title: High prevalence of HIV, HCV and tuberculosis and associated risk behaviours among new entrants of methadone maintenance treatment clinics in Guangdong Province, China.
abstract: BACKGROUND
  Methadone maintenance treatment (MMT) has been available in Guangdong province, China since 2006. This study aims to estimate the prevalence levels of HIV, Hepatitis C (HCV), Tuberculosis (TB) and their co-infections and associated demographic and risk behaviours among MMT entrants.
  
  
  METHODS
  A total of 2296 drug users at the time of their MMT enrolment were recruited from four clinics during 2006-2011. Participants' demographic characteristics, infection status and self-reported high-risk drug-use and sexual behaviours were surveyed. Log-linear contingency analysis was employed to investigate the demographic and behavioural differences between gender and drug-user type, while multivariate regression analysis was used to identify the associated factors of HIV, HCV and TB infections.
  
  
  RESULTS
  Female drug users demonstrate significantly higher frequency of daily drug consumption (Log-linear contingency analysis, G(2)=10.86, p=0.013) and higher proportion of having had sex in the past three months (G(2)=30.22, p<0.001) than their male counterparts. Among injecting drug users, females also inject (χ(2)=16.15, p=0.001) and share syringes (χ(2)=13.24, p=0.004) more frequently than males. Prevalence of HIV, HCV and TB among MMT entrants are 6.3%, 78.7% and 4.4% respectively. Co-infections of HIV/HCV, HIV/TB, HCV/TB and HIV/HCV/TB reportedly infect 5.6%, 0.5%, 3.8% and 0.3% of study participants. Infection risks of HIV, HCV and TB are consistently associated with increasing length of drug use, injecting drugs, financial dependence and reduced sexual activities.
  
  
  CONCLUSIONS
  Injecting drug use is the major contributing factor in prevalence levels of HIV, HCV and TB among MMT entrants. Female drug users are more disadvantaged in their social status and risk-taking in their drug use behaviours than males.
authors.affiliation: Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, P. R. China ; The Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Di
authors.initials: D
authors.lastname: Zhang
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.forename: Xia
authors.initials: X
authors.lastname: Zou
authors.forename: Li
authors.initials: L
authors.lastname: Ling
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D060085:Coinfection; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000453:epidemiology*; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone