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  • Title: Injecting drug use and HIV infection in southwest China.
    Author: Zheng X, Tian C, Choi KH, Zhang J, Cheng H, Yang X, Li D, Lin J, Qu S, Sun X.
    Journal: AIDS; 1994 Aug; 8(8):1141-7. PubMed ID: 7986413.
    Abstract:
    OBJECTIVES: To determine the prevalence of drug injection among drug users, the seroprevalence of HIV and risk factors for HIV infection among injecting drug users (IDU), and to determine heterosexual transmission of HIV among IDU and their spouses in southwest China. METHODS: Using a cross-sectional design, we conducted an HIV seroprevalence and behavioral survey in three rural counties of Yunnan province, Ruili, Longchuan and Luxi in southwest China, bordering Myanmar (Burma). A total of 860 drug users were recruited in randomly selected communities at the three study sites (response rate, 97%). In addition, a random sample of 62 wives of HIV-infected IDU were assembled from 460 known HIV-positive IDU in Ruili and Longchuan (response rate, 81%). RESULTS: In the sample of 860 drug users, 33% reported injecting drugs. Among the 282 subjects who injected drugs, 82% began intravenous drug use after 1988; 64% injected drugs at least once every day. All subjects shared needles but none cleaned the injection equipment with alcohol or bleach. Overall, 49% tested HIV-positive. HIV seropositivity was independently correlated with a longer history of drug injecting, daily injecting, frequent needle-sharing, being younger, and living in Ruili county. Among the 62 wives of HIV-positive IDU, none used condoms during sex and 10% tested HIV-positive. CONCLUSIONS: We conclude that the introduction of HIV into drug-using communities and the rapid increase in heroin injecting in this population appear to have triggered an explosive HIV epidemic among IDU in southwest China. We recommend that AIDS prevention efforts should begin immediately and focus on discouraging the shift from opium smoking to heroin injecting, needle-sharing, and unprotected sex among drug users and their partners. The authors investigated the prevalence of drug injection among drug users, the seroprevalence of HIV and risk factors for HIV infection among injecting drug users (IVDUs), and the extent of heterosexual transmission of HIV among IVDUs and their spouses in southwest China. Findings are based upon a cross-sectional HIV seroprevalence and behavioral survey in the rural counties Ruili, Longchuan, and Luxi of Yunnan province in southwest China. 860 drug users were recruited in randomly selected communities along with a random sample of 62 wives of HIV-infected IVDUs. 33% of the 860 drug users reported injecting drugs. Of the 282 who injected drugs, 82% began IV drug use after 1988, and 64% injected drugs at least once daily. All subjects shared needles, but none cleaned the injection equipment with alcohol or bleach. 49% overall tested HIV-seropositive. HIV seropositivity was independently correlated with a longer history of drug injecting, daily injecting, frequent needle-sharing, being younger, and living in Ruili county. None of the 62 wives of HIV-positive IVDUs used condoms during sex and 10% tested HIV-positive. The introduction of HIV into drug-using communities and the rapid increase in heroin injecting in the population appear to have triggered an explosive HIV epidemic among IVDUs in the region. It is recommended that AIDS prevention efforts begin immediately with a focus upon discouraging the shift from opium smoking to heroin injecting, needle-sharing, and unprotected sex among drug users and their partners.
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