Sexual behavior among injection drug users in 3 indonesian cities carries a high potential for HIV spread to noninjectors.
OBJECTIVE
To establish the prevalence of injecting practices that carry a risk of HIV infection among injection drug users (IDUs) in Indonesia and to examine the risk of sexual transmission of HIV from IDUs to noninjecting populations.


METHODS
A first round of behavioral surveillance among community-recruited male IDUs in 3 cities.


METHODS
In late 2002, IDU gathering places were mapped in 3 cities, and 650 IDUs were recruited using multiple wave sampling originating from sites systematically selected for diversity. Trained interviewers, mostly former IDUs, administered a questionnaire focusing on injecting practices, sexual behavior, and HIV-related knowledge.


RESULTS
Almost all IDUs knew that HIV is transmissible through shared needles, but 85% of injectors reported using a syringe previously used by another IDU in the previous week. Over two thirds of IDUs were sexually active, 48% reported multiple partners, and 40% had bought sex from a female sex worker in the preceding 12 months. Consistent condom use was reported by 10%.


CONCLUSIONS
The potential for the sexual spread of HIV from IDUs to noninjectors is extremely high in Indonesia. Interventions are urgently needed to reduce high levels of needle sharing, but a focus on needle cleaning and increasing condom use among IDUs is also essential.
Pisani
Elizabeth
E
Family Health International, Asia Regional Office, Bangkok, Thailand. episani@fhi.or.id
Dadun
Sucahya
Purwa K
PK
Kamil
Octavery
O
Jazan
Saiful
S
D000293:Adolescent; D000328:Adult; D017280:Condoms; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D015497:HIV-1; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work; D012725:Sexual Behavior; D012923:Social Class; D015819:Substance Abuse, Intravenous / Q000821:virology*; D011795:Surveys and Questionnaires