A Study on the Risk & Its Determinants of HIV Transmission by Syringe Sharing among HIV-Positive Drug Users
OBJECTIVE:
To
understand the risks and associated factors of HIV transmission by sharing
syringes among HIV-positive drug users.
METHOD:
The survey
was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received
HIV counseling, testing and treatment in Changsha city Infectious Disease
Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to
understand their socio-demographic characteristics, HIV prevalence and syringe
sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact
list of 2 460 drug users who had the syringe sharing experience over one month
with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due
to sharing syringe with at least one drug user. Among them, 234 HIV-negative
persons were in control group, and 186 HIV-positive were in cased group. A
total of 1 220 drug users were followed up among 2 460 and defined as
vulnerable population. The HIV transmission rate was calculated based on the
HIV prevalence among vulnerable population. Based on the result of HIV
transmission to vulnerable population from 420 infection sources, case-control
study and the multivariate logistic regression analysis were adopted to explore
the associated factors of HIV transmission among IDUs-HIV+.
RESULTS:
As the
sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ±
1.2) years for drug use. As a susceptible population, 1 220 drug users sharing
syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years
for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug
users, with a transmission rate of 0.57. In the case-control study, the
proportion of male subjects was 87.1% (162/186) in the case group, which was
higher than that in the control group (77.8%, 182/234). The proportion of
subjects who received support after knowing their HIV infection status was
51.1% (95/186) in the case group, which was lower than that in the control
group (79.5%, 186/234). The proportion of subjects sharing syringes every time
of using drugs was 47.8% (89/186) in the case group, which was higher than that
in the control group (36.8%, 86/234). The proportion of subjects having AIDS
awareness was 21.0% (39/186) in the case group, which was lower than that in the
control group (64.5%, 151/234); the proportion of subjects having close contact
with HIV-positive persons for more than 106 days was 60.2% (112/186) in the
case group, which was higher than that in the control group (31.6%, 74/234).
The proportion of subjects maintaining the original drug use method after being
infected with HIV was 50.5% (94/186) in the case group, which was higher than
that in the control group (16.7%, 39/234) (all P values < 0.05). The
multivariate logistic regression analysis was carried out to analyse high
correlate factors of HIV transmission by sources of transmission, and the AIDS
awareness, duration of contact between sources of transmission and vulnerable
population, access to support following confirmed HIV infection were protective
factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and
0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and
continuous drug use after being infected with HIV were risk factors, and the OR
(95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.
CONCLUSION:
HIV
transmission by IDUs-HIV+ might be contained by raising AIDS awareness,
providing comprehensive psychological support, conducting needle exchange and
methadone maintenance treatment and reducing syringe sharing.
- 1Department of Epidemiology and Biostatistics, School of Public Health, Central South University, Changsha 410008, China.
- 2Email: tanhz99@qq.com.
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