title: Findings from integrated behavioral and biologic survey among males who inject drugs (MWID) - Vietnam, 2009-2010: evidence of the need for an integrated response to HIV, hepatitis B virus, and hepatitis C virus.
abstract: BACKGROUND
  Given the overlapping modes of transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV), understanding the burden and relationship of these infections is critical for an effective response. Representative data on these infections among males who inject drugs (MWID), the key high-risk population for HIV in Vietnam, are currently lacking.
  
  
  METHODS
  Data and stored specimens from Vietnam's 2009-2010 Integrated Biologic and Behavioral Survey, a cross-sectional study among high-risk populations, were used for this analysis. Plasma samples were tested for HIV, HBV, and HCV using commercial assays. A questionnaire was administered to provide demographic, behavior, and service-uptake information. Provincial-level analyses were conducted to profile MWID enrollees and to provide estimates on the prevalence of HIV, HBV, and HCV infection.
  
  
  RESULTS
  Among 3010 MWID sampled across 10 provinces, the median (range) HIV prevalence was 28.1% (1.0%-55.5%). Median prevalence for current HBV infection (HBsAg+) was 14.1% (11.7%-28.0%), for previous exposure to HBV (total anti-HBc+) was 71.4% (49.9%-83.1%), and for current or past HCV infection (HCV Ag/Ab+) was 53.8% (10.9%-80.8%). In adjusted analysis, HBsAg+ (aOR: 2.09, 1.01-4.34) and HCV Ag/Ab+ (aOR: 19.58, 13.07-29.33) status were significantly associated with HIV infection; the association with total anti-HBc+ approached significance (aOR: 1.29, 0.99-1.68).
  
  
  CONCLUSIONS
  The prevalence and association between HIV, HBV, and HCV are high among MWID in Vietnam. These findings indicate the need for integrated policies and practice that for the surveillance, prevention, screening, and treatment of both HIV and viral hepatitis among MWID in Vietnam.
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Hanoi, Vietnam; Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nadol
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, Georgia, United States of America.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'connor
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Hanoi, Vietnam.
authors.forename: Hao
authors.initials: H
authors.lastname: Duong
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Hanoi, Vietnam.
authors.forename: Linh-Vi N
authors.initials: LV
authors.lastname: Le
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Pham Hong
authors.initials: PH
authors.lastname: Thang
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Tran Hong
authors.initials: TH
authors.lastname: Tram
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Hoang Thi Thanh
authors.initials: HT
authors.lastname: Ha
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Hanoi, Vietnam.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Mcconnell
authors.affiliation: U.S. Centers for Disease Control and Prevention, Division of Influenza Control, Atlanta, Georgia, United States of America.
authors.forename: Jeff
authors.initials: J
authors.lastname: Partridge
authors.affiliation: Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.affiliation: Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Law
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Tuan Anh
authors.initials: TA
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000821:virology*; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult