Global Areas of Drug UserTransmitted HIV

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Global Areas of Drug User-Transmitted HIV

• Europe
• North America (U.S., Canada)
• South America
• Southeast Asia (Golden Triangle - Thailand,
• Myanmar, Vietnam, NE India)
• China (originally Yunnan, now most provinces,
• highest in Xinjiang)

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Relationship of Drug Use to HIV Spread to Other
Groups

• Rapid spread (Thailand, Myanmar, NE India?)
• Initially slow spread among older addicts
  followed by rapid spread in younger addicts
  (Vietnam)
• Bridge populations and mixing rate/turnover
  (e.g., Vietnam, Yunnan China)

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Characteristics of DrugUsers in Asia

• Remain as a member of the family
• Remain as a member of the community
• High failure rate for treatment centers (80)
• Increasing drug use among commercial sex workers

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Risk Factors for Drug Use-Related Transmission of
HIV in China

• Risk factors for initiation of drug use
• Risk factors for initiation of injecting and
  sharing of equipment
• Higher levels of HIV/AIDS knowledge among
  non-sharing injectors than among sharing
  injectors
• Sexual behavior of drug users

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Risk Factors of Initiationof Drug Use

• Encouraged by friends (OR8.8)
• Prior cigarette smoking (OR-2.4)
• Jingbo ethnic group (OR1.8)
• Separated, divorced, or widowed (OR8.9)
• Had extramarital sex (OR1.5)
• Family member used drugs (OR1.5

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Risk Factors for Initiation of Injecting and
Sharing of Equipment

• Initiation
• Buddhist religion (OR0.4)
• Had extramarital sex (OR1.5)
• Family member used drugs (OR1.8)
• Sharing
• Ethnicity (OR5.8)
• Occupation (OR0.5)

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Prevention and Intervention Strategies

• Detoxification and rehabilitation programs
• Chemical replacement (e.g., methadone)
• Needle/syringe exchange
• Community intervention

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An Example of a Community Intervention Program to
Prevent Initiation of Drug Use in Yunnan, China

• Strategy
• Demographic characteristics
• Incidence of new drug users in intervention and
  control villages
• Knowledge of risk factors
• Attitudes towards drug use

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