News - HIV: Female Injection Drug Users At Higher Risk, Says Study

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 FEMALE injection drug users (IDUs) in Nigeria have higher risk of contracting the dreaded Human Immuno-deficiency Virus (HIV) that causes Acquired Immune Deficiency Syndrome (AIDS) than their male counterparts.

A study by researchers at Population Council Nigeria and the National Agency for Food and Drug Administration and Control (NAFDAC), and their United States counterparts at the University of California, San Diego, found that high risk intercourseual lifestyle, coupled with high risk injecting behaviour, will continue to propagate HIV transmission between IDUs and between IDUs and the general population, unless appropriate prevention services are in place.

The researchers include: George Eluwa, Steffanie A. Strathdeeb, Samson B. Adebayo, Babatunde Ahonsia and Sylvia B. Adebajoa.

The researchers found that IDUs are a hidden population and female IDUs are doubly so.

They wrote: "High HIV prevalence in females is indeed a cause for alarm, which necessitates further research on female IDUs. Determinants of injecting risk behaviours and the intercourseual dynamics of IDUs also need to be explored to inform programme and policies for IDUs."

"Furthermore, the size of IDUs in Nigeria also needs to be estimated through evidence-based methodologies such as capture-recapture. Finally, efforts should be made to include integrated programmes for IDUs at the national and state levels to enable a more coordinated HIV prevention, treatment and care programme in Nigeria."

The study titled: 'A profile on HIV prevalence and risk behaviours among injecting drug users in Nigeria: Should we be alarmed?' was published in Drug and Alcohol Dependence.

Also, a recent a systematic review and meta-analysis on mortality among people who inject drugs by the World Health Organisation (WHO) showed that people who do so have a much higher risk of death than those who do not.

The review published in the Bulletin of the World Health Organisation concluded: "Major causes of death in this group are often poorly specified, but death from drug overdose is common, as is AIDS-related mortality in settings with a high prevalence of HIV infection. HIV positive people who inject drugs have higher mortality not just from HIV-related causes but also from drug overdose.

"Mortality varies by participant- and study-level characteristics, which suggests that multiple factors contribute to the higher risk of death observed in people who inject drugs. Many of these factors are probably modifiable, since certain predominant causes of death account for most of the mortality observed in this group."

The Nigerian study is the first study to use respondent-driven sampling (RDS) to provide relatively unbiased estimates of HIV and risk behaviours among IDUs in Nigeria. It is an improvement of the 2007 Integrated Biologic and Behavioural Surveillance (IBBS) Survey and provides state level analysis of HIV prevalence and injecting risk behaviors.

They concluded: "This shows the higher burden of HIV among IDUs and necessitates immediate HIV prevention intervention among this high risk population. Applying criteria from Joint United Nations Programme on AIDS (UNAIDS, 2007), HIV prevalence among IDUs may be classified as being a concentrated epidemic in three of the six states we studied (that is, FCT, Oyo and Kaduna)."

Injecting drug use is now recognised as a significant risk factor for HIV in sub-Saharan Africa. The researchers evaluated prevalence and correlates of HIV among IDUs in Nigeria. A cross sectional design, using RDS was conducted in six states in 2010. Weighted HIV prevalence and injecting risk behaviors were calculated using RDS analytic tool. Logistic regression was used to determine correlates of HIV infection, stratified by state.

The results showed that the total numbers of IDUs ranged from 197 in Lagos to 273 in Cross River and Oyo States. HIV prevalence was highest in the Federal Capital Territory (FCT) at 9.3 per cent, Kaduna 5.8 per cent, Oyo 5.1 per cent, Kano 4.9 per cent, Cross River (CR) 3.3 per cent and Lagos 3.0 per cent.



The Guardian

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