Volume 106, Issue 6 , Pages 467-474, 2007
Gender Difference in the Clinical and Behavioral Characteristics of Human Immunodeficiency Virus-infected Injection Drug Users in Taiwan
Article Outline
Background/purpose
Injection drug users (IDUs) have become the major contributors to the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome epidemic in Taiwan, accounting for more than 60% of new cases in 2005. In Taiwan, gender difference in risk factors for HIV among IDUs has not been reported before. We studied the clinical and sociodemographic characteristics, sexual behaviors, drug use histories and criminal records of male and female HIV-infected IDUs.
Methods
A total of 100 male and 25 female HIV-infected inmates from two prisons were included. An individually structured interview was conducted with each inmate. Serostatus of hepatitis B virus (HBV) and hepatitis C virus (HCV) were tested. CD4+ T cell count and HIV viral load were also evaluated.
Results
The mean age of the HIV-infected inmates was 31.7 ± 6.4 years. All inmates were co-infected with HCV and 20% were HBV carriers. The mean CD4+ T cell count was 498 cells/mL, and the mean viral load was 20,119 copies/mL. Heroin use history averaged 6.3 ± 5.1 years, and 84.8% of patients had a previous criminal offense prior to current conviction. Female inmates were significantly younger, had more sexual partners, had more drug-using family members or sexual partners, shared injection paraphernalia more frequently, and started using methamphetamine and heroin at younger ages (p < 0.05). Male inmates tended to be single, had less parental support, had been more frequently convicted of non drug-related crimes, started using non-illicit substances more frequently at younger ages and had sex with prostitutes more frequently (p < 0.05).
Conclusion
The results of this study suggest that drug injection risks and sexual behavior related risks are equally important in determining the risk of HIV infection among IDUs. Gender-specific approaches to prevention which reflect differences in gender-related patterns of risk are also needed.
Key Words: acquired immunodeficiency syndrome , human immunodeficiency virus , injection
No full text is available. To read the body of this article, please view the PDF online.
References
- Global overview of injecting drug use and HIV infection among injecting drug users . AIDS . 2004;18:2295–2303
- . HIV/AIDS Surveillance Report . Atlanta, GA: Centers for Disease Control and Prevention; 1999;
- . Reports on the Global HIV/AIDS Epidemic . Geneva: UNAIDS and World Health Organization (WHO).; 2005;
- . Statistics of Communicable Diseases and Surveillance Reports in Taiwan Area . Taipei: Center for Disease Control, Department of Health, Executive Yuan, Taiwan.; December 2005;
- Temporal trends in the incidence of human immunodeficiency virus infection and risk behavior among injection drug users in Baltimore, Maryland, 1988-1998 . Am J Epidemiol . 2002;156:641–653
- . Intravenous drug users' HIV-risk behaviors with primary/other partners . Am J Drug Alcohol Abuse . 2004;30:225–236
- Sexual transmission of HIV-1 among injecting drug users in San Francisco, USA: risk factor analysis . Lancet . 2001;357:1397–1401
- . HIV in Prison and Jails, NCJ 187456 . Washington DC: Bureau of Justice Statistics.; 1999;
- Ministry of Justice, Executive Yuan, Taiwan. Justice Statistics, September 2005. Available from http://www.moj.gov.tw [Date accessed: March 27, 2006]
- Sex differences in risk factors for HIV seroconversion among injection drug users: a 10 year perspective . Arch Intern Med. . 2001;161:1281–1288
- . Short-term risk of AIDS according to current CD4 cell count and viral load in anti-retroviral drug-naïve individuals and those treated in the monotherapy era . AIDS . 2004;18:51–58
- Hepatitis C virus infection among short-term intravenous drug users in southern Taiwan . Eur J Epidemiol . 1999;15:597–601
- Chu FY, Cheng SH, Chiang SC. The rising challenge: high-prevalence of human immunodeficiency virus, hepatitis B and hepatitis C infections in illicit drug users. In: Proceedings of the 2005 Annual Meeting of the Taiwan Society of Clinical Pathologist, 2005, Taipei, Taiwan. [Abstract]
- . Hepatitis B virus infection and chronic liver disease in Taiwan . Acta Hepatogastroenterol . 1978;25:423–430
- Vertical transmission of hepatitis B antigen in Taiwan . N Engl J Med. . 1975;292:771–774
- HIV incidence among injecting drug users in New York City syringe-exchange programs . Lancet . 1996;348:987–991
- Syringe and needle exchange as HIV/AIDS prevention for injecting drug users . JAMA . 1994;271:115–120
- Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18-month prospective follow-up . J Acquir Immune Defic Syndr . 1993;6:1049–1056
- . Drugs-crime connections: elaboration from the life histories of hard-core heroin addiction . Soc Probl . 1987;34:54–68
- How effective is drug abuse resistance education? A meta-analysis of project DARE outcome evaluations . Am J Public Health . 1994;84:1394–1401
- . The effectiveness of Drug Abuse Resistance Education (project DARE): 5-year follow-up results . Prev Med. . 1996;25:307–318
- Gender differences in injection-related behaviors among injection drug users in Baltimore, Maryland . AIDS Educ Prev . 1998;10:257–263
- Reliability of self-reported HIV risk behavior of drug users . Psychol Addictive Behav . 1999;9:242–250
- . The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: a meta-analysis . Addiction . 1998;93:515–532
PII: S0929-6646(09)60296-5
doi:10.1016/S0929-6646(09)60296-5
© 2007 Formosan Medical Association & Elsevier. Published by Elsevier Inc. All rights reserved.
Volume 106, Issue 6 , Pages 467-474, 2007
