Abstract
BackgroundNetwork analyses have been widely utilized to evaluate large datasets, but have not yet been used to explore factors associated with risk behaviours. In combination with traditional regression analysis, network analyses may provide useful information and highlight key factors for reducing needle sharing behaviours among people who inject drugs (PWID).MethodsSociodemographic data, and information on injection behaviour and sexual practices were collected from a cross-sectional survey that was conducted with PWID in five prefectures of Yunnan province, China. A combination of logistic regression and correlation network analyses were used to explore key factors for reducing needle-sharing behaviours among PWID.ResultsIn a total of 1 049 PWID, 37.5 % had a history of needle or syringe sharing. The logistic analysis showed that Zhaotong, Qujing, Dehong, or Lincang residents, diazepam use, longer injection duration, needle reuse, and infection with HIV, viral hepatitis, tuberculosis and/or malaria were independently associated with needle sharing. The correlation network analyses showed that, compared to PWID who had never shared needles, PWID who did share needles would achieve harm reduction goals faster and more permanently. HIV serostatus and marital status were found to be closely associated with other risk factors. By combining regression analyses with network analyses, it was shown that PWID who are HIV seropositive will be an ideal target group for harm reduction programs.ConclusionNeedle-sharing behaviours are common among PWID in Yunnan, and harm reduction programs may help PWID who are HIV seropositive reduce risk behaviours and prevent blood borne diseases.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0169-y) contains supplementary material, which is available to authorized users.
Highlights
Network analyses have been widely utilized to evaluate large datasets, but have not yet been used to explore factors associated with risk behaviours
The HIV serostatus was assessed using a diagnostic kit for antibody to HIV (1 + 2) (Colloidal Gold) (Alere Medical Co., Ltd, Chiba, Japan), and those who tested positive were confirmed using a diagnostic kit for antibodies to HIV (1 + 2) (Wantai Medical Co., Ltd, Beijing, China), according to the manufacturers’ instructions
Of these, living in Zhaotong, Qujing, Dehong or Lincang, using diazepam, injecting for a long time, reusing needles often, and being HIV positive and having other infectious diseases, such as hepatitis, tuberculosis, and/or malaria, were found to be independently associated with needle sharing. These results showed that the factors affecting needle-sharing behaviours were mainly due to drug use behaviours rather than sociodemographic factors, verifying that contracting blood borne diseases (e.g. HIV, viral hepatitis) might be the main consequence of needle sharing
Summary
Network analyses have been widely utilized to evaluate large datasets, but have not yet been used to explore factors associated with risk behaviours. Drugs produced in the ‘Golden Triangle’ region, which consists of eastern Myanmar, western Laos, and northern Thailand, are exported from Myanmar to Yunnan [1]. Along this drug route, subtypes B and C of the human immunodeficiency virus type 1 (HIV-1) are transmitted; subtypes B, C, and B/C recombinants are transmitted through the northwest of China, through the Xinjiang province [1,2,3,4]. These findings suggest that Yunnan may be a ‘transfer station’ of multidirectional transmission of HIV between China and its bordering countries
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