Abstract
BackgroundMethadone treatment was introduced in Taiwan in 2006 as a harm-reduction program for injection drug users (IDUs), among whom HIV was endemic. We examined the association of HIV serostatus with demographic characteristics, substance use, and sexual behaviors among IDUs at methadone clinics in Taipei, Taiwan.MethodsDuring 2012–2013, IDUs at methadone clinics in Taipei were recruited to complete a risk assessment interview and undergo serologic testing for HIV infection. Correlates of HIV infection were identified by multivariate logistic regression.ResultsOf the 827 eligible participants, 85.9% were male, median age was 45 years, and mean years of injecting was 18.0 (range 1–56). The prevalence of HIV infection was 17.7%. In multivariate analysis, HIV infection was significantly associated with age ≤45 years (adjusted odds ratio [AOR] = 1.62, 95% confidence interval [CI] 1.01–2.62), being divorced (AOR = 1.67, 95% CI 1.06–2.62), deriving the majority of income during the previous 6 months from temporary jobs or other noncriminal sources (AOR = 1.53, 95% CI 1.02–2.30), unstable housing during the previous 6 months (AOR = 1.47, 95% CI 1.003–2.15), higher number of incarcerations (AOR = 1.14, 95% CI 1.03–1.26), and a history of overdose (AOR = 1.51, 95% CI 1.01–2.28).ConclusionsTaiwanese IDUs at methadone clinics have a relatively high HIV prevalence, which was associated with younger age and history of overdose. It is imperative to educate IDUs’ about HIV transmission, particularly for the younger and overdosed IDUs.
Highlights
Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program for injection drug users (IDUs), among whom human immunodeficiency virus (HIV) was endemic
Multiple logistic regression analysis showed that, after controlling for covariates, HIV infection was significantly associated with age ≤45 years (AOR = 1.62, 95% confidence intervals (CIs) 1.01–2.62), being divorced (AOR = 1.67, 95% CI 1.06–2.62), deriving the majority of income from temporary jobs or other noncriminal sources during the previous 6 months (AOR = 1.53, 95% CI 1.02–2.30), unstable housing during the previous 6 months (AOR = 1.47, 95% CI 1.003–2.15), a higher number of incarcerations (AOR per incarceration =1.14, 95% CI 1.03–1.26), and a history of overdose (AOR = 1.51, 95% CI 1.01–2.28) (Table 2)
Our analysis showed that the prevalence of HIV infection was 17.7% among IDUs at methadone clinics in Taipei during 2012–2013
Summary
Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program for injection drug users (IDUs), among whom HIV was endemic. The number of newly reported HIV/AIDS cases continued to increase rapidly every year: from 860 cases in 2003 to 1520 cases in 2004 to 3380 cases in 2005 The percentage of these cases attributed to IDUs increased markedly, from 9.3% in 2003 to 40.9% in 2004 to 71.6% in 2005 [3]. To curb this surge in HIV among IDUs, the Taiwan Centers for Disease Control (CDC) began a harm reduction program in 2006, including syringe exchange services for IDUs and methadone therapy for heroin addicts. In Taiwan, IDUs are the second most frequent source of HIV infection, accounting for 27.6% of all reported HIV cases [3]
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