Prevalence and correlates of HIV, syphilis, and hepatitis B and C infection and harm reduction program use among male injecting drug users in Kabul, Afghanistan: A cross-sectional assessment

Harm Reduction Journal

Steffanie A Strathdee⁴  David Vlahov⁶  MZafar Rasuli³  Katja Fiekert⁵  MRaza Stanekzai¹  Abdul Nasir⁵  Catherine S Todd² 

[1] United Nations Office of Drugs and Crime, Afghanistan Country Office, Kabul, Afghanistan;Department of Obstetrics & Gynecology, Columbia University, New York, New York, USA;Ministry of Counter Narcotics, Islamic Republic of Afghanistan, Kabul, Afghanistan;Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA;Health Protection and Research Organization, Kabul, Afghanistan;Center for Urban Epidemiologic Studies, The New York Academy of Medicine, New York, NY, USA

关键词: harm reduction;    hepatitis C;    HIV;    Afghanistan;    injection drug user;   

Others  :  810125
DOI  :  10.1186/1477-7517-8-22

 received in 2011-06-14, accepted in 2011-08-25,  发布年份 2011

【 摘 要 】

Background

A nascent HIV epidemic and high prevalence of risky drug practices were detected among injecting drug users (IDUs) in Kabul, Afghanistan from 2005-2006. We assessed prevalence of HIV, hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), syphilis, and needle and syringe program (NSP) use among this population.

Methods

IDUs were recruited between June, 2007 and March, 2009 and completed questionnaires and rapid testing for HIV, HCV, HBsAg, and syphilis; positive samples received confirmatory testing. Logistic regression was used to identify correlates of HIV, HCV, and current NSP use.

Results

Of 483 participants, all were male and median age, age at first injection, and duration of injection were 28, 24, and 2.0 years, respectively. One-fifth (23.0%) had initiated injecting within the last year. Reported risky injecting practices included ever sharing needles/syringes (16.9%) or other injecting equipment (38.4%). Prevalence of HIV, HCV Ab, HBSAg, and syphilis was 2.1% (95% CI: 1.0-3.8), 36.1% (95% CI: 31.8-40.4), 4.6% (95% CI: 2.9-6.9), and 1.2% (95% CI: 0.5-2.7), respectively. HIV and HCV infection were both independently associated with sharing needles/syringes (AOR = 5.96, 95% CI: 1.58 - 22.38 and AOR = 2.33, 95% CI: 1.38 - 3.95, respectively). Approximately half (53.8%) of the participants were using NSP services at time of enrollment and 51.3% reported receiving syringes from NSPs in the last three months. Current NSP use was associated with initiating drug use with injecting (AOR = 2.58, 95% CI: 1.22 - 5.44), sharing injecting equipment in the last three months (AOR = 1.79, 95% CI: 1.16 - 2.77), prior incarceration (AOR = 1.57, 95% CI: 1.06 - 2.32), and greater daily frequency of injecting (AOR = 1.40 injections daily, 95% CI: 1.08 - 1.82).

Conclusions

HIV and HCV prevalence appear stable among Kabul IDUs, though the substantial number having recently initiated injecting raises concern that transmission risk may increase over time. Harm reduction programming appears to be reaching high-risk drug user populations; however, monitoring is warranted to determine efficacy of prevention programming in this dynamic environment.

【 授权许可】

   
2011 Todd et al; licensee BioMed Central Ltd.

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