title: HIV infection among injecting drug users in north-east Malaysia, 1992.
abstract: Human immunodeficiency virus (HIV) has spread widely among injecting drug users (IDUs) in countries to the north and west of the 'Golden Triangle' region of South-East Asia; it is likely to have spread southwards to Malaysia as well. In order to assess HIV seroprevalence among IDUs in north-east Malaysia and describe risk factors for HIV infection in this population, we performed a cross-sectional seroepidemiological study among 210 IDUs recruited at the detoxification ward of the General Hospital in the capital city of the north-eastern Malaysian state, Kelantan. Subjects were sequential entrants to the detoxification ward, interviewed about HIV risk behaviour, and tested for antibody to HIV and to syphilis. Nearly a third (62/210, 30%) of these IDUs were HIV seropositive. Three-quarters (159/210) had travelled to Thailand in the preceding 5 years, of whom 32% (51/159) were HIV seropositive; this was associated with injecting in Thailand, but not with sexual contact there. Of those who had not left Malaysia in the preceding 5 years, 26% (11/43) were HIV seropositive, a rate not significantly different from those who had travelled. Travel within Malaysia was common (144/210, 69%) among IDUs interviewed, as was unsafe injecting and unsafe sexual behaviour (20% had shared injecting equipment and 21% had had unprotected intercourse) in other states. In every locale, rates of unsafe injecting behaviour were high (55% sharing in last month), even among those who knew they were HIV infected, and rates of condom usage were low (93% of 160 sexually active IDUs had never used a condom). Syphilis was not associated with HIV infection, but with contact with Thai prostitutes.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hospital Besar, Kelantan, Malaysia.
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.forename: N
authors.initials: N
authors.lastname: Crofts
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation; D006801:Humans; D015994:Incidence; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009021:Morphine Dependence / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation; D016485:Needle Sharing / Q000009:adverse effects / Q000706:statistics & numerical data; D012725:Sexual Behavior; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000534:rehabilitation