HIV prevalence and risk behaviors of male injection drug users in Cairo, Egypt.
OBJECTIVE
To measure HIV prevalence and related risk behaviors among male injection drug users (IDUs) in Cairo, Egypt in the context of the first survey wave of an integrated biological and behavioral surveillance system.


METHODS
Given the hidden nature of injection drug use, we used the peer-referral methodology of respondent-driven sampling in a cross-sectional study to recruit a sample of male IDUs in Cairo between May and August 2006. Behavioral data were collected through face-to-face interviews and serum was obtained for HIV antibody testing. Population estimates were produced using respondent-driven sampling Analysis Tool.


RESULTS
The study enrolled 413 male IDUs. The population estimated HIV prevalence was 0.6% (95% confidence interval 0.1-1.8). More than half (53.0%) reported injecting drugs with used needles or syringes and nearly one-third (32.4%) shared their used needle or syringe with one or more persons in the preceding month. Overall, 70.5% had sex in the preceding year, of whom 9.4% reported sex with male partners and 13.2% reported sex with commercial sex workers in the preceding 12 months. Ever use of a condom during sex was low with all partner types and only 5.8% ever had an HIV test.


CONCLUSIONS
This first survey wave of integrated biological and behavioral surveillance system in Egypt to track the HIV epidemic among male IDUs found relatively low prevalence of infection compared to global estimates, though the figure is many times higher than the general population. In addition, risky injection practices and unprotected sex were high with sexual networks including men who have sex with men, female sex workers, wives, and other regular and casual partners. The respondent-driven sampling method was effective in recruiting male IDUs and the results are being used to inform surveillance and prevention programs.
Soliman
Cherif
C
aFamily Health International, Egypt bMinistry of Health, Egypt cSocial Research Center, The American University in Cairo, Cairo, Egypt.
Rahman
Ihab A
IA
Shawky
Sherine
S
Bahaa
Tarek
T
Elkamhawi
Sherif
S
El Sattar
Ali Abd
AA
Oraby
Doaa
D
Khaled
Dina
D
Feyisetan
Bamikale
B
Salah
Ehab
E
El Taher
Zein
Z
El Sayed
Nasr
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D015153:Blotting, Western; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult