High-risk behaviour for sexually transmitted diseases and blood borne viral infections among institutionalized male drug addicts in Sri Lanka

Background: Risky behaviours are common among people with psychoactive substance addiction, and illicit drugs are no exception. Drug users are identified as a vulnerable group for Sexually Transmitted Diseases (STDs) and Blood Borne Viral Infections (BBVIs). This study was conducted to assess high-risk behaviour for STDs and BBVIs and their associated factors among institutionalised male drug addicts in Sri Lanka. Methods: A cross-sectional study was conducted among a sample of 431 male drug users rehabilitated at five different rehabilitation centres in Sri Lanka. High-risk behaviours for STDs and BBVIs were identified in the literature and assessed using an interviewer-assisted self-administered questionnaire. Associated factors for high-risk behaviour for STDs and BBVIs were identified using multiple logistic regression. Results: Out of the total sample, 89.4% had used heroin. Nearly 60% of the drug users reported having at least one risk behaviour for STDs and BBVIs. Almost half (55.0%) of drug users have never been investigated for STD and BBVIs. However, only 0.2% was screened positive for syphilis, Hepatitis B, and Hepatitis C out of the total sample. Hallucinogen and psychotropic drug use (p=0.040), younger age group(p=0.024), initiation of drug use during adolescence (p=0.020), residence away from the capital city of the country(p=0.005), unsatisfactory paternal care during childhood (p=0.009) and having the unsatisfactory income(p=0.034) were more likely to associate with having high-risk behaviour for STDs and BBVIs. However, in multiple logistic regression, residents in semi-urban areas (OR=1.73, 95% CI 1.05-2.85) who did not have paternal care during childhood (OR=3.53, 95% CI 1.31-9.52) and drug users who had initiated drug use behaviour during adolescence (OR=1.58, 95% CI 1.03-2.43) remained as statistically significant predictors. Conclusions: High-risk behaviour for STDs and BBVIs is common among drug addicts in Sri Lanka. Therefore, routine screening program for drug users is recommended along with other harm reduction and preventive activities targeting drug addicts.