title: Factors associated with history of drug use among female sex workers (FSW) in a high HIV prevalence state of India.
abstract: BACKGROUND
  The intersection between illicit drug use and female commercial sex work has been identified as an important factor responsible for rising HIV prevalence among female sex workers (FSW) in several northeastern states of India. But, little is know about the factors associated with the use of drugs among FSWs in this region. The objective of the paper was to describe the factors associated with history of drug use among FSWs in Dimapur, an important commercial hub of Nagaland, which is a high HIV prevalence state of India.
  
  
  METHODS
  FSWs were recruited using respondent driven sampling (RDS), and were interviewed to collect data on socio-demographic characteristics and HIV risk behaviours. Biological samples were tested for HIV, syphilis gonorrhea and Chlamydia. Logistic regression analysis was performed to identify factors associated with drug use.
  
  
  RESULTS
  Among the 426 FSWs in the study, about 25% (n = 107) reported having ever used illicit drugs. Among 107 illicit drug users, 83 (77.6%) were non-injecting and 24 (22.4%) were injecting drug users. Drug-using FSWs were significantly more likely to test positive for one or more STIs (59% vs. 33.5%), active syphilis (27.1% vs. 11.4%) and Chlamydia infection (30% vs. 19.9%) compared to their non-drug using peers. Drug-using FSWs were also significantly more likely to be currently married, widowed or separated compared with non-drug-using FSWs. In multiple logistic regression analysis, being an alcohol user, being married, having a larger volume of clients, and having sexual partners who have ever used or shared injecting drugs were found to be independently associated with illicit drug use.
  
  
  CONCLUSIONS
  Drug-using FSWs were more vulnerable to STIs including HIV compared to their non-drug using peers. Several important factors associated with being an FSW who uses drugs were identified in this study and this knowledge can be used to plan more effectively targeted harm reduction strategies and programs.
authors.affiliation: Regional Medical Research Centre (RMRC), N.E. Region (ICMR), Dibrugarh, Assam, India. gkmedhi_ro@rediffmail.com
authors.forename: Gajendra Kumar
authors.initials: GK
authors.lastname: Medhi
authors.forename: Jagadish
authors.initials: J
authors.lastname: Mahanta
authors.forename: Michelle
authors.initials: M
authors.lastname: Kermode
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape
authors.forename: Rajatashuvra
authors.initials: R
authors.lastname: Adhikary
authors.forename: Sanjib Kumar
authors.initials: SK
authors.lastname: Phukan
authors.forename: P
authors.initials: P
authors.lastname: Ngully
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D013287:Illicit Drugs; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D013287:Illicit Drugs