期刊
ADDICTION
卷 112, 期 8, 页码 1480-1487出版社
WILEY
DOI: 10.1111/add.13821
关键词
Epidemiology; India; intravenous drug abuse; hepatitis C; HIV; respondent-driven sampling; women
资金
- National Institute on Drug Abuse [R01 DA032059]
- Johns Hopkins HIV Epidemiology and Prevention Sciences Training Program [T32AI102623]
- Johns Hopkins Center for AIDS Research [P30 AI094189]
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases
Background and aimsDespite extensive research on HIV and hepatitis C (HCV) among people who inject drugs (PWID), there remains a gap in knowledge on the burden among women who inject drugs and their unique contexts and risk factors. This analysis compares HIV and HCV prevalence in female and male PWID and estimates injection and sexual risk correlates of prevalent HIV and HCV infection among women in Northeast India. DesignCross-sectional sample accrued using respondent-driven sampling. SettingSeven cities in Northeast India, 2013. ParticipantsA total of 6457 adult PWID. MeasurementsParticipants completed an interviewer-administered survey. HIV infection was diagnosed on-site and HCV antibody testing was performed on stored specimens. HIV and HCV prevalence estimates were stratified by gender. Among women, the association of risk correlates with HIV and HCV were estimated using multi-level logistic regression models. FindingsA total of 796 (15.9%) of the PWID were women, of whom 52.9% [95% confidence interval (CI)=49.3-56.5%] were HIV-infected and 22.3% (CI=19.9-24.7%) were HCV-infected. HIV and HCV prevalence among men was 17.4% (CI=16.9-24.7%) and 30.4% (CI=31.2-32.0%), respectively. Among women, correlates of HIV were widowhood [adjusted odds ratio (aOR) versus currently married=4.03, CI=2.13-7.60] and a higher number of life-time sexual partners (aOR 8 versus none=3.08, CI=1.07-8.86). Correlates of HCV were longer injection duration (aOR per 10 years=1.70, CI=1.25-2.27), injecting only heroin and a combination of drugs (aOR versus pharmaceuticals only=5.63, CI=1.68-18.9 and aOR=2.58, CI=1.60-4.16, respectively), sharing needles/syringes (aOR=2.46, CI=1.29-4.56) and a larger PWID network (aOR 51 versus 1-5=4.17, CI=2.43-7.17). ConclusionsWomen who inject drugs in Northeast India have a high HIV prevalence, which was more than double their hepatitis C (HCV) prevalence, an opposite pattern than is observed typically among male PWID. HIV infection is associated with sexual risk factors while injection-related behaviors appear to drive HCV infection.
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