Prevalence and risk factors associated with HIV-1 infection among people who inject drugs in Dar es Salaam, Tanzania: a sign of successful intervention?

Journal: Harm reduction journal

Volume: 17

Issue: 1

Year of Publication: 2021

Affiliated Institutions:  Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, United Nations Road, P.O. Box , Dar es Salaam, Tanzania. likindikoki@gmail.com. Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, United Nations Road, P.O. Box , Dar es Salaam, Tanzania. Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway. National AIDS Control Programme, Ministry of Health, Community Development, Gender, children and Elderly, Dodoma, Tanzania. Department of Behavioral Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.

Abstract summary 

Prevalence of HIV infection among people who inject drugs (PWID) has been reported to be higher than that of the general population. The present study aimed to estimate the prevalence of HIV infection and associated risk factors among PWID in Dar es Salaam, Tanzania, following the introduction of a comprehensive HIV intervention package (CHIP) for PWID in the country in 2014.We conducted an integrated bio-behavioral survey (IBBS) among PWID using respondent-driven sampling (RDS) in Dar es Salaam, Tanzania, between October and December 2017. Data on socio-demographic characteristics and risky behaviors were collected through face-to-face interviews. Blood samples were collected and tested for HIV infection. We accounted for weighting in the analyses, and logistic regression was performed to assess risk factors for HIV infection.A total of 611 PWID (94.4% males and 5.6% females) with a median age of 34 years (IQR 29-38) were recruited. The overall prevalence of HIV infection was 8.7% (95% CI 6.5-10.9). The prevalence of HIV infections for males and females were 6.8% (95% CI 4.7-8.9%) and 41.2% (95% CI 23.7-58.6%) respectively. Adjusted weighted logistic regression analysis (WLRA) showed that being a female (aOR 19.1; 95% CI 5.9-61.8), injecting drugs for more than 10 years (aOR = 7.32; 95% CI 2.1-25.5) compared to 1 year or less and being 45 years or older (aOR = 34.22; 95% CI 2.4-489.5) compared to being 25 years or younger were associated with increased odds of HIV infection. Use of a sterile needle at last injection decreased odds of HIV infection (aOR = 0.3; 95% CI 0.1-0.8).The present study observed a decline in prevalence of HIV infections among PWID in Dar es Salaam (8.7%) compared to a previous estimate of 15.5% from an IBBS conducted in 2013. Despite the decrease, HIV prevalence remains high among PWID compared to the general population, and women are disproportionally affected. The decline may be possibly attributed to the on-going implementation of CHIP for PWID, highlighting the need for strengthening the existing harm reduction interventions by incorporating access to sterile needle/syringe and addressing the layered risks for women.

Authors & Co-authors:  Likindikoki Samuel Lazarus SL Mmbaga Elia John EJ Leyna Germana Henry GH Moen Kåre K Makyao Neema N Mizinduko Mucho M Mwijage Alex Ishungisa AI Faini Diana D Leshabari Melkizedeck Thomas MT Meyrowitsch Dan Wolf DW

Study Outcome 

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Statistics
Citations :  Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, Wodak A, Panda S, Tyndall M, Toufik A, Mattick RP. 2007 Reference Group to the UNon HIV and Injecting Drug Use. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–1745.
Authors :  10
Identifiers
Doi : 18
SSN : 1477-7517
Study Population
Males,Women,Female,Females
Mesh Terms
Adult
Other Terms
HIV;IBBS;Injection drug use;Prevalence;Risk factors;Tanzania
Study Design
Study Approach
Country of Study
Tanzania
Publication Country
England