) and opioid substitution therapy (OST), encouraging safe sex and injecting practices, educating on the harmful effects of alcohol and drugs and providing alternative vocation options to secure their financial needs are several strategies that may reduce HIV transmission among FSWs.
ABSTRACT
Objective@#To explore the methods of establishing and maintaining community injecting drug user (IDU) cohort.@*Methods@#From June 2014 to June 2017, a community survey was conducted on basis of local needle and syringe exchange site to recruit 200 HIV sero-negative IDU for a prospective cohort study in Longyang district of Baoshan city, Yunan province. Follow-up was carried out every six month to investigate high risk drug use behavior and sexual behavior, and blood samples were collected from them for the tests of HIV and HCV serum antibodies. The cohort would be opened every 12 months to replenish the cohort to 200 subjects.@*Results@#The follow up was conducted for 3 years in 229 IDUs. Cohort follow-up rate was 93.0% (213/229) for 6 months, 92.1% (211/229) for 12 months, 91.7% (200/218) for 18 months, 87.2% (190/218) for 24 months, 86.0% (172/200) for 30 months and 86.0% (172/200) for 36 months.@*Conclusion@#The community IDU cohort has a high follow-up rate.
ABSTRACT
Objective To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou.Methods HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou,being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015.Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced.After that,data were submitted to the HIV resistance database of Stanford University for drug resistance analysis.Results Among the 518 HIV-1 infected IDUs,H1V-1 pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57％) aged 18-64 (37.44 ± 8.14) years.Among them,males accounted for 89.68％ (365/407),those of Han ethnic group accounted for 89.93％ (366/407),the unmarried accounted for 55.28％ (225/407),and those with education level of junior high school or below accounted for 83.78％ (341/407).The distribution of subtypes was predominated by CRF07_BC (47.18％,192/407),followed by CRF01_AE (23.83％,97/407),CRF08_BC (22.85％,93/407),and other subtypes (6.14％,25/407).The overall prevalence of drug resistance was 3.44％ (14/407).The prevalence of drug resistance to protease inhibitors,nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47％(6/407),0.25％ (1/407) and 1.72％ (7/407) respectively.The mutation rate was 12.29％ (50/407).No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions.Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC.Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes.The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23％).Two cases were resistant to all four drugs of NNRTIs.Conclusions The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015,in Guangzhou.Most infections were sensitive to existing antiviral drugs.However,drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.
ABSTRACT
Objective To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou.Methods HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou,being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015.Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced.After that,data were submitted to the HIV resistance database of Stanford University for drug resistance analysis.Results Among the 518 HIV-1 infected IDUs,H1V-1 pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57％) aged 18-64 (37.44 ± 8.14) years.Among them,males accounted for 89.68％ (365/407),those of Han ethnic group accounted for 89.93％ (366/407),the unmarried accounted for 55.28％ (225/407),and those with education level of junior high school or below accounted for 83.78％ (341/407).The distribution of subtypes was predominated by CRF07_BC (47.18％,192/407),followed by CRF01_AE (23.83％,97/407),CRF08_BC (22.85％,93/407),and other subtypes (6.14％,25/407).The overall prevalence of drug resistance was 3.44％ (14/407).The prevalence of drug resistance to protease inhibitors,nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47％(6/407),0.25％ (1/407) and 1.72％ (7/407) respectively.The mutation rate was 12.29％ (50/407).No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions.Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC.Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes.The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23％).Two cases were resistant to all four drugs of NNRTIs.Conclusions The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015,in Guangzhou.Most infections were sensitive to existing antiviral drugs.However,drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.
ABSTRACT
Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.
ABSTRACT
Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.
ABSTRACT
Objective To investigate the HIV drug resistance among HIV/AIDS patients who had received highly active antiretroviral treatment (HAATR) in Liangshan prefecture and related factors.Methods This investigation was conducted from August to October 2010.Data on epidemiology,treatment,CD4 + T cell,viral load and drug resistance tests were collected.Results 233 (73.50％) had a viral load of ＜ 1000 copy/ml,with the median CD4+T cell count as 329 cell/μl.26 samples appeared to be drug resistant,with the rate as 8.20％.Among 84 patients with antiviral therapy failure,the overall drug resistance rate was 30.95％(26/84).While 24 (28.57％) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs.Among nucleoside reverse transcriptase inhibitors (NRTI),7 (8.33％) were resistant.1 (1.19％) had protease inhibitor (PI)resistance mutations identified.Factors that significantly associated with drug resistance would include:being injecting drug users (A OR =3.37,95 ％ CI:1.06-10.66,P =0.0390),having had chronic diarrhea ＞1 month (AOR=8.38,95％ CI:1.87-37.69,P=0.0055),having had CD4+T cell＜200(AOR=3.48,95％CI:1.29-9.39,P=0.0139),being residents from Butuo area (AOR=17.68,95％ CI:4.97-62.86,P＜0.0001 ).When comparing with other areas,data from Butuo showed that people who carried Yi ethnicity (AOR=17.35,95％ CI:2.01-149.73,P=0.0095) and were literate (having had primary or higher levels of education) (AOR=0.18,95％ CI:0.08-0.42,P＜0.0001 ),being married or having cohabited relations (AOR=8.17,95％ CI:2.35-28.39,P=0.001 ) were found to be less adherent (AOR=0.05,95％ CI:0.02-0.13,P＜0.0001) to the treatment.Conclusion Successful antiviral outcomes were seen among those AIDS patients under treatment,in Liangshan prefecture.Resistance rates were significantly different in regions.For IDUs,enforcement on subjects including prevention on drug resistance,adherence to HAART and treatment for drug addiction should be strengthened and programs being integrated.
ABSTRACT
Background: In Vietnam, the HIV/AIDS pandemic is quickly spreading, almost totally in young people and among injecting drug users.The transition phase from smoking to injecting is very important for the life of injecting drug users because it is a risk factor of disease transmission. Objectives: (1) To analyze the transition phase from smoking/sniffing to injecting of the young male heroin users in Ha Noi. (2) To describe some factors related to the transition phase in these people. Subjects and method: A cross-sectional study carried out from September 2004 to September 2005 at 9 districts in Ha Noi city. The subjects were 1115 young men aged 16 to 29 years, who has been living in Ha Noi for over 6 months and smoked/sniffed heroin within the last 30 days. Results and conclusions: The average time of drug user in the 1115 subjects was 4.7 years. The majority started using drug at the age of 18.4 +/- 3.1 years. In which, 71 % consume the drugs by injection. The average time from smoking to injecting is 2.49 +/- 2.2 years. The main reasons for injecting drugs were for being faster \u2018on the height\u2019 (42%) and cheaper (40%). Some factors related to the transition phase included: age of the first heroin use, year of the first heroin use, situation for migrating into Ha Noi, knowledge level, the kind of drug used for the first time. Young people began using heroin in the year 2000 had a quicker transition phase than those using heroin before 1997 (p< 0.01).
Subject(s)
Drug Users , HeroinABSTRACT
Introduction: Hepatitis C is a dangerous disease and if left untreated can have serious consequences to the patients. While hepatitis C is difficult to treat, its vaccine is still unavailable. Previous studies have showed that there is a low rate of drug users having HCV tests. This means HCV infections does not have any great importance attached to it amongst the drug user group.\r\n', u'Objectives: To discover the status of HCV infection among drug users in Hanoi and to analyse the associated factors. \r\n', u'Subjects and methods: This crossover descriptive study was conducted in Hanoi. Research objects consisted of only men within the 16 - 25 years old age group, who used heroin from 09/2005 to 12/2006. These participants were interviewed and tested for HIV, HCV and HBV.\r\n', u'Results: HCV prevalence is 35.1 %. Especially, the research has indicated that 100% of HIV infected cases have also contracted HCV. This co - infectious status can be a challenge to subjects when they experience ARV treatment. The mean age of surveyed participants is 19. 83.6% of them have attended secondary school. 30.1 % have taken part in illegal earning activities. \r\n', u'Conclusion: HCV infection was discovered in the early drug injection stage. The proportion of HIV infection among injecting drug users is 28.24 times compared to the smoking drug users.\r\n', u'
Subject(s)
HIVABSTRACT
Since the year 2000 there has been a steep increased in the number of HIV/AIDS patients in Indonesia, coming mostly from intravenous drug users. Antiretroviral treatment has been proved to decrease mortality and increase quality of life of HIV/AIDS patients. The treatment is given according to clinical condition of the patients, number of CD4 and viral load. In this study, CD4 and viral load were examined in 71 asymptomatic HIV patients originated from injecting-drug users. CD4 counting was performed by indirect immunoflouresence method using monoclonal antibody, and viral load was tested using PCR technique. Among 56 patients who has the number of CD4 more than 200/mm3, 30 patients (55.4 %) has viral load more than 55,000 copies/ml and 35.7% has viral load 5,000-55,000 copies/ml. Correlation between the number of CD4 and viral load gave the r value of 0.194. It is concluded that there is no association between the number of CD4 and viral load in drug user HIV/AIDS patients. The treatment of HIV/AIDS for these patients should be given according to the viral load.