Risk Factors for Acquiring Human Immunodeficiency Virus (HIV) Infection among Injection Drug Users
2007 Vol.23 NO.10
Correspondence Author： Shu-Yun Hsu
Between 1977 and 2002, there were only 84 cases of HIV infection through intravenous drug use reported to the AIDS surveillance system of the Centers for Disease Control, Department of Health. By the end of April 2007, the number of HIV infections from injection drug users (IDUs) has reached 5368. In view of the increasing HIV infections among IDUs, it is essential to have an overall understanding on the relationships between HIV infections and the sources of transmission, such as sexual behavior, methods of drug injection, and the sharing of needles, diluents or containers among drug users.
The subjects for this study were male IDUs in Tai-Chung Prison, Yun-Lin Rehabilitation Institution and Chia-Yi Rehabilitation Institution. A structured questionnaire containing questions on demographics, use of illicit drugs, needle sharing and sexual behavior was used to collect data. The results indicate that there is a 2.98 times increase in the risk of contracting HIV infections is 2.98 times higher in those who do not always use (i.e. seldom, often or never use) condoms during sexual intercourse compared with those who always do. (95% confidence interval [CI] = 1.53-5.80). Sharing needles or syringes increases the risk of contracting HIV by 33.40 times (95% CI = 14.98-74.48); sharing diluents or containers increases the risk by 30.86 times (95% CI = 14.25-66.85); and concomitant use of shared needles, syringes, diluents and containers increases the risk by 45.14 times (95% CI = 20.20-100.90).
To increase the efficacy of “harm reduction programs”, the government should publicize and promote the “human immunodeficiency virus infection prevention and patient rights regulation” to help IDUs and law enforcement personnel understand the needle exchange and methadone maintenance programs, hence increasing the participation rate by IDUs without fear of criminal charges. In addition, health education may also intervene to increase awareness of HIV infection among high risk groups. IDUs may be recruited for such programs. Increasing access to counseling services and screening blood tests is also essential. Furthermore, by cooperation with non-government organizations, information on prevention of HIV transmission and methadone maintenance programs may be provided. A multidimensional approach to promoting the “harm reduction programs” is an integral part of the effort to bring HIV/AIDS under effective control.
Key words: intravenous drug users, AIDS, HIV, needle sharing, syringe sharing, drug diluents, containers