An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India

Abstract

Background: Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. Methods: A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. Results: The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Conclusion: Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.

Understanding of HIV/AIDS in the international border area, Manipur: Northeast India

“…Urgent program to build awareness among the IDUs about their HIV status is necessary to limit the expansion of HIV, timely treatment and care. Phukan et al [22] in 2017 provided a useful program to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.…”

Personal network, recruitment pattern and network characteristics of female sex workers in a high HIV prevalent state of India

“…A homophily index, H ¼ 1.0 indicates perfect homophily, indicating that ties are formed with other members of the same group; and H ¼ À 1.0 reflects perfect heterophily, indicating that ties are formed completely outside of the group (Abdul-Quader et al, 2006). Intermediate levels of homophily are described in details elsewhere (Phukan et al, 2017). The estimated transition probability matrix describes the probability of one group recruiting to another (Spiller et al, 2012).…”

“…These seeds, then initiate the chain referral by recruiting fixed numbers of eligible peers from their personal network who, in turn, recruit other peers for the study. This recruitment process continues until the target sample size is attained (Medhi, Mahanta, Paranjape et al, 2012; Phukan et al, 2017). The target sample size for the study was calculated as 400 (Saidel et al, 2008).…”

“…Research on "hidden" or "hard-to-reach" populations, [e.g., female sex workers (FSWs), specially non-brothel-based or street-based FSWs, injecting drug users (IDUs), men who have sex with men (MSM)] have been challenging due to the non-availability of their define sampling frame and various social stigma attached to it (Heckathorn, 1997;Phukan et al, 2017;Selvaraj et al, 2016). These populations continually try to avoid open interaction with the rest of society and build a personal or social network among themselves.…”

Building New Approaches to Risk Reduction With Social Networks and People Who Smoke Illegal Drugs From Participatory Community-Based Research

“…Previous studies in the area of marginalized, stigmatized, criminalized, and at-risk groups have relied on traditional qualitative and quantitative methods to reach these groups and their networks (Phukan et al, 2017). Jacques and Wright’s (2015) qualitative research for example showed how the illegal drug market and the network of producers to traffickers and to consumers operated.…”