School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia.
Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia.
BMC Public Health. 2022 Aug 10;22(1):1529. doi: 10.1186/s12889-022-13922-2.
Little is known about the epidemiology of HIV infection among HIV positive people who inject drugs (PWID) in India. Injecting drug use has emerged as an important route of HIV transmission in India. The objective of this study was to conduct a systematic review on the risk behaviours associated with HIV infection among HIV positive PWID and assess the data reported.
A systematic search of six electronic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase and Ovid Medline was conducted. These databases were searched for published studies on injecting risk behaviours, sexual risk behaviours and socio-demographic factors associated with HIV infection among HIV positive PWID in India.
A total of 15 studies were included in the review of which 3 studies evaluated HIV/HCV coinfection among HIV positive PWID. Older age, low educational level and employment status were significantly associated with HIV infection. Sharing of syringe and needle, frequency of injection, early initiation of injecting practice, inconsistent condom use and having multiple sexual partners were all commonly associated with HIV infection among HIV positive PWID.
Our study identified significant injecting and sexual risk behaviours among HIV positive PWID in India. There is an increasing HIV transmission among PWID in different states, more so in the northeastern states and in metropolitan cities in India. More studies need to be conducted in other regions of the country to understand the true burden of the disease. The lack of sufficient data among HIV positive female PWID does not preclude the possibility of a hidden epidemic among female PWID. The need of the hour is for the prevention of further transmission by this high-risk group through the provision of comprehensive programs, surveillance and robust continuation of harm reduction services.
在印度，针对 HIV 阳性的吸毒者（PWID）中 HIV 感染的流行病学情况，人们知之甚少。吸毒注射已成为印度 HIV 传播的一个重要途径。本研究的目的是对 HIV 阳性 PWID 中与 HIV 感染相关的风险行为进行系统综述，并评估报告的数据。
对六个电子数据库（Scopus、PubMed、PsycINFO、CINAHL、Embase 和 Ovid Medline）进行了系统搜索。这些数据库用于搜索关于印度 HIV 阳性 PWID 中与注射风险行为、性风险行为和社会人口统计学因素相关的 HIV 感染的已发表研究。
共纳入 15 项研究进行综述，其中 3 项研究评估了 HIV 阳性 PWID 中的 HIV/HCV 合并感染。年龄较大、教育程度低和就业状况与 HIV 感染显著相关。共用注射器和针头、注射频率、早期开始注射、不坚持使用避孕套和有多个性伴侣，这些都是与 HIV 阳性 PWID 中 HIV 感染相关的常见因素。
我们的研究确定了印度 HIV 阳性 PWID 中存在显著的注射和性风险行为。不同邦（印度的一级行政区），尤其是东北部邦和印度的大都市，PWID 中的 HIV 传播呈上升趋势。需要在该国其他地区开展更多研究，以了解该疾病的真实负担。HIV 阳性女性 PWID 中缺乏足够的数据并不能排除女性 PWID 中存在隐性流行的可能性。目前迫切需要通过提供全面的方案、监测和强有力的持续减少伤害服务，防止这一高风险群体进一步传播。
