Journal
INTERNATIONAL JOURNAL OF STD & AIDS
Volume 25, Issue 8, Pages 596-606Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0956462413515659
Keywords
Syphilis; sexually transmitted infections; Indian subcontinent; human immunodeficiency virus; sexually transmitted viral diseases; epidemiology; AIDS; injecting drug use
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Funding
- DFID through Futures Group International India Private Limited [750042-NICED-01-2010]
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In this study 1155 injection drug users (IDUs) receiving targeted intervention in five cities of Punjab were surveyed; three cities (Amritsar, Taran-Taran, Batala) were in districts sharing an international border with Pakistan and the other two were Jalandhar and Ludhiana. Information on socio-demography, substance use and sexual practices were collected; blood samples were tested for biologic markers. HIV and HCV antibody (HCVAb) prevalences in injection drug users were 29 and 49%, respectively. Of the HCVAb-seroreactive IDUs, 33% had HIV as well. HIV prevalence in young IDUs (<= 19 years), estimated as surrogate for HIV incidence, was high at 12% and HCVAb in this subgroup was 27%. Herpes simplex virus 2 antibody (IgG) was detected in 10% of IDUs; 2% had syphilis. Alcohol use prevalence was high and frequency of use concerning. In multivariate analyses, 'city of residence closer to international border' and '>1 year duration of injecting drugs were associated with HIV and HCVAb. Furthermore, 'irregular supply of syringes and needles' was associated with HCVAb seroreactive status of IDUs (adjusted odds ratio 1.7; 95% CI 1.3-2.3; P < 0.001), and 'any genital disease symptom within the last year' (adjusted odds ratio 2; 95% CI 1.4-2.9; P < 0.001) was associated with HIV infection. Alcohol and sexual risk reduction, strengthening of needle-syringe exchange, reducing injecting duration and clinical management of HIV, HCV and HIV/HCV co-infection appear as four core programme needs.
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