High HIV burden among people who inject drugs in 15 Indian cities.
High HIV burden among people who inject drugs in 15 Indian cities.
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印度 15 个城市的注射吸毒者的艾滋病毒负担很高。
DOI：
10.1097/qad.0000000000000592
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Mehta,ShrutiH
中科院分区：
文献类型：
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作者：
Lucas,GregoryM;Solomon,SunilS;Srikrishnan,AylurK;Agrawal,Alok;Iqbal,Syed;Laeyendecker,Oliver;McFall,AllisonM;Kumar,MuniratnamS;Ogburn,ElizabethL;Celentano,DavidD;Solomon,Suniti;Mehta,ShrutiH
背景：注射吸毒历来是印度东北部各邦艾滋病毒流行的主要驱动因素。然而，最近的数据表明，越来越多的人谁注射毒品（PWID）在北部和中部Indian countries.Methods：我们进行了面对面的调查PWID在7个东北部和8个北部/中部印度城市使用响应驱动的抽样。我们使用了一个快速的艾滋病毒检测协议，以确定血清阳性的个人和多测定算法，以确定那些最近感染。我们使用多层次回归模型，纳入抽样权重和随机截取的网站，以评估流行和事件（最近）HIV infection.Results的风险因素：我们调查了14 481 PWID从15个印度城市之间的1月至2013年12月。参与者报告共用针头/注射器的比例很高。估计的艾滋病毒流行率和发病率中位数（研究中心范围）分别为18.1%（5.9，44.9）和2.9/100人-年（0，12.4）。东北部地区艾滋病毒流行率较高，而北部/中部地区艾滋病毒发病率较高。妇女感染艾滋病毒的几率是男子的三倍多。其他因素与艾滋病毒的流行或发病率包括持续时间，因为第一次注射，注射药物，针头/注射器sharing.Conclusions：艾滋病毒感染的负担是高的PWID在印度，并可能增加注射毒品的使用正在出现的城市。注射毒品的妇女感染艾滋病毒的风险比男子高得多，这种情况可能是由与注射有关的双重风险和性风险介导的。
Background:Injecting drug use has historically been the principal driver of the HIV epidemic in the northeast states of India. However, recent data indicate growing numbers of people who inject drugs (PWIDs) in north and central Indian cities.Methods:We conducted face-to-face surveys among PWIDs in seven northeast and eight north/central Indian cities using respondent-driven sampling. We used a rapid HIV-testing protocol to identify seropositive individuals and multiassay algorithm to identify those with recent infection. We used multilevel regression models that incorporated sampling weights and had random intercepts for site to assess risk factors for prevalent and incident (recent) HIV infection.Results:We surveyed 14 481 PWIDs from 15 Indian cities between January and December 2013. Participants reported high rates of needle/syringe sharing. The median (site range) estimated HIV prevalence and incidence were 18.1%(5.9, 44.9) and 2.9 per 100 person-years (0, 12.4), respectively. HIV prevalence was higher in northeast sites, whereas HIV incidence was higher in north/central sites. The odds of prevalent HIV were over three-fold higher in women than in men. Other factors associated with HIV prevalence or incidence included duration since first injection, injection of pharmaceutical drugs, and needle/syringe sharing.Conclusions:The burden of HIV infection is high among PWIDs in India, and may be increasing in cities where injecting drug use is emerging. Women who inject drugs were at substantially higher risk for HIV than men–a situation that may be mediated by dual injection-related and sexual risks.