Mahanta Jagadish, Medhi Gajendra Kumar, Paranjape Ramesh S, Roy Nandan, Kohli Anjalee, Akoijam Brogen S, Dzuvichu Bernice, Das Hiranya Kumar, Goswami Prabuddhagopal, Thongamba Gay
Regional Medical Research Centre (RMRC), Dibrugarh, India.
AIDS. 2008 Dec;22 Suppl 5:S59-68. doi: 10.1097/01.aids.0000343764.62455.9e.
To describe and compare sexual and injecting risk behaviours and sexually transmitted infections (STI), hepatitis C virus (HCV) and HIV prevalence in injecting drug users (IDU) in six districts in three states of India: Manipur, Nagaland, and Maharashtra.
The respondent-driven sample consisted of 2075 IDU. Consenting participants were administered a structured questionnaire and samples of blood and urine were collected to test for HIV and STI. Data were analysed using RDSAT.
In two districts in Manipur, 77 and 98% of IDU injected heroin, whereas the main injecting drug in Nagaland was dextropropoxyphene (99%). In Mumbai/Thane, Maharashtra, the majority of respondents reported using chlorpheniramine (87%) and heroin (99%). In all districts, almost half of IDU reported generally sharing needles and syringes; consistent condom use with non-paid female partners was also low. Approximately one-quarter of IDU in Mumbai/Thane visited a paid partner in the past year. IDU with reactive syphilis serology were higher in Nagaland (7 and 19%) than in Manipur and Maharashtra. HIV in two districts of Manipur (23%, 32%) and Mumbai/Thane (16%) was greater than Nagaland (<2%). HCV prevalence was more than 50% in Mumbai/Thane and Manipur.
Irrespective of regional differences, high-risk behaviour of needle sharing and low condom use makes IDU a critical subpopulation for HIV prevention interventions. Interventions need to address the differing drug use patterns in the regions and transmission prevention among non-paid regular and casual female partners of IDU in the northeast districts and paid female partners in Mumbai/Thane.
描述并比较印度三个邦（曼尼普尔邦、那加兰邦和马哈拉施特拉邦）六个地区注射吸毒者（IDU）的性风险行为、注射风险行为以及性传播感染（STI）、丙型肝炎病毒（HCV）和艾滋病毒的流行情况。
采用应答者驱动抽样，共纳入2075名注射吸毒者。对同意参与的参与者进行结构化问卷调查，并采集血液和尿液样本检测艾滋病毒和性传播感染。使用RDSAT对数据进行分析。
在曼尼普尔邦的两个地区，77%和98%的注射吸毒者注射海洛因，而那加兰邦主要的注射毒品是右丙氧芬（99%）。在马哈拉施特拉邦的孟买/塔纳，大多数受访者报告使用氯苯那敏（87%）和海洛因（99%）。在所有地区，近一半的注射吸毒者报告普遍共用针头和注射器；与无酬女性性伴始终坚持使用避孕套的比例也很低。在孟买/塔纳，约四分之一的注射吸毒者在过去一年中与付费性伴发生过性行为。那加兰邦梅毒血清学反应阳性的注射吸毒者（7%和19%）高于曼尼普尔邦和马哈拉施特拉邦。曼尼普尔邦两个地区（23%、32%）和孟买/塔纳（16%）的艾滋病毒感染率高于那加兰邦（<2%）。孟买/塔纳和曼尼普尔邦的丙型肝炎病毒流行率超过50%。
无论地区差异如何，共用针头的高风险行为和避孕套低使用率使注射吸毒者成为艾滋病毒预防干预的关键亚人群。干预措施需要针对各地区不同的吸毒模式，以及东北部地区注射吸毒者的无酬固定和临时女性性伴及孟买/塔纳的付费女性性伴中的传播预防问题。
