Abstract

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.

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Publisher Full Text

Authors

Yen YF, Rodwell TC, Yen MY, Hsu YH, Chuang P, Li LH, Su LW, Yang YH, Jiang XR, Fang YC, Garfein RS

Institution

Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, No.145 Zhengzhou Rd., Taipei, Taiwan. dam37@tpech.gov.tw

Source

The American journal of drug and alcohol abuse 38:6 2012 Nov pg 544-50

MeSH

AIDS Serodiagnosis
Adult
Cross-Sectional Studies
Female
HIV Infections
HIV Seronegativity
Hepatitis C
Homeless Persons
Humans
Incidence
Male
Methadone
Middle Aged
Multivariate Analysis
Needle Sharing
Opiate Substitution Treatment
Prevalence
Prisons
Retrospective Studies
Risk Factors
Social Marginalization
Substance Abuse, Intravenous
Taiwan

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22783806