Abstract
People who inject drugs (PWID) are a dominant risk group afflicted by blood-borne viruses, mental health disorders, and social precariousness. Risk reduction interventions are administered to PWID regardless of their characteristics or specific risks. The objective of this cross-sectional analysis was to empirically identify profiles of PWID regarding their drug use, risk behaviors, and mental health in order to tailor adapted interventions taking into account limited access to comprehensive care in middle-income countries. PWID were recruited using respondent-driven sampling. PWID with urine testing positive for heroin or methamphetamine and manifesting recent skin injection marks were enrolled. Classification of participants was based on drug use, injection, risky sexual behavior, and mental health data. This was subjected to multiple correspondence analysis followed by hierarchical cluster analysis combined with K-means methodology. From October 2016 to January 2017, 1490 participants were recruited of which 1383 were eligible and enrolled. HCV prevalence was 70.5% and HIV prevalence 29.4%. The cluster analysis identified five distinct profiles: profile 1: recent injection practices and high alcohol consumption, profile 2: at-risk injection and sexual behaviors with precarious situations, profile 3: no sexual activity and older age, profile 4: frequent injections with high methamphetamine use, and profile 5: stable partnerships and less frequent injections. Our study has identified profiles of PWID at particularly high risks, and they should thus be targeted for interventions tailored to their specific risks.
Highlights
Vietnam is concerned with illicit drug use since the economic reform promoted liberalization of the economic market in 1986 (Doi Moi) [1]
We conducted a secondary analysis of data collected for a cross-sectional respondent-driven sampling (RDS) survey within the interventional Drugs & Infections in ViEtnam (DRIVE) research project
The 2016 RDS survey was implemented in Haiphong City with active involvement in four Community-Based Organizations (CBO) in several aspects of the study
Summary
Vietnam is concerned with illicit drug use since the economic reform promoted liberalization of the economic market in 1986 (Doi Moi) [1]. There were approximately 200,000 people who inject drugs (PWID) in 2012 in Vietnam [3]. Since 1993, the political response to drug use was to send PWID to rehabilitation centers without any addiction care [4]. HCV prevalence in 2014 was approximately 74% among PWID in Vietnam [6] and approximately 67% in Haiphong [7]. We recently estimated both the incidences of HIV and HCV infections among PWID in Haiphong; we reported a low HIV incidence (between 0 and 1.8 per 100 person-years (PY), contrasting with a very high HCV prevalence (19.4/100 PY, 95% CI: 11.5-30.7) [8]
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