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Risk factors for HIV seropositivity in a sample of drug users in drug treatment in Ho Chi Minh City, Vietnam.

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1
Yale School of Epidemiology and Public Health, New Haven, Connecticut, USA.

Abstract

The article describes drug use behaviors, AIDS knowledge, risks for HIV infection, and HIV seroprevalence in drug users entering rehabilitation in Ho Chi Minh City, Vietnam. A cross-sectional, descriptive survey of all new entrants to a residential drug treatment center was conducted with linked HIV serology between July 1 and July 14, 1995. A total of 105 subjects participated: 101 men and 4 women. HIV serostatus was available for 88 subjects. Forty-seven percent (41 of 88 subjects) were HIV-positive. Median age of the subjects was 38 years. Mean length of injection drug use was 13.2 years (range, 1-27 years). The primary drug of injection was opium (96%), although 59% of subjects also injected "Western" drugs such as sedatives or tranquilizers. Eighty-two percent (86 of 105 subjects) correctly answered at least 7 of 10 AIDS knowledge questions, and only 28% (27 of 97 subjects) reported any needle sharing in the last 5 years. Seropositivity was associated with a history of previous treatment for drug abuse (p = 0.002), longer history of injecting drugs (p = 0.003), use of Western drugs (p = 0.03), and higher educational level (p = 0.05). Multivariate analysis found that the independent predictors of HIV seropositivity were history of previous treatment for drug abuse (p = 0.06) and longer history of injecting drugs (p = 0.05). Despite low levels of self-reported needle sharing and high levels of AIDS knowledge, HIV seroprevalence was high in this sample. The potential for epidemic spread of HIV in Vietnamese drug users is substantial. Risk-reduction programs and intense AIDS education projects targeting the population of drug users are necessary to control the AIDS epidemic in Vietnam.

PIP:

A cross-sectional survey of all 105 new entrants to a residential drug treatment center in Ho Chi Minh City, Viet Nam, in a 2-week period in 1995 investigated HIV seroprevalence and its risk factors. The median age of study participants was 38 years and the mean length of injection drug use--primarily of opium--was 13.2 years. 86 drug users (82%) correctly answered at least 7 of 10 questions assessing knowledge of AIDS. Only 27 (28%) of the 97 intravenous drug users reported any needle-sharing in the last 5 years. Of the 88 subjects for whom HIV serostatus results were available, 41 (47%) were HIV-positive. Seropositivity was significantly associated with a history of previous treatment for drug use, longer history of injecting drugs, use of Western drugs, and higher educational level. The multivariate analysis identified 2 independent predictors of HIV seropositivity: history of previous treatment for drug abuse (odds ratio (OR), 1.26; 95% confidence interval (CI), 1.00-1.58) and longer history of injecting drugs (OR, 1.06; 95% CI, 1.00-1.14). These findings indicate the potential for epidemic spread of HIV among drug users in Viet Nam and pinpoint a need for risk-reduction programs in this population.

PMID:
9495230
[Indexed for MEDLINE]
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