HIV Seroprevalence in a Sample of Tanzanian Intravenous Drug Users

Abstract

Injection drug use has recently emerged in sub-Saharan Africa. The purpose of this study was to assess the factors associated with increased risk of testing HIV-positive in a sample of injection drug users (IDUs) in Dar es Salaam, Tanzania. Participants were recruited by a trained outreach worker or were referred by IDUs who had completed the study. Blood specimens and self-reported socioeconomic and behavioral data were collected from 315 male and 219 female IDUs. Data were analyzed using univariate odds ratios and multivariate logistic regression modeling. Forty-two percent of the sample tested HIV-positive. Several socioeconomic, injection, and sexual factors were found to be associated with increased odds of testing HIV-positive. Multivariate analysis showed that having had sex more than 81 times in past 30 days, earning less than 100,000 shillings (US$76) in the past month, residency in Dar es Salaam for less than 5 years, and injecting for 3 years were independently associated with the greatest risk of infection. The rate of HIV infection in this sample of IDUs was found to be very high, suggesting that injection drug use may be a factor in the continuing epidemic in sub-Saharan Africa. The factors associated with increased risk of HIV infection suggest further research is needed on the needle use and sexual networks of IDUs.

An Overview of HIV Prevention Interventions for People Who Inject Drugs in Tanzania

“…Since 2003, the majority of PWID in Dar es Salaam reported injecting three times per day [2, 5, 6], with 41% of all users sharing needles in the past 30 days [6]. In addition, 28% of PWID reported reusing used rinse water [1], which is not effective in preventing HIV.…”

“…With regard to sexual risk behavior, only 42% of PWID reported using condoms during sex in the last 30 days [7]. Studies conducted between 2003 and 2007 estimated an HIV prevalence of 42% among PWID [6, 8], compared to an estimated prevalence of 9% in the general population [9]. Subsequent studies conducted between 2009 and 2010 found an HIV prevalence among younger PWID of approximately 31% and 35%, respectively [5, 10].…”

Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

“…An estimated 42% of people who inject drugs (PWID) in Dar es Salaam have HIV. 3 These HIV-infected injectors have a more than 20- to 37-fold risk of TB compared to non-HIV-infected persons. 4,5 As of 2009, Tanzania ranked fifteenth among the 22 high TB burden countries.…”

Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use

“…With financial support from the U.S. National Institutes Drug Abuse, researchers conducted numerous studies of drug use practices in Dar es Salaam and on the island of Zanzibar between 2003 and 2007 to demonstrate the links between heroin injection and HIV transmission (Dahoma, et al, 2006; McCurdy, et al, 2005; 2006; Timpson, et al, 2006; Williams, et al, 2007). Results from these surveys indicated that the prevalence of HIV infection among those who injected heroin was between 26% and 42% in Dar es Salaam, compared to an overall national prevalence of 9% (Williams, et al, 2009). …”