HIV Infection Risk among Injection Drug Users in a Methadone Maintenance Treatment Program, Taipei, Taiwan 2007-2010

Background: Taiwan has a growing HIV/AIDS epidemic that has recently shifted to an increase among injection drug users (IDUs). This study aimed to measure the prevalence and incidence and identify the correlates of HIV infection among IDUs in a large methadone maintenance treatment program (MMTP) in...

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Bibliographic Details
Published in:The American journal of drug and alcohol abuse 2012-11, Vol.38 (6), p.544-550
Main Authors: Yen, Yung-Feng, Rodwell, Timothy C., Yen, Muh-Yong, Hsu, Yun-Hsia, Chuang, Peing, Li, Lan-Huei, Su, Lien-Wen, Yang, Yi-Hong, Jiang, Xiao-Ru, Fang, Yung-Chun, Garfein, Richard S.
Format: Article
Language:English
Subjects:
Acquired Immune Deficiency Syndrome
Adult
AIDS
AIDS Serodiagnosis - methods
Cities
Cross-Sectional Studies
Drug Injection
Drug use
Female
Harm Reduction
Health education
Hepatitis C - epidemiology
Hepatitis C - transmission
hepatitis C virus
HIV
HIV Infections - epidemiology
HIV Infections - transmission
HIV Seronegativity
Hospitalization
Hospitals
Human immunodeficiency virus
Humans
Ill-Housed Persons - statistics & numerical data
Incidence
Infection
injection drug use
Intravenous drug addicts
Male
Males
Methadone
Methadone - administration & dosage
Methadone Maintenance
Middle Aged
Multivariate Analysis
Needle Sharing - statistics & numerical data
Opiate Substitution Treatment - methods
Prevalence
Prisons - statistics & numerical data
Retrospective Studies
Risk
Risk Factors
Social Marginalization
Substance abuse treatment
Substance Abuse, Intravenous - complications
Substance Abuse, Intravenous - rehabilitation
Taiwan
Taiwan - epidemiology
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Summary:Background: Taiwan has a growing HIV/AIDS epidemic that has recently shifted to an increase among injection drug users (IDUs). This study aimed to measure the prevalence and incidence and identify the correlates of HIV infection among IDUs in a large methadone maintenance treatment program (MMTP) in Taipei, Taiwan. Methods: Data from intake interviews and HIV testing completed by IDUs upon admission to the Taipei City Hospital MMTP in 2007-2010 were included in this analysis. HIV testing was repeated semi-annually among maintained clients who were HIV-negative during MMTP admission. Results: Of 1444 IDUs admitted, 85.9% were male, median age was 40 years, and mean years of injecting was 14.3 (range: 1-64). The prevalence of HIV, HCV, and HIV/HCV co-infection was 13.4%, 91.1%, and 13.2%, respectively. In multivariable analysis, HIV infection was associated with sharing syringes during the 6 months prior to admission (OR = 14.76, 95% CI 10.31-21.13), homelessness (OR = 6.46, 95% CI 1.49-28.00), and lifetime number of MMTP admissions (OR = 1.76, 95% CI 1.30-2.38) and times incarcerated (OR = 1.10, 95% CI 1.03-1.18). HIV seroincidence was 1.15/100 person-years at risk (95% CI .62-8.77/100 PY) among IDUs who were HIV-negative at first admission. Conclusions: Taiwanese IDUs in MMTP have a high HIV prevalence, which was associated with syringe sharing and other factors related to social marginalization. Our findings highlight the importance of harm reduction programs, including syringe exchange, along with HIV-prevention education.
ISSN:0095-2990
1097-9891
DOI:10.3109/00952990.2012.702171