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  • Title: Alarming epidemics of human immunodeficiency virus and hepatitis C virus among injection drug users in the northwestern bordering state of Punjab, India: prevalence and correlates.
    Author: Panda S, Roy T, Pahari S, Mehraa J, Sharma N, Singh G, Singh J, Joseph F, Singh S, Sharma NM.
    Journal: Int J STD AIDS; 2014 Jul; 25(8):596-606. PubMed ID: 24352120.
    Abstract:
    In this study 1155 injection drug users (IDUs) receiving targeted intervention in five cities of Punjab were surveyed; three cities (Amritsar, Taran-Taran, Batala) were in districts sharing an international border with Pakistan and the other two were Jalandhar and Ludhiana. Information on socio-demography, substance use and sexual practices were collected; blood samples were tested for biologic markers. HIV and HCV antibody (HCVAb) prevalences in injection drug users were 29 and 49%, respectively. Of the HCVAb-seroreactive IDUs, 33% had HIV as well. HIV prevalence in young IDUs (≤19 years), estimated as surrogate for HIV incidence, was high at 12% and HCVAb in this subgroup was 27%. Herpes simplex virus 2 antibody (IgG) was detected in 10% of IDUs; 2% had syphilis. Alcohol use prevalence was high and frequency of use concerning. In multivariate analyses, 'city of residence closer to international border' and '>1 year duration of injecting drugs were associated with HIV and HCVAb. Furthermore, 'irregular supply of syringes and needles' was associated with HCVAb seroreactive status of IDUs (adjusted odds ratio 1.7; 95% CI 1.3-2.3;P < 0.001), and 'any genital disease symptom within the last year' (adjusted odds ratio 2; 95% CI 1.4-2.9;P < 0.001) was associated with HIV infection. Alcohol and sexual risk reduction, strengthening of needle-syringe exchange, reducing injecting duration and clinical management of HIV, HCV and HIV/HCV co-infection appear as four core programme needs.
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