Lifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia

Drug Alcohol Depend. 2012 Jul 1;124(1-2):177-80. doi: 10.1016/j.drugalcdep.2011.12.024. Epub 2012 Jan 21.

Abstract

Background: Malaysia has been experiencing significant drug abuse problems since the 1970s, and drug abuse is the major driver of HIV transmission in Malaysia. We investigated risk factors for HIV associated with use of amphetamine type stimulants (ATS) among not-in-treatment opiate injectors in Malaysia.

Methods: Between October of 2006 and May of 2008, we conducted a series of surveys in three major urban areas of Malaysia. A total of 732 opiate IDUs (679 males and 53 females) were enrolled in the three surveys. The survey instruments consisted of a structured interview on demographic characteristics, drug use history (including year of first use, and past month history of use of illicit drugs; lifetime and past month history of IDU or needle or equipment sharing), and HIV status.

Results: There were 194/704 (27.6%) HIV positive participants in the sample. Two factors were significantly associated with HIV infection in this sample: lifetime history of ATS use (OR [95%CI]: 2.3 [1.5-3.6]) and lifetime history of sharing of injection equipment (OR [95% CI]: 4.2 [1.8-9.8]). Both HIV-positive and HIV-negative participants reported high levels of current needle/equipment sharing practices: 82% vs. 75%, respectively.

Conclusions: ATS use spread rapidly in the study sample after 1997 and is associated with an increased risk of HIV infection in this population already at high risk because of opiate IDU. Out-of-treatment IDUs in Malaysia engage in high risk behaviors regardless of their HIV status. Increased education and public health prevention measures are needed to reduce HIV transmission risks in this population.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amphetamines / administration & dosage
  • Central Nervous System Stimulants / administration & dosage
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • HIV Seropositivity / complications
  • HIV Seropositivity / epidemiology*
  • HIV Seropositivity / virology
  • Humans
  • Illicit Drugs*
  • Malaysia / epidemiology
  • Male
  • Middle Aged
  • Needle Sharing / statistics & numerical data
  • Opioid-Related Disorders / complications
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / virology
  • Risk
  • Risk Factors
  • Risk-Taking*
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / epidemiology*
  • Substance Abuse, Intravenous / virology

Substances

  • Amphetamines
  • Central Nervous System Stimulants
  • Illicit Drugs