Geographical and temporal variation of injection drug users in Pakistan
Chris P. Archibald,Souradet Y. Shaw,Faran Emmanuel,Suleman Otho,Tahira Reza,Arshad Altaf,Nighat Musa,Laura H. Thompson,James F. Blanchard +8 more
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TLDR
There is a high prevalence of HIV among injection drug users in Pakistan and considerable potential for further transmission through risk behaviours, and HIV prevention programs may be improved through geographic targeting of services within a city and for involving groups that interact with IDU in harm reduction initiatives.Abstract:
Objectives We describe the characteristics of injecting drug users (IDU) in Pakistan in 2006 and 2011, and assess the heterogeneity of IDU characteristics across different cities and years as well as factors associated with HIV infection. Methods Cross-sectional, integrated behaviouralbiological surveys of IDU were conducted in 10 cities across Pakistan in 2006 and 2011. Univariate and multivariable analyses were used to describe the differences in HIV prevalence and risk behaviours between cities and over time. Results Large increases in HIV prevalence among injection drug users in Pakistan were observed, with overall HIV prevalence increasing from 16.2% in 2006 to 31.0% in 2011; an increase in HIV prevalence was also seen in all geographic areas except one. There was an increase in risk behaviours between 2006 and 2011, anecdotally related to a reduction in the availability of services for IDU. In 2011, larger proportions of IDU reported injecting several times a day and using professional injectors, and fewer reported always using clean syringes. An increase in the proportion living on the street was also observed and this was associated with HIV infection. Cities differ in terms of HIV prevalence, risk profiles, and healthcare seeking behaviours. Conclusions There is a high prevalence of HIV among injection drug users in Pakistan and considerable potential for further transmission through risk behaviours. HIV prevention programs may be improved through geographic targeting of services within a city and for involving groups that interact with IDU (such as pharmacy staff and professional injectors) in harm reduction initiatives.read more
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Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review
Louisa Degenhardt,Amy Peacock,Samantha Colledge,Janni Leung,Jason Grebely,Peter Vickerman,Jack Stone,Evan B Cunningham,Adam Trickey,Kostyantyn Dumchev,Michael T. Lynskey,Paul Griffiths,Richard P. Mattick,Matthew Hickman,Sarah Larney +14 more
TL;DR: A global multistage systematic review of sharing of equipment used for injecting drug use (IDU) identified evidence of IDU in more countries than in 2008, with the new countries largely consisting of low-income and middle-income countries in Africa.
Journal ArticleDOI
Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia.
TL;DR: The molecular epidemiology of HIV among people who inject drugs (PWID) in Europe and Asia is summarized and Russia, Ukraine, and other Former Soviet Union states are still facing the devastating effects of epidemics in PWID produced by AFSU, IDU, and BFSU.
Journal ArticleDOI
High HIV incidence among persons who inject drugs in Pakistan: greater risk with needle sharing and injecting frequently among the homeless.
Rab Nawaz Samo,Arshad Altaf,Ajmal Agha,Omrana Pasha,Shafquat Rozi,Ashraf Memon,Saleem Azam,Meridith Blevins,Sten H. Vermund,Sharaf Ali Shah +9 more
TL;DR: Even though all members of the cohort of PWID were attending risk reduction programs, the HIV incidence rate was very high in Karachi from 2009–2011, suggesting absence of opiate substitution therapy and incomplete needle/syringe exchange coverage undermines success in HIV risk reduction.
Journal ArticleDOI
Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan
Sharmistha Mishra,Laura H. Thompson,Altaf Sonia,Nosheen Khalid,Faran Emmanuel,James F. Blanchard +5 more
TL;DR: HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed.
Journal ArticleDOI
Patterns and trends in Pakistan's heterogeneous HIV epidemic.
Tahira Reza,Dessalegn Y. Melesse,Leigh Anne Shafer,Momina Salim,Arshad Altaf,Altaf Sonia,Gayatri C. Jayaraman,Faran Emmanuel,Laura H. Thompson,James F. Blanchard +9 more
TL;DR: In this article, the authors used the UNAIDS Estimation and Projection Package model to estimate and project HIV epidemics among these key populations in several cities in Pakistan, including Karachi, Lahore, Faisalabad, Larkana, Peshawar and Quetta.
References
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Tim Rhodes,Andrew Ball,Gerry V. Stimson,Y Kobyshcha,Chris Fitch,V Pokrovsky,M Bezruchenko-Novachuk,D Burrows,Adrian Renton,L Andrushchak +9 more
TL;DR: The social and economic contexts mediating HIV spread is a prerequiste to identifying the environmental "pre-conditions" of epidemic outbreaks, and thus also, for predicting and preventing HIV transmission.
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Problematic use of prescription-type opioids prior to heroin use among young heroin injectors.
Robin A. Pollini,Caleb J. Banta-Green,Jazmine Cuevas-Mota,Mitcheal Metzner,Eyasu H. Teshale,Richard S. Garfein +5 more
TL;DR: A high proportion of young heroin IDUs reported problematic prescription-type opioid use prior to initiating heroin use, and this subset of IDUs and their risks and perceptions related to HIV and other blood-borne pathogens are characterized.