title: High Mortality Among Non-HIV-Infected People Who Inject Drugs in Bangkok, Thailand, 2005-2012.
abstract: OBJECTIVE
  We examined the causes of hospitalization and death of people who inject drugs participating in the Bangkok Tenofovir Study, an HIV preexposure prophylaxis trial.
  
  
  METHODS
  The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial conducted during 2005 to 2012 among 2413 people who inject drugs. We reviewed medical records to define the causes of hospitalization and death, examined participant characteristics and risk behaviors to determine predictors of death, and compared the participant mortality rate with the rate of the general population of Bangkok, Thailand.
  
  
  RESULTS
  Participants were followed an average of 4 years; 107 died: 22 (20.6%) from overdose, 13 (12.2%) from traffic accidents, and 12 (11.2%) from sepsis. In multivariable analysis, older age (40-59 years; P = .001), injecting drugs (P = .03), and injecting midazolam (P < .001) were associated with death. The standardized mortality ratio was 2.9.
  
  
  CONCLUSIONS
  People who injected drugs were nearly 3 times as likely to die as were those in the general population of Bangkok and injecting midazolam was independently associated with death. Drug overdose and traffic accidents were the most common causes of death, and their prevention should be public health priorities.
authors.affiliation: Suphak Vanichseni, Pravan Suntharasamai, Udomsak Sangkum, and Kachit Choopanya are with the Bangkok Tenofovir Study Group, Bangkok, Thailand. Michael Martin, Philip A. Mock, Marcel E. Curlin, and Benjamaporn Chaipung are with the Thailand Ministry of Public Health, US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. Somyot Kittimunkong is with the Thailand Ministry of Public Health, Nonthaburi. Roman J. Gvetadze, Janet M. McNicholl, and Lynn A. Paxton are with the Centers for Disease Control and Prevention, Atlanta, GA. Manoj Leethochawalit and Sithisat Chiamwongpaet are with the Bangkok Metropolitan Administration, Bangkok, Thailand.
authors.forename: Suphak
authors.initials: S
authors.lastname: Vanichseni
authors.forename: Michael
authors.initials: M
authors.lastname: Martin
authors.forename: Pravan
authors.initials: P
authors.lastname: Suntharasamai
authors.forename: Udomsak
authors.initials: U
authors.lastname: Sangkum
authors.forename: Philip A
authors.initials: PA
authors.lastname: Mock
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Gvetadze
authors.forename: Marcel E
authors.initials: ME
authors.lastname: Curlin
authors.forename: Manoj
authors.initials: M
authors.lastname: Leethochawalit
authors.forename: Sithisat
authors.initials: S
authors.lastname: Chiamwongpaet
authors.forename: Benjamaporn
authors.initials: B
authors.lastname: Chaipung
authors.forename: Janet M
authors.initials: JM
authors.lastname: McNicholl
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Paxton
authors.forename: Somyot
authors.initials: S
authors.lastname: Kittimunkong
authors.forename: Kachit
authors.initials: K
authors.lastname: Choopanya
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality; D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D002423:Cause of Death; D004311:Double-Blind Method; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D063065:Organophosphonates / Q000008:administration & dosage; D065129:Pre-Exposure Prophylaxis; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000401:mortality*; D011795:Surveys and Questionnaires; D000068698:Tenofovir; D013785:Thailand / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine