Female injecting drug users in Nepal Pokhara valley 2017

Abstract

Injecting drugs users are the challenging segments of the population to control sexually transmitted infections. This is the first survey conducted among female injecting drug users in Pokhara Valley. To determine the prevalence of Human Immune Virus (HIV), Syphilis, Hepatitis B and Hepatitis C infection among female injecting drug users. Objective of this study is to evaluate the prevalence of HIV, Syphilis, Hepatitis B and Hepatitis C and also identified the sexual behavior and associated risk of HIV/AIDs infection among FIDUs in Pokhara Valley. This was a cross sectional survey conducted among 155 female injecting drug users. The females of 16 years and above who had been injecting drugs for at least three months preceding the survey were defined as female injecting drug users and enrolled in the survey. The survey carried out during March-April 2017. The network sampling method was applied to recruit the participants. A structured questionnaires was used to collect behavioral data related to background information, sexual and injecting behaviors among the respondents. Blood samples were collected to test HIV, Syphilis, Hepatitis B and Hepatitis C. The rapid test kits recommended by National Centre for AIDS and STD Control were used to test aforementioned diseases. The ethical approval for the study was obtained from the Ethical Review Board of Nepal Health Research Council. The prevalence of HIV among FIDUs was 1.9 percent (95% CI = 0.5, 5.9), syphilis was 3.9 percent (95% CI = 1.5, 8.6), Hepatitis B and Hepatitis C were 2.6 percent (95% CI = 0.8, 6.9) and 1.3 percent (95% CI = 0.2, 5.1) respectively. About two out of three female injecting drug users were identified with HIV during the survey and remaining were previously diagnosed. The newly positives were linked with the National program for treatment, care and support. Among them 3 respondents have HIV; one was identified before the survey and 2 were newly recognized HIV. This survey provides an insight into the estimated prevalence of HIV, Syphilis, HBV and HCV infection among FIDUs and explores their injecting and risky sexual behaviors. The large proportion of FIDUs are at risk of HIV as they have used needles that were already used, shared syringe with the usual sexual partner and shared needle during the last injection. Harm reduction programs including risk of needle sharing behavior and advocacy on practicing safer injecting behaviors should be launched.