HIV infection risk among injection drug users in a methadone maintenance treatment program, Taipei, Taiwan 2007-2010.
BACKGROUND
Taiwan has a growing HIV/AIDS epidemic that has recently shifted to an increase among injection drug users (IDUs). This study aimed to measure the prevalence and incidence and identify the correlates of HIV infection among IDUs in a large methadone maintenance treatment program (MMTP) in Taipei, Taiwan.


METHODS
Data from intake interviews and HIV testing completed by IDUs upon admission to the Taipei City Hospital MMTP in 2007-2010 were included in this analysis. HIV testing was repeated semi-annually among maintained clients who were HIV-negative during MMTP admission.


RESULTS
Of 1444 IDUs admitted, 85.9% were male, median age was 40 years, and mean years of injecting was 14.3 (range: 1-64). The prevalence of HIV, HCV, and HIV/HCV co-infection was 13.4%, 91.1%, and 13.2%, respectively. In multivariable analysis, HIV infection was associated with sharing syringes during the 6 months prior to admission (OR = 14.76, 95% CI 10.31-21.13), homelessness (OR = 6.46, 95% CI 1.49-28.00), and lifetime number of MMTP admissions (OR = 1.76, 95% CI 1.30-2.38) and times incarcerated (OR = 1.10, 95% CI 1.03-1.18). HIV seroincidence was 1.15/100 person-years at risk (95% CI .62-8.77/100 PY) among IDUs who were HIV-negative at first admission.


CONCLUSIONS
Taiwanese IDUs in MMTP have a high HIV prevalence, which was associated with syringe sharing and other factors related to social marginalization. Our findings highlight the importance of harm reduction programs, including syringe exchange, along with HIV-prevention education.
Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, No.145 Zhengzhou Rd., Taipei, Taiwan. dam37@tpech.gov.tw
Yung-Feng
YF
Yen
Timothy C
TC
Rodwell
Muh-Yong
MY
Yen
Yun-Hsia
YH
Hsu
Peing
P
Chuang
Lan-Huei
LH
Li
Lien-Wen
LW
Su
Yi-Hong
YH
Yang
Xiao-Ru
XR
Jiang
Yung-Chun
YC
Fang
Richard S
RS
Garfein
D015492:AIDS Serodiagnosis / Q000379:methods; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D018023:HIV Seronegativity; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D015999:Multivariate Analysis; D016485:Needle Sharing / Q000706:statistics & numerical data; D058850:Opiate Substitution Treatment / Q000379:methods; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D062487:Social Marginalization; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000534:rehabilitation; D013624:Taiwan / Q000453:epidemiology
D008691:Methadone