title: A profile on HIV prevalence and risk behaviors among injecting drug users in Nigeria: should we be alarmed?
abstract: OBJECTIVE
  Injecting drug use is now recognized as a significant risk factor for HIV in sub-Saharan Africa. We evaluated prevalence and correlates of HIV among injecting drug users (IDUs) in Nigeria.
  
  
  METHODS
  A cross sectional design using respondent driven sampling was conducted in six states in 2010. Weighted HIV prevalence and injecting risk behaviors calculated using RDS analytic tool. Logistic regression was used to determine correlates of HIV infection, stratified by state.
  
  
  RESULTS
  Total numbers of IDUs ranged from 197 in Lagos to 273 in Cross River and Oyo states. HIV prevalence was highest in Federal Capital Territory (FCT) at 9.3%, Kaduna 5.8%, Oyo 5.1%, Kano 4.9%, CR 3.3% and Lagos 3.0%. Although >90% of participants were male, females had higher HIV prevalence in all states surveyed except FCT (range: 7.4% in CR to 37.7% in Kano). Logistic regression showed that females were significantly more likely to be HIV positive in Kano [OR=33.2, 95% CI: 6.8-160.4], Oyo [AOR=15.9, 95% CI: 3.69-68.51], Lagos [OR=15.5, 95% CI: 2.41-99.5] and Kaduna states [AOR=19.6, 95% CI: 4.4-87.6]. For injecting risk behavior, only receptive sharing was associated with HIV [AOR=7.6, 95% CI: 1.2-48.7] and [AOR=0.2, 95% CI: 0.04-0.92] in Oyo and Kaduna states respectively.
  
  
  CONCLUSIONS
  Considerable heterogeneity in the prevalence of HIV and associated risk behaviors exist among IDUs across Nigeria. Females had higher HIV prevalence among IDUs in five of six states, suggesting a need for targeted interventions for this hidden subgroup. Further research is needed to understand HIV transmission dynamics of IDUs in Nigeria. Community-based opioid substitution therapy and needle exchange programs should be implemented without delay.
authors: Population Council Nigeria, 3rd Floor, Bassan Plaza, Plot 759 Cadastral Zone AO, Central Business District, Abuja, Nigeria. geluwa@popcouncil.org
authors: George I
authors: GI
authors: Eluwa
authors: Steffanie A
authors: SA
authors: Strathdee
authors: Samson B
authors: SB
authors: Adebayo
authors: Babatunde
authors: B
authors: Ahonsi
authors: Sylvia B
authors: SB
authors: Adebajo
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000639:trends*; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult