Guure Chris, Obiri-Yeboah Laryea Sharren Margaret, Dery Samuel, Baptista da Silva Carlota, Asamoah-Adu Comfort, Ayisi-Addo Stephen, Loglo Maria-Goretti, Mohammed Adamu, Torpey Kwasi
Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana.
International Consultant, Harm Reduction and Key Population Expert, Lisbon, Portugal.
Interdiscip Perspect Infect Dis. 2022 Sep 1;2022:2544481. doi: 10.1155/2022/2544481. eCollection 2022.
Blood borne infections such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV) are of great importance to governments and their implementing partners, especially among people who use drugs (PWUD) and people who inject drugs (PWID). Prevalence and determinants of HIV, HBV, and HCV among PWUD and PWID in Ghana are not well established, the significance of this study.
This assessment was a cross-sectional study implemented via the respondent driven sampling approach. A team of community advisory boards that comprised former users, current users, and civil society organizations were constituted to help in the implementation of the study. The study was conducted in four regions in Ghana. The assessment was based on a representation of populations of PWID and PWUD from the four regions. Efforts were made by the team to ensure adequate representation of women where feasible. A quantitative questionnaire was developed and used to obtain information on the respondents' sociodemographics, sexual behavior, substance use, and biological characteristics. The prevalence of HIV, HBV, and HCV among PWID and PWUD was determined using blood samples. First response and oral quick test for confirmation of HIV positivity were carried out, while SD bioline was used to test for the presence of HBV and HBC. Data were analyzed using the Bayesian generalized linear model via the binomial family of distributions under the logit link function with weak Cauchy and Normal distribution as prior.
A total of 323 PWUD and PWID participants were interviewed across four regions of Ghana. The overall median age of the respondents was 36 (28, 43) years. The prevalence of HIV, HBV, and HCV infection in the study was 2.5%, 4.6%, and 5.9%, respectively. The prevalence of HIV, HBV, and HCV among drug users was 2.5% (95% CI: 0.7%-4.2%), 4.1% (95% CI: 1.8%-6.2%), and 6.7% (95% CI: 3.9%-9.4%), respectively. Most drug injectors and users started using and injecting drugs at ages less than 20 years and between 20 and 29 years, respectively. Drug users who identified themselves as part of the general population were 66% less likely to be tested HIV positive (POR = 0.34, CrI: 0.12-0.81) compared to sex workers. Part time employment respondents had fivefold odds (POR = 5.50, CrI: 1.20-16.16) of being HBV positive as against full-time employment.
Most of the injectors and users started drugs at an early age. Drug users and injectors are at higher risk of these infections because of associated risky sexual behaviors and risky injection practices. Harm reduction programs to help addicts who are willing to quit the practice are recommended.
血源性感染，如艾滋病毒、乙型肝炎（HBV）和丙型肝炎（HCV），对各国政府及其执行伙伴极为重要，尤其是在吸毒者（PWUD）和注射吸毒者（PWID）当中。加纳吸毒者和注射吸毒者中艾滋病毒、HBV和HCV的流行情况及决定因素尚不明确，本研究旨在明确这一点。
本评估为一项通过应答者驱动抽样方法实施的横断面研究。组建了一个由前吸毒者、现吸毒者和民间社会组织组成的社区咨询委员会团队，以协助开展研究。研究在加纳的四个地区进行。评估基于这四个地区注射吸毒者和吸毒者人群的代表性样本。研究团队努力确保在可行的情况下有足够的女性代表。编制了一份定量问卷，用于获取受访者的社会人口统计学、性行为、物质使用和生物学特征方面的信息。通过血液样本确定注射吸毒者和吸毒者中艾滋病毒、HBV和HCV的流行情况。对艾滋病毒阳性进行首次检测及口服快速检测以确认，同时使用SD生物线检测HBV和HBC的存在。数据通过贝叶斯广义线性模型，在logit链接函数下，采用二项分布族，以弱柯西分布和正态分布作为先验进行分析。
在加纳的四个地区共采访了323名注射吸毒者和吸毒者参与者。受访者的总体中位年龄为36（28，43）岁。研究中艾滋病毒、HBV和HCV感染的流行率分别为2.5%、4.6%和5.9%。吸毒者中艾滋病毒、HBV和HCV的流行率分别为2.5%（95%置信区间：0.7%-4.2%）、4.1%（95%置信区间：1.8%-6.2%）和6.7%（95%置信区间：3.9%-9.4%）。大多数注射吸毒者和吸毒者分别在20岁以下和20至29岁开始吸毒和注射毒品。与性工作者相比，自认为属于普通人群的吸毒者艾滋病毒检测呈阳性的可能性低66%（优势比=0.34，可信区间：0.12-0.81）。兼职工作的受访者HBV呈阳性的几率是全职工作受访者的五倍（优势比=5.50，可信区间：1.20-16.16）。
大多数注射吸毒者和吸毒者在早年就开始吸毒。由于相关的危险性行为和危险的注射行为，吸毒者和注射吸毒者感染这些疾病的风险更高。建议实施减少伤害计划，以帮助愿意戒毒的成瘾者。
