Decreased Injecting Is Associated with Increased Alcohol Consumption among Injecting Drug Users in Northern Vietnam

Background

Reducing injecting frequency may reduce the risk of HIV infection and improve health outcomes among injection drug users (IDU). However, the reduction of one risk behavior may be associated with an increase in other risk behaviors, including the use of other risk-associated substances. Our objective was to determine if an association exists between a reduction in injecting and level of alcohol use among IDU.

Methods

We conducted a longitudinal analysis of data collected for a randomized controlled trial examining the efficacy of a peer education intervention in reducing HIV risk among IDU and their network members in Thai Nguyen, Vietnam. Our analysis included active male injectors (n=629) who were study participants and attended both baseline and 3-month visits. Frequency of alcohol consumption was assessed as the number of alcoholic drinks in the past 30 days. Change in risk and outcome behaviors was calculated as the difference in frequencies of behaviors between baseline and 3-month follow-up visits. The outcome of interest was concurrent decreased drug injection and increased alcohol consumption.

Results

The mean difference between baseline and 3-month follow-up of alcohol consumption and injection frequency in the past 30 days was 19.03 drinks (93.68 SD) and 20.22 injections (35.66 SD), respectively. Participants who reported reduced injection frequency were almost three times as likely to report increased alcohol consumption (OR 2.8; 95% CI, 2.0, 4.0). The proportion that both decreased injecting and increased alcohol by any amount in the past 30 days was 35.6%. In multivariate analysis higher education was significantly associated with an increase in alcohol and decrease in injecting of any amount.

Conclusion

Male IDU may be at risk for increasing alcohol consumption when they reduce injection frequency. Interventions with male IDU that encourage reduction of injection may need to review specific strategies to limit alcohol consumption.

Below:  Change in # days consumed alcohol (y-axis) by Change in # days injected drugs (x-axis), in past 3 months: Visit2 – Visit1 = (3 months – Baseline).

Full article at:   http://goo.gl/quESju

By:  Vivian F. Go,^a,* Nguyen Le Minh,^b Constantine Frangakis,^c Tran Viet Ha,^a Carl A. Latkin,^d Teerada Sripaipan,^a Wendy Davis,^a Carla Zelaya,^a Nguyen Phuong Ngoc,^b and Vu Minh Quan^a

^aJohns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe St. Baltimore, Maryland 21205 USA

^bThai Nguyen Center for Preventive Medicine, Thai Nguyen, Vietnam

cJohns Hopkins Bloomberg School of Public Health, Department of Biostatistics, 615 N. Wolfe St. Baltimore, Maryland 21205 USA

^dJohns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N. Broadway, Baltimore, Maryland 21205 USA

Corresponding Author: Vivian F. Go, PhD, MPH, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E6610, Baltimore, MD 21205, USA, Phone: 1-215-572-5736, Fax: 1-215-616-2334, Email: ude.hpshj@ogv

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Prevalence & Correlates of HCV Monoinfection & HIV & HCV Coinfection among Persons Who Inject Drugs in Vietnam

Vietnam bears a high burden of hepatitis C virus (HCV) and HIV infection among persons who inject drugs (PWID). The high prevalence of HCV and HIV occurs in a context of stigma and limited preventive interventions for PWID.

This study aims to estimate the prevalence of HCV, HIV, and HIV/HCV coinfection among PWID and to explore their associations with lifetime injection behaviors.

A total of 1434 PWID were recruited from the Thai Nguyen Province of Vietnam between 2005 and 2007. Participants responded to a structured questionnaire and provided blood samples at baseline. A cross-sectional analysis of data collected at baseline was carried out. Factors associated with HCV monoinfection and HIV/HCV coinfection were evaluated by multinomial logistic regression.

The prevalences of HIV and HCV were 35.1 and 88.8%, respectively, and the prevalences of HIV/HCV coinfection and HCV monoinfection were 34.8 and 53.9%, respectively. After adjusting for confounders in multivariate analysis, ever reusing a syringe and needle was found to be significantly associated with HIV monoinfection and HIV/HCV coinfection. Ever sharing diazepam or novocaine was also found to be significantly associated with HIV monoinfection and HIV/HCV coinfection.

Our findings demonstrate a high burden of HIV and HCV infection among PWID in Vietnam. Lifetime injection behaviors, including sharing of diazepam or novocaine, may account for the high prevalence of HIV and HCV. Improving prevention and ensuring access to care remain critically important for this vulnerable population.

Via:  http://ht.ly/SASgJ Purchase full article at: http://goo.gl/6UrXVl

By: Zhang L1, Celentano DD, Le Minh N, Latkin CA, Mehta SH, Frangakis C, Ha TV, Mo TT, Sripaipan T, Davis WW, Quan VM, Go VF.

• 1Departments of aEpidemiology bHealth, Behavior and Society cBiostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland dDepartment of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA eThai Nguyen Center for Preventive Medicine, Thai Nguyen, Vietnam.
• 
  
  
  More at:  https://twitter.com/hiv_insight