Association of sociodemographic factors with needle sharing and number of sex partners among people who inject drugs in Egypt

Objectives Gender norms, especially among men, can reduce the effectiveness of HIV prevention programs. We sought to assess the association between attitudes towards gender norms and risky sexual behaviours, and identify sociodemographic factors that predict gender-inequitable and masculinity norms among men in western Jamaica. Methods: A cross-sectional, survey of 549 men aged 19–54 years was conducted. Attitudes towards gender norms were measured using the Gender Equitable Men and Macho scales. Logistic regression and general linear models were used to assess associations between gender norms and multiple sexual partners, and to identify the associated sociodemographic factors. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) are presented. Results: Fifty-four percent of the participants (mean age = 32.4 years) reported multiple sex partners and 22% reported unprotected sex with non-regular partner in the past 12 months. Men with moderate (AOR = 2.2; 95% CI = 1.4–3.3) and high (AOR = 4.2; 95% CI = 2.0–8.5) support for inequitable gender norms, and moderate (AOR = 1.7; 95% CI = 1.1–2.7) and high (AOR = 2.5; 95% CI = 1.5–4.3) support for masculinity norms were more likely to report multiple sex partners. Similarly, men with moderate (AOR = 2.4; 95% CI = 1.3–4.3) and high (AOR = 2.5; 95% CI = 1.2–5.2) support for inequitable gender norms were more likely to report unprotected sex with a nonregular partner. Conclusion: A high proportion of Jamaican men engage in risky sexual behaviours. These results highlight the need for behaviour change interventions addressing gender norms targeting Jamaican men.

Download Full-text

Early age at first sex: associations with sexual health and sociodemographic factors among a sample of young music festival attendees in Melbourne

Sexual Health ◽

10.1071/sh14058 ◽

2014 ◽

Vol 11 (4) ◽

pp. 359 ◽

Cited By ~ 2

Author(s):

Alyce M. Vella ◽

Paul A. Agius ◽

Anna L. Bowring ◽

Margaret E. Hellard ◽

Megan S. C. Lim

Keyword(s):

Sex Education ◽

Illicit Drugs ◽

Cox Regression ◽

Sociodemographic Factors ◽

Adverse Outcomes ◽

Sexually Active ◽

Sex Partners ◽

Inconsistent Condom ◽

Music Festival ◽

First Sex

Background Age at first sex (AFS) is associated with adverse outcomes. We explore associated factors and correlates of ‘early’ AFS (<16 years). Methods: In 2009–11, participants (16–29 years) were recruited. Multivariate Cox regression explored correlates of AFS. Logistic regression analysis explored associations between early AFS and risk behaviours. Results: Of 3563 participants, 79% were sexually active. Median AFS was 17 years. Compared with those aged 25–29 years, younger participants reported younger AFS [16–17 years: adjusted hazard ratio (AHR) = 1.87, P < 0.01; 18–19 years: AHR = 1.47, P < 0.01, 20–24 years: AHR = 1.19, P < 0.01]. Of those sexually active, 29% reported early AFS. Early AFS was associated with being male [adjusted odds ratio (AOR) = 1.25, P < 0.05], being younger (16–17 years: AOR = 11.10, P < 0.01; 18–19 years: AOR = 3.60, P < 0.01; 20–24 years: AOR = 1.83, P < 0.01; compared with 25–29 years), having no education after high school (AOR = 1.52, P < 0.01), living alone (AOR = 1.84, P < 0.01) or with a partner (AOR = 1.57, P = 0.01), having more than five lifetime sex partners (AOR = 3.22, P = 0.01), inconsistent condom use in the past 12 months (AOR = 1.43, P < 0.01), ever using illicit drugs (AOR = 1.69, P < 0.01) and ever injecting drugs (AOR = 3.45, P < 0.01). Conclusions: The results highlight the importance of comprehensive sex education.

Download Full-text

P3.103 Sexual Act with Multiple Sex Partners is an Upcoming Threat For Rapid Transmission of HIV Among People Who Inject Drugs (PWID) in Bangladesh

Sexually Transmitted Infections ◽

10.1136/sextrans-2013-051184.0562 ◽

2013 ◽

Vol 89 (Suppl 1) ◽

pp. A179.3-A179 ◽

Cited By ~ 1

Author(s):

A Bosu

Keyword(s):

People Who Inject Drugs ◽

Sex Partners ◽

Multiple Sex Partners ◽

Rapid Transmission

Download Full-text

Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study

Harm Reduction Journal ◽

10.1186/s12954-021-00579-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jean Olivier Twahirwa Rwema ◽

Vianney Nizeyimana ◽

Neia M. Prata ◽

Nneoma E. Okonkwo ◽

Amelia A. Mazzei ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Injection Drug Use ◽

People Who Inject Drugs ◽

Cross Sectional Study ◽

Injection Drug ◽

People Who Use Drugs ◽

Needle Sharing ◽

Sectional Study ◽

Cross Sectional

Abstract Background In Rwanda, epidemiological data characterizing people who inject drugs (PWID) and their burden of HIV are limited. We examined injection drug use (IDU) history and practices, and HIV infection in a sample of PWID in Kigali. Methods From October 2019 to February 2020, 307 PWID aged ≥ 18 were enrolled in a cross-sectional study using convenience sampling in Kigali. Participants completed interviewer-administered questionnaires on IDU history and practices and HIV testing. We used Poisson regression with robust variance estimation to assess IDU practices associated with HIV infection and assessed factors associated with needle sharing in the six months preceding the study. Results The median age was 28 years (IQR 24–31); 81% (251) were males. Female PWID were more likely to report recent IDU initiation, selling sex for drugs, and to have been injected by a sex partner (p < 0.05). In the prior six months, heroin was the primary drug of choice for 99% (303) of participants, with cocaine and methamphetamine also reported by 10% (31/307) and 4% (12/307), respectively. In total, 91% (280/307) of participants reported ever sharing needles in their lifetime and 43% (133) knew someone who died from a drug-related overdose. HIV prevalence was 9.5% (95% CI 8.7–9.3). Sharing needles at least half of the time in the previous six months was positively associated with HIV infection (adjusted prevalence ratio (aPR) 2.67; 95% CI 1.23–5.78). Overall, 31% (94/307) shared needles and 33% (103/307) reused needles in the prior six months. Female PWID were more likely to share needles compared to males (aPR 1.68; 95% CI 1.09–2.59). Additionally, bisexual PWID (aPR 1.68; 95% CI 1.09–2.59), those who shared needles at the first injection (aPR 2.18; 95% CI 1.59–2.99), reused needles recently (aPR 2.27; 95% CI 1.51–3.43) and shared other drug paraphernalia (aPR 3.56; 95% CI 2.19–5.81) were more likely to report recent needle sharing. Conclusion HIV infection was common in this study. The high prevalence of needle reuse and sharing practices highlights significant risks for onward transmission and acquisition of HIV and viral hepatitis. These data highlight the urgent need for PWID-focused harm reduction services in Rwanda, including syringe services programs, safe injection education, naloxone distribution, and substance use disorder treatment programs and optimizing these services to the varied needs of people who use drugs in Rwanda.

Download Full-text

Per-Contact Infectivity of Hepatitis C Virus Acquisition in Association With Receptive Needle Sharing Exposures in a Prospective Cohort of Young Adult People who Inject Drugs in San Francisco, California

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa092 ◽

2020 ◽

Vol 7 (4) ◽

Author(s):

Yuridia Leyva ◽

Kimberly Page ◽

Stephen Shiboski ◽

Judith A Hahn ◽

Jennifer Evans ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Young Adult ◽

Prospective Cohort ◽

People Who Inject Drugs ◽

Hcv Infection ◽

Exposure Model ◽

Risk Exposure ◽

Hcv Rna ◽

Needle Sharing

Abstract Background Sharing needles and ancillary injecting equipment is a primary risk exposure for hepatitis C virus (HCV) infection among people who inject drugs (PWID); however, infectivity of these exposures is not well quantified. We aimed to estimate per-event HCV infectivity associated with receptive needle sharing (RNS) among susceptible PWID. Methods Participants in a prospective cohort study of young adult PWID who were anti-HCV and HCV RNA negative at baseline and attended at least 2 follow-up study visits between 2003 and 2014 were eligible. Data were selected from the first HCV-negative through the first HCV-positive visit (or last HCV-negative among those uninfected). Anti-HCV and HCV-RNA tests were used to determine infection status. A probabilistic exposure model linking observed HCV infection outcomes to self-reported exposure events was applied to estimate infectivity. Results Among 344 participants, a maximum likelihood estimate considering RNS yielded a pooled population per RNS event HCV probability of 0.25% (95% confidence interval [CI], 0.10%–0.43%), and 1.12% (95% CI, 0.48%–2.35%) among those who acquired any HCV infection (primary or reinfection). Conclusions HCV is highly infectious in association with RNS, a primary injection-related risk exposure. Our infectivity estimate among participants who acquired any HCV infection is 1.7 times higher than that estimated for HIV infection in PWID and 2.24 times higher than that estimated among health care workers exposed through needle sticks. The strengths of this study include the assessment of receptive needle sharing events, the prospective design, and relatively short recall and testing periods. These results can inform transmission models and research to prevent HCV infection.

Download Full-text

The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs

Epidemiology and Infection ◽

10.1017/s0950268816002892 ◽

2016 ◽

Vol 145 (4) ◽

pp. 796-801 ◽

Cited By ~ 17

Author(s):

C. K. AITKEN ◽

P. A. AGIUS ◽

P. G. HIGGS ◽

M. A. STOOVÉ ◽

D. S. BOWDEN ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

People Who Inject Drugs ◽

Hcv Infection ◽

Protective Effects ◽

Needle Sharing ◽

Substitution Therapy ◽

Opioid Substitution Therapy ◽

Cross Model ◽

Opioid Substitution

SUMMARYAlthough high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs’ use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7·6 [95% confidence interval (CI) 4·8–11·9], 12·4 (95% CI 9·1–17·0) and 9·7 (95% CI 7·4–12·6) per 100 person-years, respectively. Needle-sharing was significantly associated with higher incidence of naive HCV infection [hazard ratio (HR) 4·9, 95% CI 1·3–17·7] but not reinfection (HR 1·85, 95% CI 0·79–4·32); however, a cross-model test suggested this difference was sample specific. Past month use of OST had non-significant protective effects against naive HCV infection and reinfection. Our data confirm previous evidence of greatly reduced HCV incidence in PWID, but not the significant protective effect of OST on HCV incidence detected in recent studies. Our findings reinforce the need for greater access to HCV testing and prevention services to accelerate the decline in incidence, and HCV treatment, management and support to limit reinfection.

Download Full-text

Intravenous Drug Use and the AIDS Epidemic: Findings from a 20-City Sample of Arrestees

Crime & Delinquency ◽

10.1177/0011128792038004006 ◽

1992 ◽

Vol 38 (4) ◽

pp. 492-509 ◽

Cited By ~ 11

Author(s):

Scott Decker ◽

Richard Rosenfeld

Keyword(s):

Drug Use ◽

Drug Users ◽

Large Fraction ◽

Intravenous Drug ◽

Needle Sharing ◽

Sex Partners ◽

Multiple Sex Partners ◽

Aids Epidemic ◽

Aids Risk ◽

Sharing Behavior

This study identifies characteristics of arrestees at risk for AIDS and assesses the effects of knowledge of AIDS on needle sharing among those who inject drugs. Many of the intravenous drug users—particularly those with multiple sex partners—report that AIDS risk has had no effect on their needle-sharing behavior. A large fraction of those who report that they have altered their behavior in response to AIDS risk nonetheless continue to share needles. These findings indicate that the effectiveness of AIDS counseling in reducing high-risk drug use behaviors among arrestees may depend on the availability of drug treatment.

Download Full-text