title: Alarming epidemics of human immunodeficiency virus and hepatitis C virus among injection drug users in the northwestern bordering state of Punjab, India: prevalence and correlates.
abstract: In this study 1155 injection drug users (IDUs) receiving targeted intervention in five cities of Punjab were surveyed; three cities (Amritsar, Taran-Taran, Batala) were in districts sharing an international border with Pakistan and the other two were Jalandhar and Ludhiana. Information on socio-demography, substance use and sexual practices were collected; blood samples were tested for biologic markers. HIV and HCV antibody (HCVAb) prevalences in injection drug users were 29 and 49%, respectively. Of the HCVAb-seroreactive IDUs, 33% had HIV as well. HIV prevalence in young IDUs (≤19 years), estimated as surrogate for HIV incidence, was high at 12% and HCVAb in this subgroup was 27%. Herpes simplex virus 2 antibody (IgG) was detected in 10% of IDUs; 2% had syphilis. Alcohol use prevalence was high and frequency of use concerning. In multivariate analyses, 'city of residence closer to international border' and '>1 year duration of injecting drugs were associated with HIV and HCVAb. Furthermore, 'irregular supply of syringes and needles' was associated with HCVAb seroreactive status of IDUs (adjusted odds ratio 1.7; 95% CI 1.3-2.3;P < 0.001), and 'any genital disease symptom within the last year' (adjusted odds ratio 2; 95% CI 1.4-2.9;P < 0.001) was associated with HIV infection. Alcohol and sexual risk reduction, strengthening of needle-syringe exchange, reducing injecting duration and clinical management of HIV, HCV and HIV/HCV co-infection appear as four core programme needs.
authors.affiliation: National Institute of Cholera and Enteric Diseases (NICED)/ICMR, Beliaghata, Kolkata, India pandasamiran@gmail.com.
authors.forename: Samiran
authors.initials: S
authors.lastname: Panda
authors.affiliation: NICED Project on Baseline assessment among IDUs in Punjab, Kolkata, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Roy
authors.affiliation: NICED Project on Baseline assessment among IDUs in Punjab, Kolkata, India.
authors.forename: Sobha
authors.initials: S
authors.lastname: Pahari
authors.affiliation: HIV Prevention Advisor Abt JTA, Australia.
authors.forename: Jyotiee
authors.initials: J
authors.lastname: Mehraa
authors.affiliation: Blood Bank, Amritsar Medical College, Amritsar, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Blood Bank, Civil Hospital, Jalandhar, India.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Singh
authors.affiliation: Blood Bank, Civil Hospital, Ludhiana, India.
authors.forename: Jasbir
authors.initials: J
authors.lastname: Singh
authors.affiliation: India HIV/AIDS Alliance, New Delhi, India.
authors.forename: Francis
authors.initials: F
authors.lastname: Joseph
authors.affiliation: Punjab State AIDS Control Society, Chandigarh, India.
authors.forename: Sukhvinder
authors.initials: S
authors.lastname: Singh
authors.affiliation: Punjab State AIDS Control Society, Chandigarh, India.
authors.forename: Narinder M
authors.initials: NM
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies
keywords: AIDS; Indian subcontinent; Syphilis; epidemiology; human immunodeficiency virus; injecting drug use; sexually transmitted infections; sexually transmitted viral diseases