Heroin Use and Injection Risk Behaviors in Colombia: Implications for HIV/AIDS Prevention

Abstract

Background Heroin production in Colombia has increased dramatically in recent decades, and some studies point to an increase in local heroin use since the mid-1990s. Despite this rapid increase, little is known about the effects of these activities on heroin injection within Colombia. One of the biggest concerns surrounding heroin injection is the potential spread of HIV through drug user networks. Objectives This article examines injection risk behaviors among heroin injectors in the Colombian cities of Medellín and Pereira to explore the implications for possible increased HIV transmission within this group. Methods A cross-sectional study used respondent-driving sampling to recruit a sample of 540 people who inject drugs (PWID) over 18 years of age (Medellín: n = 242, Pereira: n = 298). Structured interviews with each participant were conducted using the World Health Organization Drug Injection Study Phase II Survey. An HIV test was also administered. Results Information regarding the socio-demographics, injection drug use, HIV risk and transmission behaviors, injection risk management, and HIV knowledge and prevalence of participants are reported. The study identified many young, newly initiated injectors who engage in risky injection practices. The study also found that HIV prevalence is fairly low among participants (2.7%). Conclusions/Importance Findings indicate a potential risk for the spread of HIV among PWID in Colombia given their widespread sharing practices, high rate of new injector initiation, and unsafe syringe cleaning practices. Colombia has a possibly time-limited opportunity to prevent an HIV epidemic by implementing harm reduction interventions among young, newly initiated PWID.

Uso de heroína inyectada y el riesgo de hepatitis C en tres ciudades de Colombia

“…There are few studies on hepatitis C in Colombia 32 , and this investigation identified a significant number of injection drugs users who share and reuse injection equipment, similarly to what was observed in other cities of Colombia in 2010 [33][34][35] ; widely documented and discussed factors in other countries, though for Colombia, represent the first step toward intervention strategies 36 . Co-infections of HIV and HCV have been reported among drug users in different countries.…”

HIV prevention intervention for substance users: a review of the literature

“…Some have reported that IDU populations require increased HIV testing and implementation of alternative programs to reduce sexual and drug use risk behaviors [5]. IDU populations also have higher transmission rates of HIV than NIDU populations due to widespread needle sharing practices, high rate of new injector initiation, and unsafe syringe cleaning practices [6, 7]. MSM who are also in the IDU population further have been reported to have increased violence, which should be considered in HIV prevention efforts [8].…”

Foot drop with a popliteal artery aneurysm due to heroin use: A case report

“…Another complication due to IV substance use is HCV and HIV infections via contaminated injectors. [5][6][7][18][19][20] Several studies have shown that 70 to 90% of substance users are HCV-positive. [18,19] In a study including young individuals who use IV substances in the United States of America, 48% of the population were tested positive for HCV.…”

“…[3] The use of injections increases the risk of bacterial skin and soft tissue infections, abscess formation, phlebitis, endocarditis, and osteomyelitis and it also escalates the risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. [4][5][6][7][8] Another important complication due to IV drug use is that it potentiates vascular damage. [9] Sharing injectors, using them multiple times, and misuse cause septic and infective complications.…”