Regional Medical Research Centre (RMRC), N.E. Region (ICMR), Post Box No. 105, Dibrugarh, AS, 786 001, India.
Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Science (NEIGRIHMS), Shillong, ML, India.
Harm Reduct J. 2017 Jul 3;14(1):41. doi: 10.1186/s12954-017-0171-0.
Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur.
A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes.
The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors.
Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.
个人网络是向难以接触的人群（如注射吸毒者、性工作者等）传播 HIV 或其他血源感染的重要社交空间。吸毒者之间共用受感染的针头或注射器是印度 HIV 高发州曼尼普尔邦 HIV 传播的主要途径之一。本研究旨在描述注射吸毒者的网络特征和招募模式，并评估个人网络与曼尼普尔邦注射吸毒者的危险行为之间的关系。
采用基于响应者驱动抽样（RDS）的方法，从曼尼普尔邦比什努普尔和乔拉昌德布尔地区招募了 821 名注射吸毒者，从他们那里收集了人口统计学特征、HIV 风险行为和网络规模等数据。使用转移概率矩阵和同质性指数来描述网络特征和注射吸毒者的招募模式。采用单变量和多变量二元逻辑回归模型分析个人网络与共用针具或注射器之间的关联。
两个地区的平均网络规模相似。招募分析表明，注射吸毒者主要在混合年龄组进行注射实践。已婚和新注射者显示缺乏同组关系。年轻的注射吸毒者主要从他们的个人网络中招募年长的注射吸毒者。在逻辑回归分析中，发现较高的个人网络与注射危险行为的可能性增加显著相关。
由于新注射者的个人网络混合以及与 HIV 暴露相关的较高网络密度，年长的注射吸毒者可能成为 HIV 传播或其他血源感染向新注射者以及他们的性伴侣传播的纽带。本研究的信息可能有助于了解注射吸毒者的网络模式，为该地区的 HIV 预防提供参考。
