An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India

Sanjib Kumar Phukan,Brogen S Akoijam,Gay Thongamba,Gajendra Kumar Medhi,Jagadish Mahanta,Ramesh S Paranjape,Rajatashuvra Adhikary

doi:10.1186/s12954-017-0171-0

Abstract

BackgroundPersonal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur.MethodsA total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes.ResultsThe average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors.ConclusionBecause of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.

Highlights

Personal networks are significant social spaces to spread of Human immunodeficiency virus (HIV) or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc
The Injecting drug user (IDU) members connected through social network to each other, like themselves, may influence to get involved the risky behavior of HIV or hepatitis C virus (HCV) that assist disease transmission [5,6,7]
The size of personal network was determined by asking the respondents—“how many male IDUs do you personally know and they know you?” Average network size of IDU’s was similar (8.8 and 8.1) in both the districts

Summary

Introduction

Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Accessing “hard-to-reach” populations such as injecting drug users (IDUs), female sex workers (FSWs), men who have sex with men (MSM), and clients of sex workers for research activities has historically been challenging due to the non-availability of their sampling frame and their stigmatized behavior [1]. The IDU members connected through social network to each other, like themselves, may influence to get involved the risky behavior of HIV or hepatitis C virus (HCV) that assist disease transmission [5,6,7] Various network characteristics such as size of network, sharing injecting equipment [8,9,10,11], drug injection network size, and network dynamics [12, 13] have been found to be associated with HIV risk

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