OBJECTIVETo estimate the number of drug users in Hongjiang, Hunan and to develop strategy for drug reduction in the future.

METHODSTwo capture-recapture methods were used to estimate the numbers of drug addicts. Random stratified sampling survey was used to verify the optimum allocation. The first capture-recapture method (CR1) referred to the number from optimum allocation random stratified sampling survey conducted in the communities and the number from local Public Security Bureau list being the second capture. The second capture-recapture method (CR2) referred to the collection of records in the detoxification unit with an interval of 4 months. The estimated number was calculated under Seber's adjustment formula. Face to face interview was carried out during the optimum allocation random stratified sampling survey process.

RESULTSOf 1388 interviewed in the communities, 24 (1.73%) were identified as drug addicts under the optimum allocation random stratified sampling survey. When the figure 1.73% was applied to the total population (72,709) in Hongjiang, the result yielded an estimation of 1258 drug addicts. The estimated numbers of CR1 and CR2 were 904 and 1069 respectively. However, the number was 1.3 to 1.6 fold higher than the reported number (687) by local Public Security Bureau.

CONCLUSIONThe capture-recapture method seemed a better method in estimating the number of drug addicts.

China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Needle Sharing ; Population Surveillance ; methods ; Substance Abuse, Intravenous ; epidemiology

OBJECTIVETo understand the risks and associated factors of HIV transmission by sharing syringes among HIV-positive drug users.

METHODThe survey was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received HIV counseling, testing and treatment in Changsha city Infectious Disease Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to understand their socio-demographic characteristics, HIV prevalence and syringe sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact list of 2 460 drug users who had the syringe sharing experience over one month with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due to sharing syringe with at least one drug user. Among them, 234 HIV-negative persons were in control group, and 186 HIV-positive were in cased group. A total of 1 220 drug users were followed up among 2 460 and defined as vulnerable population. The HIV transmission rate was calculated based on the HIV prevalence among vulnerable population. Based on the result of HIV transmission to vulnerable population from 420 infection sources, case-control study and the multivariate logistic regression analysis were adopted to explore the associated factors of HIV transmission among IDUs-HIV+.

RESULTSAs the sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ± 1.2) years for drug use. As a susceptible population, 1 220 drug users sharing syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug users, with a transmission rate of 0.57. In the case-control study, the proportion of male subjects was 87.1% (162/186) in the case group, which was higher than that in the control group (77.8%, 182/234). The proportion of subjects who received support after knowing their HIV infection status was 51.1% (95/186) in the case group, which was lower than that in the control group (79.5%, 186/234). The proportion of subjects sharing syringes every time of using drugs was 47.8% (89/186) in the case group, which was higher than that in the control group (36.8%, 86/234). The proportion of subjects having AIDS awareness was 21.0% (39/186) in the case group, which was lower than that in the control group (64.5%, 151/234); the proportion of subjects having close contact with HIV-positive persons for more than 106 days was 60.2% (112/186) in the case group, which was higher than that in the control group (31.6%, 74/234). The proportion of subjects maintaining the original drug use method after being infected with HIV was 50.5% (94/186) in the case group, which was higher than that in the control group (16.7%, 39/234) (all P values < 0.05). The multivariate logistic regression analysis was carried out to analyse high correlate factors of HIV transmission by sources of transmission, and the AIDS awareness, duration of contact between sources of transmission and vulnerable population, access to support following confirmed HIV infection were protective factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and 0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and continuous drug use after being infected with HIV were risk factors, and the OR (95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.

CONCLUSIONHIV transmission by IDUs-HIV+ might be contained by raising AIDS awareness, providing comprehensive psychological support, conducting needle exchange and methadone maintenance treatment and reducing syringe sharing.

Aged ; Case-Control Studies ; Drug Users ; HIV Infections ; Humans ; Male ; Methadone ; Needle Sharing ; Prevalence ; Risk Factors ; Substance Abuse, Intravenous

OBJECTIVE: This study was performed to determine the prevalence and age-adjusted prevalence of anti-HCV antibody among the employees and their partners in Korea, and whether prevalence varies with job type. METHOD: The blood serum of 29, 278 people, employees and their partners aged between 20 and 60 residing in Seoul or Kyung-gee province, were tested with Immunoradiometric Assay (IRMA) method using third generation anti-HCV serum. RESULTS: Twenty-five among the 29, 278 people tested positive; a prevalence rate of 0.9 per 1, 000 (95% CI 0.6-1.3). The prevalences of different age groups were 0, 0.5, 1.3, and 4.2 per 1, 000 among the subjects in their 20s, 30s, 40s and 50s respectively, which shows the increasing rate of prevalence with age. Age adjusted prevalence among employees was 1.3 per 1, 000. The prevalences among different kinds of job were 1.9 per 1, 000 (95% CI: 0.5~7.0) for construction, 1.7 per 1, 000 (95% CI: 0.7~3.9) for finance, and 1.2 per 1, 000 (95% CI: 0.2~6.6) for telecommunication. No significant statistical difference was found in the prevalence according to job type(p>0.05). CONCLUSIONS: Employees in Korea showed a lower prevalence rate of anti-HCV antibody than that of blood donors, health screening examinees and the general population. This result is in line with that of other studies abroad and is considered to be because employees may have lower rates of Hepatitis C risk activities, such as needle sharing, than unemployed.
Blood Donors ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoradiometric Assay ; Korea* ; Mass Screening ; Needle Sharing ; Prevalence* ; Seoul ; Serum ; Telecommunications

OBJECTIVETo investigate prevalence of human immunodeficiency virus (HIV) infection and risk factors for its transmission among injection drug users (IDUs) in Liangshan Yizu Autonomous Prefecture of Sichuan Province, China.

METHODSA community-based survey was conducted to investigate demographic characteristics, pattern and frequency of sharing injection equipment, and sexual behaviors in IDUs. Blood samples were also collected from them to detect for antibodies against HIV and syphilis.

RESULTSA total of 379 subjects were recruited with informed consent for study through community outreach and peer recruiting methods. Their prevalence of HIV infection was 11.3% (43/379). Ethnicity, frequency of sharing syringes and cotton swab during the past three months and syphilis infection associated with HIV infection by univariate analysis using chi-square test. Multivariate logistic regression analysis showed odds ratio of frequency of sharing syringes for HIV infection during the past three months was 2.28 (95% CI 1.18 - 4.43), and that for syphilis infection 3.10 (95% CI 1.48 - 6.48).

CONCLUSIONFrequency of sharing syringes during the past three months associated with syphilis and HIV infection.

Adolescent ; Adult ; China ; epidemiology ; Disease Transmission, Infectious ; Female ; HIV Infections ; epidemiology ; transmission ; Humans ; Logistic Models ; Male ; Needle Sharing ; adverse effects ; Prevalence ; Sexual Behavior ; Substance Abuse, Intravenous ; virology

OBJECTIVETo determine the incidence and risk factors on HIV infection among injection drug users (IDU) in Dehong prefecture area of Yunnan province.

METHODSAn epidemiological cohort of HIV-negative IDU had been developed and followed since October, 2004. HIV new infections and related behaviors had been investigated every six months.

RESULTSBy the end of 2008, 760 HIV-negative IDU had been recruited and followed for a total of 1153.6 person-years. 47 new HIV infections were identified, with an overall incidence of 4.07/100 person-years during the follow-up period. The HIV incidence was 4.45/100 person-years during 2004 - 2006, 4.50/100 person-years in 2007 and 2.54/100 person-years in 2008. Both the behavior of drug injection and the HIV incidence among the cohort had substantially decreased during the follow-up period. Multiple regression analysis using Cox proportional hazard model indicated that people with Jing-po ethnicity (Hazard ratio, HR = 2.56, 95%CI: 1.06 - 6.19) and other minorities except for Dai (HR = 3.26, 95%CI: 0.89 - 11.96) were at higher risk for HIV infection than the people with Han ethnicity. People injecting drugs with (HR = 2.27, 95%CI: 0.98 - 5.25) or without (HR = 5.27, 95%CI: 2.25 - 12.34) needle sharing were at higher risk for HIV infection than those reporting having no drug injection behavior during the follow-up period.

CONCLUSIONBoth the behavior of drug injection and the HIV incidence among former IDU in Dehong prefecture area of Yunnan province had been decreasing during the four years. However, needle sharing remained the most important risk factor for HIV new infection among IDUs. IDUs with different ethnicities seemed to have different risks towards HIV infection.

Adult ; China ; epidemiology ; Cohort Studies ; Female ; HIV Infections ; epidemiology ; Humans ; Incidence ; Male ; Minority Groups ; Needle Sharing ; Risk Factors ; Substance Abuse, Intravenous ; epidemiology

OBJECTIVETo understand the status of recent infected and newly reported HIV cases in Jiangsu province.

METHODSInformation including general demographic, mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated, and associated factors of recent HIV infection calculated.

RESULTSAmong cases infected through different channels as homosexual, heterosexual and needles sharing, the proportions of recent infections were 29.19% , 17.40% and 21.75% , respectively. Statistically significant difference was seen between different populations(P < 0.05). Compared with female cases, male cases were more likely to be recent infected (OR = 1.569, 95%CI: 1.168-2.107). Compared with cases older than 35 years of age, the ones that younger than that age were more likely to be recently infected (OR = 1.556, 95% CI:1.289-1.879). Compared with cases who remained single, those married cases were more likely to be long-term infections(OR = 0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling programs and testing (OR = 2.278, 95%CI: 1.853-2.801), project-based surveillance programs (OR = 2.409, 95%CI:1.860- 3.120), and unpaid blood donation sites (OR = 2.911, 95%CI:2.118-4.001)(P < 0.05).

CONCLUSIONProportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Age Distribution ; China ; epidemiology ; Female ; HIV Infections ; diagnosis ; epidemiology ; HIV Seropositivity ; Heterosexuality ; Homosexuality ; Humans ; Male ; Marital Status ; statistics & numerical data ; Needle Sharing ; adverse effects ; Sex Distribution

OBJECTIVETo investigate the epidemiology of pediatric human immunodeficiency virus (HIV) infection in six provinces of China.

METHODSA cross-sectional study was conducted in six provinces with the highest HIV prevalence. Surveys on demographics and HIV-related questions (transmission modes, time of diagnosis, clinical stage, laboratory test) were distributed to clinicians in these provinces. Descriptive and bivariate analyses were performed on the completed surveys.

RESULTSSurvey results of 650 children [405 males and 245 females; average age: (7.9 +/- 3.2) years] were eligible for analysis. The interval between possible transmission and diagnosis was (7.1 +/- 3.2) years. The location distribution was as follows: 570 cases (87.7%) in Henan Province, 23 cases (3.5%) in Guangxi Province, 21 cases (3.2%) in Yunnan Province, 19 cases (2.9%) in Hubei Province, 10 cases (1.5%) in Anhui Province, and 7 cases (1.1%) in Shanxi Province. Transmission routes included mother-to-child transmission (75.1%), blood transfusion/ plasma donation (15.7 %), and injecting drug use (IDU, 0.5%). Former plasma donation (FPD) was the main transmission route in some provinces (Henan, Shanxi, Hubei, and Anhui), while IDU was the main transmission route in other provinces (Guangxi and Yunnan). The average age in the FPD provinces was significantly higher than that in IDU provinces [(8.1 +/- 3.2) vs. (5.4 +/- 2.2) years, P <0.001]. Among 178 patients in all six provinces who required treatment (on the basis of CD4 count or WHO staging), 133 (74.7%) did not receive treatment and 45 (25.3%) received antiretroviral therapy.

CONCLUSIONMother-to-child transmission is the main transmission mode in pediatric patients. Efforts should be made to strengthen the diagnosis and treatment of pediatric HIV/AIDS patients.

Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; diagnosis ; epidemiology ; therapy ; transmission ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Male ; Needle Sharing ; adverse effects ; Transfusion Reaction

OBJECTIVETo evaluate the feasibility and effectiveness of needle and syringe exchange program among a community of injecting drug users (IDUs) on AIDS prevention.

METHODSA quasi-experiment design was used in a controlled community intervention study. Needle and syringe exchange program was implemented for 10 months in IDUs of an intervention community, including peer education and health education, provision of free needles and syringes, and collecting back of used needles and syringes by trained peer educators and local health workers, whereas no intervention measure in a control community was instituted. Interviews with IDUs were conducted before and after intervention with a snowballing strategy to evaluate its effectiveness.

RESULTSA total of 428 and 429 IDUs were interviewed with structured questionnaire before and after intervention in intervention and control communities, respectively. Results revealed that awareness of HIV-related knowledge increased from 29.4% to 58.7% in the intervention community. Multivariate logistic regression analysis showed that awareness of HIV-related knowledge was higher in those who had read health education materials (OR = 2.93, 95% CI 2.12 - 4.04). As compared with the baseline data, frequency of sharing needles and syringes in past 30 days in the intervention community decreased from 48.9% to 20.4% in before intervention community (chi(2) = 41.02, P = 0.001), whereas there was no significant change in the control community. The causes of sharing needles and syringes in the intervention community included 'disable to get needle and syringe during the night', 'lack of needle and syringe when injecting at friend's home', 'not daring to buy needle and syringe for fear of being arrested' and 'no money to buy needle and syringe', declined markedly.

CONCLUSIONSNeedle and syringe exchange program was feasible and effective in reducing their risky drug injecting behavior among IDUs in communities. Such strategy should be adopted in the country to reduce rapid spread of HIV.

Adult ; China ; epidemiology ; Female ; HIV Infections ; prevention & control ; transmission ; Health Education ; Humans ; Male ; Needle Sharing ; adverse effects ; statistics & numerical data ; Needle-Exchange Programs ; economics ; organization & administration ; Pilot Projects ; Program Evaluation ; Substance Abuse, Intravenous ; complications ; epidemiology

OBJECTIVETo understand that whether initiation of antiretroviral therapy (ART) would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment (MMT).

METHODSIn-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART. The related contents would include information on general demographic charicteristics, HIV infection,MMT, number of sexual partners before and after ART, sexual behavior and frequency of condom use, drug use, needle sharing, changes in risk behaviors before and after the ART, reasons for high-risk behavior, of the clients.

RESULTSThe average age of the interviewees was 38.5 years, and most of them were male (70.6%). The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation, with the main reasons as increasing HIV related awareness, the use of methadone, high accessibility of free condoms and access to clean needles etc. However, 12 of 34 reported being relapsed and 3 reported inconsistent condom use. The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use.

CONCLUSIONNo evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients. However, attention needs to be paid to the new challenges caused by high expectation of ART.

Adult ; China ; epidemiology ; Condoms ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Methadone ; therapeutic use ; Needle Sharing ; Opiate Substitution Treatment ; Qualitative Research ; Risk-Taking ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Substance-Related Disorders ; drug therapy ; Unsafe Sex

OBJECTIVETo understand the demography changes and behaviors in drug users.

METHODSelf-reported questionnaires was used and longitudinal investigation was conducted in one of the detoxication centers in Beijing in 1998 and 2000. Drug users were randomly chosen.

RESULTSResults showed that age of drug users tend to become younger with the numbers of drug users aged below 25, increased from 18.7% in 1998 to 28.2% in 2000. Majority of drug users remained males, but the proportion of females seemed to increase. Distribution of occupation showed that the largest increase fell among individual enterprisers, from 15.2% in 1998 to 25.9% in 2000. With educational back-ground, the proportion of lower than elementary education level, including illiterate, increased. Fifty percent of drug users were unmarried which increased from 40.8% in 1998 to 53.2% in 2000. Needle sharing was quite common, 16.5% in 1998 and 11.9% in 2000, but the decrease was not statistically significant (P > 0.05). Fifty-seven point three percent of the injecting drug users did not have constant partners to share equipments. Proportion of extra-marriage sexual practice increased from 12.5% in 1998 to 27.5% in 2000, and significant difference (Chi-square = 12.50, P < 0.001). Multiple partners in extra-married drug users was also found (mean = 2). Compared to 1998, condom use during every sexual practice increased in 2000, but 47.7% drug users still never used condom.

CONCLUSIONIn summary, as the quick increase of drug users, sharing of injecting equipment and high-risk sexual behavior, including multiple partners and unprotected sex, were quite common, with the possibility of HIV epidemic in drug users.

Adult ; China ; epidemiology ; Demography ; Female ; HIV Infections ; epidemiology ; Humans ; Longitudinal Studies ; Male ; Needle Sharing ; adverse effects ; Prevalence ; Risk Factors ; Safe Sex ; statistics & numerical data ; Substance Abuse, Intravenous ; epidemiology ; Surveys and Questionnaires