Geographical and temporal variation of injection drug users in Pakistan

Sexually Transmitted Infections - Tập 89 Số Suppl 2 - Trang ii18-ii28 - 2013
Chris Archibald1, Souradet Y. Shaw2, Faran Emmanuel3, Suleman M. Otho3, Tahira Reza3, Arshad Altaf3, Nighat Musa3, Laura H. Thompson2, James Blanchard2
1Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
2University of Manitoba
3HIV/AIDS Surveillance Project

Tóm tắt

ObjectivesWe describe the characteristics of injecting drug users (IDU) in Pakistan in 2006 and 2011, and assess the heterogeneity of IDU characteristics across different cities and years as well as factors associated with HIV infection.MethodsCross-sectional, integrated behavioural-biological surveys of IDU were conducted in 10 cities across Pakistan in 2006 and 2011. Univariate and multivariable analyses were used to describe the differences in HIV prevalence and risk behaviours between cities and over time.ResultsLarge increases in HIV prevalence among injection drug users in Pakistan were observed, with overall HIV prevalence increasing from 16.2% in 2006 to 31.0% in 2011; an increase in HIV prevalence was also seen in all geographic areas except one. There was an increase in risk behaviours between 2006 and 2011, anecdotally related to a reduction in the availability of services for IDU. In 2011, larger proportions of IDU reported injecting several times a day and using professional injectors, and fewer reported always using clean syringes. An increase in the proportion living on the street was also observed and this was associated with HIV infection. Cities differ in terms of HIV prevalence, risk profiles, and healthcare seeking behaviours.ConclusionsThere is a high prevalence of HIV among injection drug users in Pakistan and considerable potential for further transmission through risk behaviours. HIV prevention programs may be improved through geographic targeting of services within a city and for involving groups that interact with IDU (such as pharmacy staff and professional injectors) in harm reduction initiatives.

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Tài liệu tham khảo

UNAIDS. AIDS Epidemic Update: December 2007 http://www.data.unaids.org/pub/epislides/2007/2007_epiupdate_en.pdf (accessed 29 Apr 2008).

Choopanya, 1991, Risk factors and HIV seropositivity among injecting drug users in Bangkok, AIDS, 5, 1509, 10.1097/00002030-199112000-00014

10.1001/jama.1989.03420070058030

Sarkar, 1993, Rapid spread of HIV among injecting drug users in north-eastern states of India, Bull Narc, 45, 91

10.1258/095646203765371231

10.1016/j.socscimed.2004.12.024

10.1046/j.1360-0443.1999.94913235.x

United Nations Office on Drug and Crime. Drug Use Survey. Vienna, 2002.

10.1258/004947507779951989

United Nations Office on Drug and Crime. World Drug Report. Vienna, 2006.

Emmanuel, 2006, Correlates of injection use of synthetic drugs among drug users in Pakistan: a case controlled study, J Pak Med Assoc, 56, 119

10.1016/S0376-8716(03)00072-3

National AIDS Control Program. HIV Second Generation Surveillance in Pakistan: National Report Round II 2006–07 . Islamabad: Ministry of Health; 2007.

10.1016/j.ijid.2005.07.010

10.1186/1477-7517-3-26

10.1186/1742-4690-4-22

10.1136/sti.2009.041335

10.1136/sti.2008.033167

10.1097/01.aids.0000386737.25296.c4

10.3109/10826080903452447

Pollini, 2011, Problematic use of prescription-type opioids prior to heroin use among young heroin injectors, Subst Abuse Rehabil, 2, 173, 10.2147/SAR.S24800

10.1093/bmb/58.1.7

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Sexually Transmitted Infections

Tập 89 Số Suppl 2

ii18-ii28

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