title: High prevalence of syringe lending among HIV-positive people who inject drugs in Bangkok, Thailand.
abstract: BACKGROUND
  Syringe sharing continues to be a major driver of the HIV pandemic. In light of efforts to enhance access to sterile syringes and promote secondary prevention among HIV-positive individuals, we sought to identify the prevalence and correlates of used syringe lending among self-reported HIV-positive people who inject drugs (PWID) in Bangkok, Thailand.
  
  
  RESULTS
  We used bivariable statistics to examine factors associated with self-reported syringe lending among self-reported HIV-positive PWID participating in the Mitsampan Community Research Project, a serial cross-sectional study of PWID in Bangkok, between June 2009 and October 2011. In total, 127 individuals were eligible for this analysis, including 25 (19.7%) women. Twenty-one (16.5%) participants reported syringe lending in the prior 6 months. Factors significantly associated with syringe lending included daily methamphetamine injection (odds ratio (OR) = 10.2, 95% CI, 2.1-53.6), daily midazolam injection (OR = 3.1, 95% CI, 1.1-8.7), use of drugs in combination (OR = 4.5, 95% CI, 1.0-41.6), injecting with others on a frequent basis (OR = 4.25, 95% CI, 1.3-18.3), and not receiving antiretroviral therapy (OR = 2.9, 95% CI, 1.1-7.9).
  
  
  CONCLUSIONS
  A high prevalence of syringe lending was observed among self-reported HIV-positive PWID in Bangkok, which was associated with high intensity drug use, polysubstance use, and frequently injecting with others. It is particularly concerning that individuals who lent syringes were more likely to be untreated for HIV disease given the known benefits of antiretroviral provision on the prevention of HIV transmission. These findings underscore the need to expand access to sterile syringes and HIV treatment among HIV-positive PWID in Thailand.
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. pvoon@cfenet.ubc.ca.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. pvoon@cfenet.ubc.ca.
authors.forename: Pauline
authors.initials: P
authors.lastname: Voon
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. khayashi@cfenet.ubc.ca.
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. mintti@cfenet.ubc.ca.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. mintti@cfenet.ubc.ca.
authors.forename: Lianping
authors.initials: L
authors.lastname: Ti
authors.affiliation: Thai AIDS Treatment Action Group, Bangkok, Thailand. karyn.kaplan@treatmentactiongroup.org.
authors.forename: Karyn
authors.initials: K
authors.lastname: Kaplan
authors.affiliation: Thai AIDS Treatment Action Group, Bangkok, Thailand. paisan.suwannawong@gmail.com.
authors.forename: Paisan
authors.initials: P
authors.lastname: Suwannawong
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-ew@cfenet.ubc.ca.|Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada. uhri-ew@cfenet.ubc.ca.
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-tk@cfenet.ubc.ca.|Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology