title: HIV prevalence and risks among injection and noninjection drug users in northern Thailand: need for comprehensive HIV prevention programs.
abstract: The authors sought to determine sociodemographic and sexual and drug use risk factors for HIV infection among drug users in northern Thailand adjacent to the Golden Triangle. The authors enrolled patients admitted for inpatient drug detoxification at one treatment center in northern Thailand and studied HIV risks and prevalence using an interviewer-administered questionnaire and serum collection with HIV pretest and posttest counseling. Between February 1, 1999 and January 31, 2000, 1865 patients admitted for opiate and methamphetamine dependence completed study procedures. Overall HIV prevalence was 10.3%: 30.0% among 513 injection drug users (IDUs) and 2.8% among non-IDUs (OR = 14.8, 95% CI: 10.2, 21.6). HIV seroprevalence was 2.4% among exclusive methamphetamine users (98% of whom are non-IDUs) and 3.4% among opium smokers. Injection drug use was the dominant risk factor in multivariate models. Although Thailand is widely recognized as having a successful national response to the heterosexual HIV epidemic, seroprevalence in IDUs remains high. Despite a sharp increase of non-IDUs admitted to the drug treatment center, HIV infection and risks remained high among IDUs in northern Thailand. HIV prevention campaigns need to focus on IDUs and to implement harm reduction strategies to reduce transmission to IDUs and further contain the HIV epidemic in Thailand.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe Street (E-6008), Baltimore, MD 21205, U.S.A.
authors.forename: Myat Htoo
authors.initials: MH
authors.lastname: Razak
authors.forename: Jaroon
authors.initials: J
authors.lastname: Jittiwutikarn
authors.forename: Vinai
authors.initials: V
authors.lastname: Suriyanon
authors.forename: Tassanai
authors.initials: T
authors.lastname: Vongchak
authors.forename: Namtip
authors.initials: N
authors.lastname: Srirak
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
authors.forename: Surinda
authors.initials: S
authors.lastname: Kawichai
authors.forename: Sodsai
authors.initials: S
authors.lastname: Tovanabutra
authors.forename: Kittipong
authors.initials: K
authors.lastname: Rungruengthanakit
authors.forename: Pathom
authors.initials: P
authors.lastname: Sawanpanyalert
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D008297:Male; D008694:Methamphetamine; D015999:Multivariate Analysis; D009294:Narcotics; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology
chemical_list: D009294:Narcotics; D008694:Methamphetamine