Factors associated with incarceration and incident human immunodeficiency virus (HIV) infection among injection drug users participating in an HIV vaccine trial in Bangkok, Thailand, 1999-2003.
OBJECTIVE
To determine if incarceration was associated with human immunodeficiency virus (HIV) infection and identify risk factors for incarceration among injection drug users (IDUs) participating in an HIV vaccine trial in Bangkok.


METHODS
The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled study. A proportional hazards model was used to evaluate demographic characteristics, risk behavior and incarceration as predictors of HIV infection and generalized estimation equation logistic regression analysis to investigate demographic characteristics and risk behaviors for predictors of incarceration.


METHODS
The trial was conducted in Bangkok Metropolitan Administration drug-treatment clinics, 1999-2003.


METHODS
A total of 2546 HIV-uninfected IDUs enrolled in the trial.


METHODS
HIV testing was performed and an interviewer-administered questionnaire was used to assess risk behavior and incarceration at baseline and every 6 months for a total of 36 months.


RESULTS
HIV incidence was 3.4 per 100 person-years [95% confidence interval (CI), 3.0-3.9] and did not differ among vaccine and placebo recipients. In multivariable analysis, being in jail (P < 0.04), injecting (P < 0.0001), injecting daily (P < 0.0001) and sharing needles (P = 0.02) were associated with HIV infection and methadone maintenance was protective (P = 0.0006). Predictors of incarceration in multivariable analysis included: male sex (P = 0.04), younger age (P < 0.0001), less education (P = 0.001) and being in jail (P < 0.0001) or prison (P < 0.0001) before enrollment.


CONCLUSIONS
Among IDUs in the AIDSVAX B/E trial, incarceration in jail was associated with incident HIV infection. IDUs in Thailand remain at high risk of HIV infection and additional prevention tools are needed urgently. HIV prevention services, including methadone, should be made available to IDUs.
Suntharasamai
Pravan
P
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Martin
Michael
M
Vanichseni
Suphak
S
van Griensven
Frits
F
Mock
Philip A
PA
Pitisuttithum
Punnee
P
Tappero
Jordan W
JW
Sangkum
Udomsak
U
Kitayaporn
Dwip
D
Gurwith
Marc
M
Choopanya
Kachit
K
D016915:AIDS Vaccines / Q000008:administration & dosage*; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D004311:Double-Blind Method; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics; D016485:Needle Sharing; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
D016915:AIDS Vaccines; C112734:AIDSVAX; D009294:Narcotics; D008691:Methadone