Transcript No Slide Title

Risk Behavior among Current and Former
Injecting Drug Users in Bandung, Indonesia
S. Iskandar1,2, D. A.E.P Basar1, T. Hidayat1, I.M.P. Siregar1, L. Pinxten2, R. van Crevel3,
A.J.A.M. Van der Ven3, C.A.J. de Jong5
1Padjajaran
University/ Hasan Sadikin Hospital, Bandung, Indonesia 2Maastricht University, Maastricht, the Netherlands
3Radboud
4Nijmegen
University Nijmegen Medical Centre, the Netherlands
Institute for Scientist-Practitioners in Addiction (NISPA); Nijmegen, the Netherlands
Introduction
• Efforts to prevent HIV-transmission through injecting drug use
(IDU) mostly target subjects who regularly inject
• The prevalence of HIV/AIDS in the people with a history of
previous IDU (former IDUs) is high
• Former IDUs are more accepted by community
• The transmission of HIV from former IDUs to the general
community is especially through sexual contacts.
Results (2)
HIV Status among IDUs
Former
IDUs
Objective
to explore and compare the characteristics and the risk
behaviors among current and former IDUs  a better
understanding of these risk behaviors may contribute to the
design of specifically tailored prevention programs
Current
IDUs
Interview Center
Methods
Results (3)
Screening,
informed consent
Get a coupon
Interview
Free HIV, HBV, HCV,
Syphilis Test
HIV (+)
New respondents
Risk
fIDUs
cIDUs
Behavior
N = 92
N = 118
N (%)
N (%)
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testing
Syphilis (+)
Free CD4 test &
Chest X-ray
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recruiting other IDUs
Payment for
recruiting other IDUs
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Treatment
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treatment
This process (respondent driven sampling) is continued
until the number of IDUs recruited reach 210
Results (1)
X2
P
Injecting risk
Yes
12 (13)
90 (76) 82,7 p<0,01**
behavior
No
80 (87)
28 (24)
Sexual risk
Yes
39 (42)
65 (56) 3,57
behavior
No
53(58)
52 (44)
Other skin
Yes
47 (52)
62 (53) 0,02
penetration
No
44 (48)
56 (47)
3
0,06
0,90
risk behavior
Characteristics of IDUs (n=210)
Age
Total
fIDUs
cIDUs P-value
group
(N = 92) (N = 118)
(N = 210)
27,8 (3,8) 28,1 (4,0) 27,5 (3,8) 0,639
Age first time use drug
14,0 (2,8) 14,2 (3,3) 13,8 (2,2)
Age first time inject
18 (3,1)
18,4 (3,1) 17,8 (3,1)
Years of injecting in life
time
Gender
Male
Female
Marital Status
Ever married
Never married
Education
Junior high school or
under
Senior high school
Diploma or higher
7,1 (3,8)
5,5 (3,6)
0,314
0,168
8,4 (3,4) P<0,01**
0,117
194 (92)
16 (8)
82 (89)
10 (11)
0,352
42 (45)
50 (55)
49 (41)
69 (59)
12 (6)
4(4)
8 (7)
164 (77)
34 (17)
74 (80)
14 (14)
90 (76)
20
• High HIV prevalence among former & current IDUs
• Former & current IDUs engaged with high sexual & other
skin penetration risk behavior
• Harm reduction program should address current as well as
former IDUs to prevent the spread of HIV to non-drug users
Acknowledgments
112 (95)
6 (5)
91 (43)
119 (57)
Conclusion
We would like to thank Prof. Cissy B. Sudjana Prawira, Director of Hasan Sadikin
General Hospital, and Prof. Eri Surahman, Dean of the Medical Faculty Padjadjaran
University for encouraging and accommodating research in their institutions.
Municipal health department, the interviewers, Rinske de Graaff Stoffers, Mark
Holland, staffs and ORC from Salam Primary Health Center. Rumah Cemara,
Bahtera, PKBI, and Grapiks are thanked for their valuable help
IMPACT (5-year program for
HIV care and drug addiction in
West Java, Indonesia) is funded
by the European Union