HIV Prevalence and Risks Among Injection and Noninjection Drug Users in Northern Thailand: Need for Comprehensive HIV Prevention Programs

Abstract

The authors sought to determine sociodemographic and sexual and drug use risk factors for HIV infection among drug users in northern Thailand adjacent to the Golden Triangle. The authors enrolled patients admitted for inpatient drug detoxification at one treatment center in northern Thailand and studied HIV risks and prevalence using an interviewer-administered questionnaire and serum collection with HIV pretest and posttest counseling. Between February 1, 1999 and January 31, 2000, 1865 patients admitted for opiate and methamphetamine dependence completed study procedures. Overall HIV prevalence was 10.3%: 30.0% among 513 injection drug users (IDUs) and 2.8% among non-IDUs (OR = 14.8, 95% CI: 10.2, 21.6). HIV seroprevalence was 2.4% among exclusive methamphetamine users (98% of whom are non-IDUs) and 3.4% among opium smokers. Injection drug use was the dominant risk factor in multivariate models. Although Thailand is widely recognized as having a successful national response to the heterosexual HIV epidemic, seroprevalence in IDUs remains high. Despite a sharp increase of non-IDUs admitted to the drug treatment center, HIV infection and risks remained high among IDUs in northern Thailand. HIV prevention campaigns need to focus on IDUs and to implement harm reduction strategies to reduce transmission to IDUs and further contain the HIV epidemic in Thailand.

Socio-demographic and drug use factors associated with HIV-1 recombinants and dual infections in Northern Thai drug users: Associations of risk with genetic complexity

“…Inclusion criteria included being 13 years of age or older, provision of informed consent, admission for substance use dependence, agreement to submit to pre-and post-test HIV counseling and venipuncture for HIV serology and HIV subtyping, and completion of a behavioral questionnaire, which was administered in a confidential face-to-face interview. Detailed methods and findings from this study have been previously published elsewhere (Cheng et al, 2006;Razak et al, 2003). The study was approved by the institutional review boards of the Royal Thai Ministry of Public Health, Research Institute of Health Sciences, Chiang Mai University and the Johns Hopkins University.…”

Illicit Opioid Use and its Key Characteristics: A Select Overview and Evidence from a Canadian Multisite Cohort of Illicit Opioid Users (OPICAN)

“…Overall, noninjectors are exposed to fewer health risks and harms, compared with injectors. For example, being a noninjector has been shown to indicate lower levels and shorter duration of drug dependency (34), lower prevalence of and fewer risks for transmission of blood-borne infectious disease (that is, HIV and HCV) (35)(36)(37), and less exposure to overdose risks (38). However, the oral use of opioids, that is, by way of smoke inhalation, can produce its own distinct health problems, such as pulmonary dysfunction, asthma, or leukoencephalopathy (39,40).…”

Young Thai women who use methamphetamine: Intersection of sexual partnerships, drug use, and social networks

“…HIV prevalence among Thai MA users is higher than the rate among the general Thai adult population (approximately 3% compared to 1.5%) (UNAIDS, 2006;Beyrer et al, 2004;Razak et al, 2003) and MA use was associated with HIV infection among female drug users (Srirak et al, 2005). Epidemiological studies show high levels of sexual experience among young Thais (Allen et al, 2003;Jenkins et al, 2002;van Griensven et al, 2001).…”