Scaling up HIV prevention efforts targeting people who inject drugs in Central Asia: A review of key challenges and ways forward

Boltaev, Azizbek; El‐Bassel, Nabila; Deryabina, Anna; Terlikbaeva, Assel; Gilbert, Louisa; Hunt, Timothy; Primbetova, Sholpan; Strathdee, Steffanie A.

doi:10.1016/j.drugalcdep.2013.07.033

Cited by 36 publications

(31 citation statements)

References 18 publications

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“…Transmission from PWID to their sex partners is increasing in many parts of the world (2; 7) and the number of FWID is rising (44). The recent body of literature we reviewed identifies the following major micro-social contexts driving drug and sexual risk behaviors among PWID in intimate relationships: 1) power and social inequalities, 2) trust and commitment, 3) social support and the network’s role, and 4) IPV.…”

Section: Conclusion and Way Forwardmentioning

confidence: 99%

People Who Inject Drugs in Intimate Relationships: It Takes Two to Combat HIV

et al. 2014

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We reviewed papers published during the past 18 months (2012-2013) focusing on micro-social contexts of gender and power inequalities as drivers of HIV risks among people who inject drugs (PWID) in intimate heterosexual relationships. Although there has been a proliferation of social and behavioral research on the micro-social contexts of drug injection in heterosexual intimate relationships, there is still a gap in knowledge of these issues, particularly in low- and middle-income countries. Research has identified couple-based approaches for PWID in intimate relationships as an effective HIV prevention strategy to address micro-social contexts driving HIV risks. While HIV incidence has declined in many countries, prevalence remains at troubling levels among PWID and transmission from PWID to their sex partners is increasing in many parts of the world. HIV prevention among drug-using couples must address the importance of the relationship dyad and micro-social contexts.

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Section: Conclusion and Way Forwardmentioning

confidence: 99%

People Who Inject Drugs in Intimate Relationships: It Takes Two to Combat HIV

et al. 2014

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“…Indonesia in particular saw a ten-fold increase in HIV incidence between 2006 and 2011 (33). In 2011, heterosexual transmission represented half of all new HIV infections in Kazakhstan (34, 35), suggesting that a transition from IDU-concentrated epidemics to heterosexual HIV epidemics (5) is occurring in Central Asia. Condom use between PWID and their sex partners remains low (17, 20, 36) and non-injecting female sex partners may be at particular risk (16).…”

Section: Drug-using Populations and The Hiv Epidemicmentioning

confidence: 99%

Drug use as a driver of HIV risks

El‐Bassel

Shaw

Dasgupta

et al. 2014

Current Opinion in HIV and AIDS

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Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs.

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“…However, in recent years there has been a steady rise in the incidence of sexual transmission of HIV, especially among heterosexual partners of men who inject drugs (MWID) (UNAIDS, 2012b). In 2011, heterosexual transmission consisted of slightly more than half (50.7%) of all newly acquired HIV cases in Kazakhstan (Boltaev, Deryabina, Kusainov, & Howard, 2012; Boltaev et al, In press). The majority of females who inject drugs (FWID) have male sex partners who also inject, whereas the majority of MWID have non-injecting female sex partners (Roberts, Mathers, & Degenhardt, 2010).…”

Section: Introductionmentioning

confidence: 99%

HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: Implications for HIV prevention, research, and policy

El‐Bassel¹,

Gilbert²,

Terlikbayeva³

et al. 2014

International Journal of Drug Policy

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Background Kazakhstan and other countries in Central Asia are experiencing a rapidly growing HIV epidemic, which has historically been driven by injection drug use, but is more recently being fueled by heterosexual transmission. Methods This paper examines HIV and HCV infection, as well as sexual and drug-related risks among female partners of men who inject drugs (MWID), comparing females who inject drugs (FWID) to non-injecting female partners on socio-demographic, relationship context, and structural characteristics. Results The prevalence rate of HIV was 30.1% among FWID and 10.4% among non-IDU female partners of MWID. The prevalence rate of HCV was 89.8% among FWID and 14.8% among female non-IDUs. Less than one-fifth of all female participants had access to HIV education and services or harm reduction programs. Although high rates of non-injection drug use and sexual risk behaviors were found among both FWID and non-injecting female partners of MWID, we found that FWID were more likely to be HIV seropositive (aRR = 3.03; 95% CI = 1.78, 5.18) and HCV seropositive than non-IDU females (aRR = 6.05; 95% CI = 4.05, 9.04), were more likely to have used alcohol or drugs before sex (aRR = 1.67; 95% CI = 1.40, 2.00), and were more likely to have used sedatives, barbiturates, tranquilizers, sleeping pills, or painkillers that were not prescribed by a physician (aRR = 17.45; 95% CI = 8.01, 38.01). Conclusion Given the spread of the HIV epidemic to heterosexual partners in Kazakhstan, more attention is needed in research, prevention, and policies regarding female partners of male injection drug users.

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Scaling up HIV prevention efforts targeting people who inject drugs in Central Asia: A review of key challenges and ways forward

Cited by 36 publications

References 18 publications

People Who Inject Drugs in Intimate Relationships: It Takes Two to Combat HIV

People Who Inject Drugs in Intimate Relationships: It Takes Two to Combat HIV

Drug use as a driver of HIV risks

HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: Implications for HIV prevention, research, and policy

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