HIV- and hepatitis C-related risk behaviors among people who inject drugs in Uganda: implications for policy and programming
HIV- and hepatitis C-related risk behaviors among people who inject drugs in Uganda: implications for policy and programming
复制标题
DOI：
10.1186/s12954-019-0324-4
复制
发表时间：
2019-09-03
影响因子：
4.4
通讯作者：
Muhangi, Denis
中科院分区：
文献类型：
--
作者：
Baluku, Matayo;Wamala, Twaibu;Muhangi, Denis
背景在乌干达，注射毒品使用和相关的HIV和丙型肝炎病毒（HCV）感染的证据缺乏。因此，由于缺乏流行病学数据，针对注射吸毒者的政策和方案编制受到限制。因此，我们进行了这项研究，以评估注射毒品和性行为之间的PWID在坎帕拉首都和姆巴莱市。方法采用快速情况评估框架，我们进行了半结构化访谈125 PWID（102男，23女），通过外展和雪球抽样招募。我们评估了他们的注射毒品和性行为。此外，我们亦与残疾人士进行了12次焦点小组讨论，并与30名主要举报人进行深入访谈。结果125名PWID患者（男81.6%，女18.4%）被纳入研究。大约四分之三的PWID在25岁之前开始注射。17岁开始注射的女性（21.7%）多于男性（13.7%）。坎帕拉和姆巴莱分别有57%和50%的PWID在研究前的最后3个月共用注射设备。有一种新兴的做法，将药物与血液混合，并在不同的PWID之间分享，作为统一的标志。72%的参与者注射了海洛因。不到一半的PWID在最近一次随意性行为中使用了安全套，42.7%的PWID在最近一次从事性工作时没有使用安全套。76%的PWID在过去12个月内进行了艾滋病毒检测，9.2%的人自称艾滋病毒呈阳性。结论这项研究强调了引入减少伤害政策和服务的必要性，包括增加获得无菌注射设备的机会和围绕安全注射和性行为的教育。针对PWID的计划还应解决注射毒品的女性性工作者的具体需求。
Background There is a dearth of evidence on injecting drug use and associated HIV and hepatitis C virus (HCV) infections in Uganda. As such, policy and programming for people who inject drugs (PWID) is limited due to scarcity of epidemiological data. We therefore conducted this study to assess the injecting drug and sexual practices among PWID in Kampala Capital City and Mbale Municipality. Methods Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)-recruited through outreach and snowball sampling. We assessed their injecting drug and sexual practices. We also conducted 12 focus group discussions among PWID and 30 in-depth interviews among key informants. Results A total of 125 PWID (81.6% males and 18.4% females) were recruited into the study. Approximately three quarters of PWID started injecting before the age of 25. More females (21.7%) compared to males (13.7%) started injecting by the age of 17. Fifty-seven percent of the PWID in Kampala and 50% in Mbale shared injecting equipment in the last 3 months prior to the study. There was an emerging practice of mixing drugs with blood and sharing it among different PWID as a sign of oneness. Heroin was being injected by 72% of the participants. Less than one half of the PWID had used a condom during the last casual sex, and 42.7% did not use a condom the last time they engaged in sex work. Seventy-six percent of the PWID had undertaken an HIV test in the last 12 months, and 9.2% self-reported to be HIV positive. Conclusions This study highlights the need for introducing harm reduction policies and services including increased access to sterile injecting equipment and education around safer injecting and sexual practices. Programs for PWID should also address the specific needs of female sex workers who inject drugs.