Abstract
Peer-based models for human immunodeficiency virus (HIV) testing have been implemented to increase access to testing in various settings. However, little is known about the acceptability of peer-delivered testing and counseling among people who inject drugs (IDU). During July and October 2011, data derived from the Mitsampan Community Research Project were used to construct three multivariate logistic regression models identifying factors associated with willingness to receive peer-delivered pre-test counseling, rapid HIV testing, and post-test counseling. Among a total of 348 IDU, 44, 38, and 36 % were willing to receive peer-delivered pre-test counseling, rapid HIV testing, and post-test counseling, respectively. In multivariate analyses, factors associated with willingness to access peer-delivered pre-test counseling included: male gender (adjusted odds ratio (AOR) = 0.48), higher than secondary education (AOR = 1.91), and binge drug use (AOR = 2.29) (all p < 0.05). Factors associated with willingness to access peer-delivered rapid HIV testing included: higher than secondary education (AOR = 2.06), binge drug use (AOR = 2.23), incarceration (AOR = 2.68), avoiding HIV testing (AOR = 0.24), and having been to the Mitsampan Harm Reduction Center (AOR = 1.63) (all p < 0.05). Lastly, binge drug use (AOR = 2.40), incarceration (AOR = 1.94), and avoiding HIV testing (AOR = 0.23) (all p < 0.05) were significantly associated with willingness to access peer-delivered post-test counseling. We found that a substantial proportion of Thai IDU were willing to receive peer-delivered HIV testing and counseling. These findings highlight the potential of peer-delivered testing to complement existing HIV testing programs that serve IDU.
Highlights
Thailand continues to experience ongoing epidemics of illicit drug use and human immunodeficiency virus (HIV) infection among people who inject drugs (IDU)
To minimize the morbidity and mortality associated with HIV, many international health organizations are urging countries to scale up their voluntary HIV counseling and testing services (VCT) for IDU [2, 3], as testing can lead to the identification of undiagnosed HIV infection and early treatment [4,5,6]
348 IDU who were HIV-negative or of unknown HIV serostatus participated in this study; 68 (19.5 %) were female, and the median age was 38 years (IQR: 34–48 years)
Summary
Thailand continues to experience ongoing epidemics of illicit drug use and HIV infection among people who inject drugs (IDU). Since the 2003 ‘‘War on Drugs’’ campaign launched Thai Prime Minster Thaksin Shinawatra, there has been continued reliance on drug law enforcement approaches to control drug trafficking and drug use in Thailand [10] This has forced many IDU into hiding and has rendered them out of reach of potentially life-saving healthcare services [11]. Stigmatizing attitudes of healthcare providers and the sharing of information between healthcare workers and police have been identified as factors that may cause some IDU to avoid conventional healthcare settings, including those that provide HIV testing services [11, 15] These social and structural barriers may contribute to a reluctance on the part of IDU to access VCT services, and may increase their risk of HIV infection. We sought to identify the prevalence and correlates of willingness to receive peer-delivered VCT among a community-recruited sample of IDU in Bangkok, Thailand
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