Caste- and Ethnicity-Based Inequalities in HIV/AIDS-Related Knowledge Gap: A Case of Nepal

et al. 2020

Preprint

Background HIV is a major public health issue around the world, especially in developing countries.Although the overall prevalence of HIV in Nepal is relatively low and the country itself is considered low risk, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male injection drug users (IDUs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledgebased risk factors need to be assessed. MethodsThe study used a series of 7 cross-sectional survey datasets, collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male IDUs by key socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV in the Pokhara valley, Nepal.Results A lower risk of HIV was associated with younger age (≤24 years compared to >24 years, OR = 0.17, 95% CI = 0.10, 0.31), not being married (OR = 0.51, 95% CI = 0.33, 0.80) and shorter duration of drug use (≤4 years compared to >4 years, OR = 0.16, 95% CI = 0.09, 0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75, 4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64, 4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20, 4.11).Conclusion Although knowledge of HIV is high among male IDUs, the prevalence of individuals who possess comprehensive knowledge and the number of individuals who have received treatment for drug addiction has decreased. This may indicate that addiction treatment and HIV education programs need to be strengthened.

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal

et al. 2020

Preprint

“…There has been previous descriptive research in the Kathmandu Valley in Nepal into key risk factors and prevalence trends (7)(8)(9)17), however, more detailed analytic approaches to investigate socio-demographic and behavioural factors are currently lacking for this setting. Previous behavioural studies have also shown that there are multiple risk factors that act as determinants for HIV and other sexually transmitted diseases within other areas of Nepal (10,11), such as social class and education level (21). Accordingly, this study aimed to investigate trends and the associations between sociodemographic, behavioural and knowledge-based factors and HIV transmission among male intravenous drug users (IDUs) in the Pokhara valley, Nepal from 2003 to 2017.…”

Section: Introductionmentioning

confidence: 97%

Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal: Analysis of cross-sectional studies

et al. 2020

Preprint

Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low and the country itself is considered low risk, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male injection drug users (IDUs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors need to be assessed. Methods The study used a series of 7 cross-sectional survey datasets, collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male IDUs by key socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV in the Pokhara valley, Nepal. Results Overall HIV prevalence has decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence has increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (less than or equal to 24 years compared to greater than 24 years, OR = 0.17, 95% CI = 0.10, 0.31), not being married (OR = 0.51, 95% CI = 0.33, 0.80) and shorter duration of drug use (less than or equal to 4 years compared to greater than 4 years, OR = 0.16, 95% CI = 0.09, 0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75, 4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64, 4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20, 4.11). Conclusion Although knowledge of HIV is high among male IDUs, the prevalence of individuals who possess comprehensive knowledge and the number of individuals who have received treatment for drug addiction has decreased. This may indicate that addiction treatment and HIV education programs need to be strengthened.

“…There has been previous descriptive research in the Kathmandu Valley in Nepal into key risk factors and prevalence trends (7)(8)(9)17), however, more detailed analytic approaches to investigate socio-demographic and behavioural factors are currently lacking for this setting. Previous behavioural studies have also shown that there are multiple risk factors that act as determinants for HIV and other sexually transmitted diseases within other areas of Nepal (10,11), such as social class and education level (21). Accordingly, this study aimed to investigate trends and the associations between socio-demographic, behavioural and knowledge-based factors and HIV transmission among male intravenous drug users (IDUs) in the Pokhara valley, Nepal from 2003 to 2017.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal: Analysis of cross-sectional studies

et al. 2020

Preprint

Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low and the country itself is considered low risk, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male injection drug users (IDUs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors need to be assessed. Methods The study used a series of 7 cross-sectional survey datasets, collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male IDUs by key socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV in the Pokhara valley, Nepal. Results Overall HIV prevalence has decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence has increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (less than or equal to 24 years compared to greater than 24 years, OR = 0.17, 95% CI = 0.10, 0.31), being married (OR = 1.91, 95% CI = 1.25, 3.02) and shorter duration of drug use (less than or equal to 4 years compared to greater than 4 years, OR = 0.16, 95% CI = 0.09, 0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75, 4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64, 4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20, 4.11). Conclusion The main determinants which increase the risk of HIV among male IDUs in Pokhara were low education level, a lack of treatment for drug addiction and the recent use of unsterilised equipment. Each of these indicate the need to improve addiction treatment and education programs for intra-venous drug use to aid this at-risk group in avoiding risk-taking behaviours.