Risk factors for HIV infection among drug injectors in southern Thailand

Abstract

Background: To determine HIV sero-prevalence and risk factors for HIV infection among injecting drug users (IDU) in southern Thailand. Methods: Using a cross-sectional HIV sero-prevalence and behavioral survey, 272 active IDU were interviewed about background, life-style, drug use patterns, and sexual behaviors at six drug-treatment clinics in southern Thailand. Results: Ninety-one percent reported lifetime needle sharing; 96% had tried HIV risk-reduction by either stopping/decreasing visits to sex workers and/or stopping/decreasing needle sharing. Only 5% knew that bleaching needles could reduce transmission risks. Overall, 51% tested HIV-positive (43% ethnic Thai vs. 64% ethnic Malay). HIV seropositivity among ethnic Thai was independently correlated with past history of needle sharing (OR 6.95; 1.89–25.58), injecting immediately at drug onset (OR 2.53; 1.25–5.13), and starting first injection at younger age (OR 2.61; 1.31–5.22). Injecting immediately at drug onset (OR 4.32; 1.23–15.14) and not carrying new needles (OR 4.47; 1.27–15.69) were risk factors among minority ethnic Malay. Conclusion: A high rate of HIV infection persists among southern-Thai IDU. HIV-infected individuals may act as a bridge of HIV transmission to their sex partners. AIDS prevention efforts should more intensely focus on minority ethnic Malays, discouraging needle sharing and increasing protected sex with regular sexual partners.