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      Continued spread of HIV among injecting drug users in southern Sichuan Province, China

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          Abstract

          Objective

          To estimate HIV prevalence among injecting drug users (IDUs) in a drug trafficking city in southwest Sichuan Province, China.

          Methods

          A total of 314 IDUs was invited to participate in the cross-sectional survey in 2004 through community outreach recruitment and peer referrals. Blood sample was taken for HIV antibody testing and a structured questionnaire was administered to collect information on socio-demographics, drug using and sexual behaviors.

          Results

          HIV prevalence among IDUs was 17.8% (56/314), about one half higher than that in previous survey in 2002 (11.3%, 43/379). Yi and other minority ethnicity (Odds ratio [OR], 3.1; 95% confidence interval [CI], 1.7–5.8; P < 0.001), and total times of sharing injecting equipments 1–9 times versus none, OR, 2.7; 95% CI 1.2–6.2; P = 0.02; and ≥10 times versus none, OR, 7.5; 95% CI, 3.2–17.7; P < 0.001) were independent risk factors for HIV infection.

          Conclusion

          IDUs with high prevalence rates of HIV and equipment sharing behavior in the drug trafficking city may serve a source for further spread of HIV to other areas in China. The increasing trend of HIV epidemic among IDUs underscores the urgency of scaling up interventions.

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          Risk of HIV/AIDS in China: subpopulations of special importance.

          H Z Qian, S H Vermund, N Wang (2005)
          To describe the HIV/AIDS epidemic in mainland China. We review the magnitude of the HIV/AIDS epidemic and the social characteristics and geographic distribution of at-risk groups in China based on published literature and unpublished official data. Injection drug use has been the dominant route for HIV infection in China, and will continue to be a major risk factor with increasing numbers of new drug users and needle sharing. Commercial plasma donation with unhygienic re-infusion of red blood cells was common in rural communities in the early 1990s. While this is unlikely to constitute a major factor for future HIV spread, those already infected represent a formidable treatment challenge. Huge seasonal work migration facilitates disease spread across regions. Many homosexual men have unprotected sex with men, women, or both, and may contract or spread HIV. Though commercial sex workers have contributed to a small proportion of the reported epidemic thus far, flourishing commercial sex is of growing concern and may have a bridging role in transmitting HIV from core groups to the general population. Increasing numbers of sex workers and drug users, internal migration, high risk behaviours, and low condom use suggest a future upward trend for HIV/AIDS and underscore the urgency of scaling up interventions in China.
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            Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia.

            Adam V S Parry, Matthew Hickman, Catherine M Lowndes … (2002)
            To establish the prevalence of antibodies to HIV (anti-HIV) and associated risk factors among injecting drug users (IDU) in Togliatti City, Samara Oblast, Russian Federation. An unlinked anonymous cross-sectional community recruited survey with oral fluid sample collection. Between September and October 2001, 426 IDU were recruited by trained fieldworkers. Participants completed an interviewer administered questionnaire, and oral fluid samples were tested for anti-HIV. Univariate and multivariate analyses compared potential risk factors for anti-HIV. Anti-HIV prevalence was 56% (234/418). Three-quarters of anti-HIV-positive IDU (74%) were unaware of their positive status. In an adjusted model, the odds of HIV infection were higher among IDU who had ever injected home-produced drugs, who reported injecting with used needles and syringes in the past 4 weeks, and who were living in one particular district of the city (Komsomolksii). The high prevalence of HIV, and a recent increase in HIV detected through routine screening tests since 2000, suggests that an explosive epidemic has occurred among IDU in Togliatti City. In the face of currently inadequate HIV prevention coverage among IDU, this has urgent implications for maximizing the distribution of sterile injecting equipment as well as for enhancing sexual risk reduction. Recognizing that it is likely that similar explosive epidemics are taking place in other Russian cities, we recommend community-wide HIV prevention coverage supported by city and state policies oriented to harm reduction. Copyright 2002 Lippincott Williams & Wilkins
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              Community-based survey of HIV transmission modes among intravenous drug users in Sichuan, China.

              Kanglin Chen, Jianping Chen, Q. Y. He … (2004)
              The goal of this study was to investigate the prevalence and different transmission risk factors of HIV among intravenous drug users (IDUs) in the Liangshan Yizu Autonomous Region of Sichuan province, China. From November 8, 2002, to November 29, 2002, a community-based survey was conducted to investigate demographic characteristics, sharing patterns of injection equipment, frequencies of injection equipment, and sexual behaviors in IDUs. Blood samples were also collected to test for HIV and syphilis infection. A total of 379 subjects were recruited for the study through community outreach and peer recruiting methods. Of 379 IDUs, HIV prevalence was 11.3% (43 of 379). Ethnicity, total times of shared injection equipment in the past 3 months, shared cotton in the past 3 months, and syphilis infection were associated with HIV infection after univariate analysis using the chi-squared test. Multivariate logistic regression analysis showed total times of sharing injection equipment in the past 3 months (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.18-4.43) and syphilis infection (OR, 3.10; 95% CI, 1.48-6.48) in the final model were independently associated with HIV prevalence. The results of this study suggested total times of sharing injection equipment in the past 3 months and syphilis infection were significantly associated with HIV infection. Further seroepidemiologic prospective cohort studies should be conducted to clarify the impact of syphilis and high-risk sexual behaviors on HIV transmission through unprotected sexual intercourse.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Harm Reduct J
                Title: Harm Reduction Journal
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1477-7517
                Publication date Collection: 2007
                Publication date (Electronic): 8 February 2007
                Volume: 4
                Page: 6
                Affiliations
                [1 ]State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xuanwu District, Beijing 100050, China
                [2 ]Sichuan Provincial Center for Disease Control and Prevention, 6 Zhongxue Road, Wuhou District, Chengdu, Sichuan Province 610031, China
                [3 ]Department of Medicine/Division of Preventive Medicine, University of Alabama at Birmingham, Room 645, 1717 11th Avenue South Medical Towers Bld. Birmingham, Alabama 35205, USA
                [4 ]Xichang Center for STD and Leprosy Control, 5 Chang'an Road, Zhangjiatunxiang, Xichang County, Sichuan Province 615000, China
                Article
                Publisher ID: 1477-7517-4-6
                DOI: 10.1186/1477-7517-4-6
                PMC ID: 1802748
                PubMed ID: 17286871
                SO-VID: 62ba6315-1929-4c52-9945-2e9d285e17d4
                Copyright © Copyright © 2007 Yin et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 March 2006
                Date accepted : 8 February 2007
                Categories
                Subject: Research

                ScienceOpen disciplines: Health & Social care
                Data availability:
                ScienceOpen disciplines: Health & Social care

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