title: A cross-sectional assessment of utilization of addiction treatment among injection drug users in Kabul, Afghanistan.
abstract: The purpose of this study was to describe prior use of detoxification and addiction-treatment programs among injection drug users (IDUs) in Kabul, Afghanistan. From 2005-2006, IDUs (n = 464) recruited into this cross-sectional study completed an interviewer-administered questionnaire and whole blood rapid testing with fingerstick samples for HIV, syphilis, and hepatitis C antibody and B surface antigen testing. Participants were predominantly male (99.8%), Afghan (98.9%), and had little formal education. Correlates of detoxification and addiction treatment were identified with logistic regression. The majority (94.0%, n = 435) felt great/urgent need for treatment, of whom 56.3% (n = 245) reported inability to access treatment. Prior detoxification was associated with new needle use with each injection (AOR = 1.91, 95% CI: 1.12-3.26) and prior incarceration (AOR = 1.81, 95% CI: 1.04-3.13). The study's limitations are noted. Rapid scale-up and subsidy of needle and syringe programs and opioid agonist treatment is urgently needed in Kabul.
authors.affiliation: Department of Family & Preventive Medicine, University of California, San Diego, California, USA. cstodd@ucsd.edu
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Todd
authors.forename: Abdullah M S
authors.initials: AM
authors.lastname: Abed
authors.forename: Paul T
authors.initials: PT
authors.lastname: Scott
authors.forename: Naqibullah
authors.initials: N
authors.lastname: Safi
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Earhart
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000293:Adolescent; D000346:Afghanistan; D003430:Cross-Sectional Studies; D006801:Humans; D008658:Inactivation, Metabolic; D007407:Interviews as Topic; D008297:Male; D018671:Needle-Exchange Programs; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous; D055815:Young Adult