Alarming epidemics of human immunodeficiency virus and hepatitis C virus among injection drug users in the northwestern bordering state of Punjab, India: prevalence and correlates. (July 2014)

• Record Type: Journal Article
• Authors: Panda, Samiran; Roy, Tarun; Pahari, Sobha; Mehraa, Jyotiee; Sharma, Neeraj; Singh, Gagandeep; Singh, Jasbir; Joseph, Francis; Singh, Sukhvinder; Sharma, Narinder M
• Is Part Of: International journal of STD & AIDS. Volume 25:Number 8(2014:Aug.)
• Page Start: 596
• Page End: 606
• Publication Date: 2014-07
• Subjects: Syphilis -- sexually transmitted infections -- Indian subcontinent -- human immunodeficiency virus -- sexually transmitted viral diseases -- epidemiology -- AIDS -- injecting drug use; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462413515659
• Languages: English
• ISSNs: 0956-4624

Abstract

Summary: In this study 1155 injection drug users (IDUs) receiving targeted intervention in five cities of Punjab were surveyed; three cities (Amritsar, Taran-Taran, Batala) were in districts sharing an international border with Pakistan and the other two were Jalandhar and Ludhiana. Information on socio-demography, substance use and sexual practices were collected; blood samples were tested for biologic markers. HIV and HCV antibody (HCVAb) prevalences in injection drug users were 29 and 49%, respectively. Of the HCVAb-seroreactive IDUs, 33% had HIV as well. HIV prevalence in young IDUs (≤19 years), estimated as surrogate for HIV incidence, was high at 12% and HCVAb in this subgroup was 27%. Herpes simplex virus 2 antibody (IgG) was detected in 10% of IDUs; 2% had syphilis. Alcohol use prevalence was high and frequency of use concerning. In multivariate analyses, 'city of residence closer to international border' and '>1 year duration of injecting drugs were associated with HIV and HCVAb. Furthermore, 'irregular supply of syringes and needles' was associated with HCVAb seroreactive status of IDUs (adjusted odds ratio 1.7; 95% CI 1.3–2.3; P < 0.001), and 'any genital disease symptom within the last year' (adjusted odds ratio 2; 95% CI 1.4–2.9; P < 0.001) was associated with HIV infection. Alcohol and sexual risk reduction, strengthening of needle–syringe exchange, reducing injecting duration and clinical management of HIV, HCV and HIV/HCV co-infection appear as four core programme needs.