title: Background demographics and risk behaviors of injecting drug users in Karachi, Pakistan.
abstract: OBJECTIVE
  To find the prevalence of HIV infection and risk behaviors among injecting drug users (IDUs) in Karachi, Pakistan.
  
  
  METHODS
  A cross-sectional study of IDUs conducted in Karachi, Pakistan from February through June 1996.
  
  
  RESULTS
  Of the 242 IDUs, 11 (4%) refused HIV testing. One (0.4%; 95% confidence interval (CI) = 0.37-0.48%) was HIV positive. All subjects were male. Over the past 6 months 47% had engaged in receptive needle sharing, 38% had perceived a change in their social network, 22% had had sexual intercourse, of whom only 7% always used condoms, and none had washed their needles with bleach. Younger age (28 vs. 31 years; p = 0.01), younger age at first injection (25 vs. 28 years; p = 0.001), fewer years of schooling (3 vs. 5 years; p = 0.001), lower monthly income (70 dollars vs. 80 dollars; p = 0.03), inhaling fumes of heroin from a foil in the year before injecting (OR = 4.8; CI = 2.2-10.3), injecting first time with heroin (OR = 3.6; CI = 1.2-12.6), having a temporary job (OR = 2.5; CI = 1.2-5.2), and a perceived change in one's social network (OR = 4.4; CI = 2.4-7.9) were all associated with receptive needle sharing. IDUs who knew about HIV spread through contaminated needles were less likely to share (OR = 0.4; CI 0.2-0.8). In the final logistic regression model receptive needle sharing was associated with inhaling of fumes of heroin on a foil in the year prior to injecting (adjusted OR = 5.6; CI = 2.6-12.0), a perceived change in one's social network (adjusted OR = 4.0; CI = 2.2-7.4), and inversely associated with age at first time of injection (beta = -0.07; p = 0.002).
  
  
  CONCLUSIONS
  Background HIV prevalence was low among IDUs in Karachi despite high-risk behavior in 1996. In order to control HIV transmission among IDUs in Pakistan, continual HIV surveillance with well-coordinated and effective HIV risk reduction, and drug demand reduction programs need to be implemented among drug users.
authors.affiliation: Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan. sparviz19@hotmail.com
authors.forename: Shehzad
authors.initials: S
authors.lastname: Parviz
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
authors.forename: Arshad
authors.initials: A
authors.lastname: Altaf
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
authors.forename: S
authors.initials: S
authors.lastname: Fischer-Hoch
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rahbar
authors.forename: Stephen
authors.initials: S
authors.lastname: Luby
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006678:HIV; D015658:HIV Infections / Q000276:immunology / Q000635:transmission; D006801:Humans; D008297:Male; D016485:Needle Sharing; D010154:Pakistan; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous