High HIV incidence in a cohort of male injection drug users in Delhi, India

被引:8
作者
Sarna, Avina [1 ]
Saraswati, Lopamudra Ray [1 ]
Sebastian, Mary [1 ]
Sharma, Vartika [1 ]
Madan, Ira [2 ]
Lewis, Dean [2 ]
Pulerwitz, Julie [3 ,4 ]
Thior, Ibou [3 ]
Tun, Waimar [4 ]
机构
[1] Populat Council, India Habitat Ctr, New Delhi 110003, India
[2] Sahara Ctr Residential Care & Rehabil, New Delhi 110030, India
[3] PATH, ARISE Project, Washington, DC 20006 USA
[4] Populat Council, Washington, DC 20008 USA
关键词
Injection drug user; HIV-incidence; Sexual behavior; Unsafe injection practices; Cohort study; India; HUMAN-IMMUNODEFICIENCY-VIRUS; RISK BEHAVIORS; PROPENSITY SCORE; INFECTION; CHENNAI; PREVALENCE; TRANSMISSION; CAUSAL;
D O I
10.1016/j.drugalcdep.2014.03.021
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: India has an estimated 177,000 injection drug users (IDU) with a national HIV prevalence of 7.14%. Reliable estimates of HIV incidence are not available for this population. Methods: We report HIV incidence in a cohort of male, HIV-negative IDUs recruited through peer-referral, targeted outreach and as walk-in clients in Delhi from May to October, 2011. Fourth-generation Antigen-Antibody tests were used to diagnose new infections and results were confirmed using Western blot tests. HIV incidence based on HIV seroconversion was calculated as number of events/person-years. Cox regression was used to identify significant (p < 0.05) seroconversion predictors. Results: A total of 2790 male HIV-negative IDUs were recruited at baseline; 67.4% (n = 1880) returned for their first follow-up visit and 96% (n = 1806) underwent HIV testing. Participants were followed for a median of 9.7 months. A total of 112 new HIV infections occurred over a cumulative 1398.5 person-years of follow-up resulting in an incidence rate of 8.01 hew infections/100 person-years (95% CI: 6.65-9.64); 74% of these participants reported risky injection practices in the past month. In multivariate analysis, moderate-high risk injection behaviors (Adjusted Hazard Ratio [AHR] 2.59; 95% CI 1.45-4.62) were associated with a higher risk of new infections. Conclusions: Male IDUs in Delhi continue to practice unsafe injection practices leading to high sero-incidence despite the availability of HIV prevention services offered through targeted intervention programs. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:106 / 114
页数:9
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