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Addiction. 2011 Mar;106(3):583-9. doi: 10.1111/j.1360-0443.2010.03175.x. Epub 2010 Nov 4.

Mortality and HIV transmission among male Vietnamese injection drug users.

Author information

  • 1Johns Hopkins University Bloomberg School of Public Health-Epidemiology, Chiang Mai, Thailand. vquan@jhsph.edu

Abstract

AIMS:

To estimate all-cause mortality rate and to assess predictors of all-cause mortality among injection drug users (IDUs) in Thai Nguyen province, Vietnam between 2005 and 2007.

DESIGN:

Prospective cohort study.

SETTING:

Community-dwelling IDUs were enrolled and followed at 3-month intervals for up to 2 years.

PARTICIPANTS:

A total of 894 male IDUs (median age of 32 years, 22.8% HIV-positive, all having injected opioids).

MEASUREMENTS:

Deaths were confirmed by family members and by reviewing government records. Marginal Cox proportional hazards models for clustered data were constructed to determine the independent predictors of all-cause mortality, using both fixed baseline measurements and time-dependent repeated measurements.

FINDINGS:

During 710.1 person-years of follow-up, 45 (5.0%) drug injectors died. The causes of deaths were AIDS-related (14 cases, 31%), drug overdose (12, 27%), suicide (three, 7%), traffic accident (three, 7%), violence (two, 4%), pneumonia (two, 4%), non-traffic accident (one, 2%) and unknown causes (eight, 18%). The all-cause mortality rate was 6.3% (95% CI = 4.6-8.5) per 100 person-years. The standardized mortality ratio was 13.4. The HIV incidence rate was 5.2 (95% CI = 3.5-7.6) per 100 person-years. In multi-factorial analysis, HIV infection [hazard ratio (HR) = 3.5, 95% CI = 1.9-6.3] and previous diagnosis of tuberculosis (HR = 10.0, 95% CI = 4.1-24.3) were associated significantly with increased hazard of death.

CONCLUSIONS:

The all-cause, age- and sex-standardized mortality among Vietnamese IDUs is 13-fold higher than the general population and substantially higher than IDUs studied in developed countries. Effective prevention and control of HIV infection and tuberculosis are needed urgently.

© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

PMID:
21054619
[PubMed - indexed for MEDLINE]
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