Prevalence and correlates of HIV infection among men who inject drugs in a remote area of Vietnam

Abstract

BackgroundLack of information on the HIV epidemic among men who inject drugs (MWID) in northwestern Vietnam, a remote area, may hamper national efforts to control the disease. We examined HIV prevalence, needle–syringe sharing behaviors, and associated factors among MWID in three areas of northwestern Vietnam.MethodsWe used descriptive analysis to report the characteristics, frequency of risk behaviors, and of access to healthcare services among the MWID. Univariable logistic regression was used to assess the associations between the HIV infection, needle–syringe sharing behaviors, and their independent variables. We further explored these associations in multivariable analyses where we included independent variables based on a priori knowledge and their associations with the dependent variables determined in univariable analyses (p < 0.25).ResultsThe HIV prevalence was 37.9, 16.9, and 18.5% for Tuan Giao, Bat Xat, and Lao Cai City, respectively, and 25.4% overall. MWID of Thai minority ethnicity were more likely to be HIV-positive (adjusted odds ratio (AOR) 3.55; 95% confidence interval (CI) 1.84–6.87). The rate of needle–syringe sharing in the previous 6 months was approximately 9% among the MWID in Tuan Giao and Lao Cai City, and 27.8% in Bat Xat. Two thirds of the participants never underwent HIV testing before this study. Ever having been tested for HIV before this study was not associated with any needle–syringe sharing behaviors. Among the HIV-positive MWID, those who received free clean needles and syringes were less likely to give used needles and syringes to peers (AOR 0.21; 95% CI 0.06–0.79). Going to a “hotspot” in the previous week was associated with increased odds of needle–syringe sharing in multiple subgroups.ConclusionOur findings on HIV prevalence and testing participation among a subset of MWID in the northwestern Vietnam were corroborated with trend analysis results from the most recent HIV/STI Integrated Biological and Behavioral Surveillance report (data last collected in 2013.) We provided important insights into these MWID’s risky injection behaviors. We suggest heightened emphasis on HIV testing and needle and syringe provision for this population. Also, policymakers and program implementers should target hotspots as a main venue to tackle HIV epidemics.

Challenges of sexually transmitted infections and sexual health among people who inject drugs

“…At early stages of opioid use disorder, sexual desire is originally stimulated but then drops to lower levels that at baseline [15][16][17]. Studies from Vietnam and Ukraine, where opioid use is predominated, reported that between 40 and 66% of male PWID were sexually active in the past 6 months [18][19][20]. The reduced sexual exposure leads to the lower rates of STI, including syphilis, chlamydia, and HIV, among more frequent users of opioids [21].…”

Comparing a standard and tailored approach to scaling up an evidence-based intervention for antiretroviral therapy for people who inject drugs in Vietnam: study protocol for a cluster randomized hybrid type III trial

“…Vietnam is a prime country example of an HIV epidemic that has been primarily driven by injection drug use. Vietnam has over 271,000 PWID in the country [9] with an HIV prevalence among PWID in different provinces ranging from 17 to 25% [10][11][12]. In 2014, the 90-90-90 targets were launched by the Joint United Nations Programme on HIV/AIDS: 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90% of all people receiving antiretroviral therapy will have viral suppression [13].…”