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1.
AIDS Res Hum Retroviruses ; 25(9): 853-60, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19689193

RESUMO

This study aimed to determine HIV, HCV, and syphilis prevalence and correlates, and to characterize the molecular epidemiology of HIV-1 among injecting drug users (IDUs) in Dushanbe, Tajikistan. A cross-sectional study assessing risk factors for HIV and HCV through an interview administered survey was conducted. A total of 491 active adult IDUs were recruited from May to November 2004 in Dushanbe, Tajikistan. HIV-1 antibody status was determined with rapid testing and confirmed with ELISA. HCV antibody testing was conducted using a BIOELISA HCV kit. HIV-1 subtyping was done on a subset with full-length sequencing. Correlates of HIV and HCV infection were assessed using logistic regression. Overall prevalence of HIV was 12.1%, HCV was 61.3%, and syphilis was 15.7%. In a multivariate logistic regression model controlling for gender and ethnicity, daily injection of narcotics [odds ratio (OR) OR 3.22] and Tajik nationality (OR 7.06) were significantly associated with HIV status. Tajik nationality (OR 1.91), history of arrest (OR 2.37), living/working outside Tajikistan in the past 10 years (OR 2.43), and daily injection of narcotics (OR 3.26) were significantly associated with HCV infection whereas being female (OR 0.53) and always using a sterile needle (OR 0.47) were inversely associated with HCV infection. Among 20 HIV-1-positive IDU with specimens available for typing, 10 were subtype A, 9 were CRF02_AG, and one was an A-CRF02_AG recombinant. Epidemics of HIV-1, HCV, and drug use are underway in Dushanbe. The molecular epidemiology is distinctive, with West African variants accounting for roughly 50% of prevalent infections. Targeted prevention programs offering both needle exchange programs and opiate substitution therapies are urgently called for to prevent the further spread of HIV and HCV in Tajikistan.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Hepatite C/epidemiologia , Hepatite C/virologia , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Comorbidade , Estudos Transversais , Feminino , Genótipo , Anticorpos Anti-HIV/sangue , HIV-1/classificação , HIV-1/genética , HIV-1/isolamento & purificação , Hepacivirus/isolamento & purificação , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Epidemiologia Molecular , RNA Viral/genética , Fatores de Risco , Estudos Soroepidemiológicos , Sífilis/epidemiologia , Tadjiquistão/epidemiologia , Adulto Jovem
3.
Drug Alcohol Depend ; 82 Suppl 1: S7-14, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16769449

RESUMO

OBJECTIVE: To examine differences by ethnicity of HIV prevalence and correlates among injection drug users (IDUs) in Dushanbe, Tajikistan. METHODS: The researchers enrolled 489 active adult IDUs in a cross-sectional risk factor study of HIV infection. Participants were provided HIV pre-and posttest counseling and risk reduction counseling and answered an interviewer-administered questionnaire. HIV-1 status was determined with rapid tests and confirmed with ELISA. RESULTS: Participants included four ethnicities: 204 Tajiks (49.1%), 145 Russians (29.7%), 58 Uzbeks (11.9%), and 46 participants of other nationalities (9.4%). Overall prevalence of HIV-1 infection was 12% and varied significantly by ethnicity: it was highest among ethnic Tajiks, at 19.2%; lowest among Russians and Uzbeks, at 3.4%; and 13% among other nationalities. Ethnic groups differed significantly in years injecting, receiving a needle from a needle exchange program (NEP), injecting in groups, having undergone drug treatment, reported condom use, and arrest history. Among Tajiks, HIV infection was significantly associated with daily injecting (OR 2.16); reporting that narcotics were very easy to obtain (OR 2.46); having undergone drug treatment (OR 2.75), and injecting "alone" (OR 3.12). CONCLUSIONS: Ethnic differences were strongly associated with HIV prevalence and risk behaviors in this multiethnic study, and prevention efforts might need to be targeted by ethnicity.


Assuntos
Etnicidade/estatística & dados numéricos , Infecções por HIV/etnologia , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/etnologia , Adulto , Área Programática de Saúde , Aconselhamento , Estudos Transversais , Demografia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Características de Residência , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/epidemiologia , Tadjiquistão/epidemiologia
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