Abstract

BackgroundSyringe sharing continues to be a major driver of the HIV pandemic. In light of efforts to enhance access to sterile syringes and promote secondary prevention among HIV-positive individuals, we sought to identify the prevalence and correlates of used syringe lending among self-reported HIV-positive people who inject drugs (PWID) in Bangkok, Thailand.FindingsWe used bivariable statistics to examine factors associated with self-reported syringe lending among self-reported HIV-positive PWID participating in the Mitsampan Community Research Project, a serial cross-sectional study of PWID in Bangkok, between June 2009 and October 2011. In total, 127 individuals were eligible for this analysis, including 25 (19.7 %) women. Twenty-one (16.5 %) participants reported syringe lending in the prior 6 months. Factors significantly associated with syringe lending included daily methamphetamine injection (odds ratio (OR) = 10.2, 95 % CI, 2.1–53.6), daily midazolam injection (OR = 3.1, 95 % CI, 1.1–8.7), use of drugs in combination (OR = 4.5, 95 % CI, 1.0–41.6), injecting with others on a frequent basis (OR = 4.25, 95 % CI, 1.3–18.3), and not receiving antiretroviral therapy (OR = 2.9, 95 % CI, 1.1–7.9).ConclusionsA high prevalence of syringe lending was observed among self-reported HIV-positive PWID in Bangkok, which was associated with high intensity drug use, polysubstance use, and frequently injecting with others. It is particularly concerning that individuals who lent syringes were more likely to be untreated for HIV disease given the known benefits of antiretroviral provision on the prevention of HIV transmission. These findings underscore the need to expand access to sterile syringes and HIV treatment among HIV-positive PWID in Thailand.

Highlights

  • Syringe sharing among people who inject drugs (PWID) continues to be a major driver of the global human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) pandemic

  • A high prevalence of syringe lending was observed among self-reported HIV-positive PWID in Bangkok, which was associated with high intensity drug use, polysubstance use, and frequently injecting with others

  • It is concerning that individuals who lent syringes were more likely to be untreated for HIV disease given the known benefits of antiretroviral provision on the prevention of HIV transmission

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Summary

Introduction

Syringe sharing among people who inject drugs (PWID) continues to be a major driver of the global HIV/AIDS pandemic. The World Health Organization and other United Nations agencies consider needle and syringe programs (NSPs) to be a Despite the legal controversy regarding NSPs, efforts are currently underway to enhance access to sterile syringes and promote secondary prevention among HIV-positive PWID in Thailand, including the provision of sterile syringes within drop-in centers for PWID that are operated by civil society and international organizations [5]. In light of these efforts, we investigated the prevalence and correlates. In light of efforts to enhance access to sterile syringes and promote secondary prevention among HIV-positive individuals, we sought to identify the prevalence and correlates of used syringe lending among self-reported HIV-positive people who inject drugs (PWID) in Bangkok, Thailand

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