BACKGROUND: HIV spread rapidly amongst injecting drug users (IDUs) in Bangkok in the late 1980s. In recent years, changes in the drugs injected by IDUs have been observed. We examined data from an HIV vaccine trial conducted amongst IDUs in Bangkok during 1999-2003 to describe drug injection practices, drugs injected, and determine if drug use choices altered the risk of incident HIV infection. METHODS: The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled trial. At enrolment and every 6 months thereafter, HIV status and risk behaviour were assessed. A proportional hazards model was used to evaluate demographic characteristics, incarceration, drug injection practices, sexual activity, and drugs injected during follow-up as independent predictors of HIV infection. RESULTS: The proportion of participants injecting drugs, sharing needles, and injecting daily declined from baseline to month 36. Amongst participants who injected, the proportion injecting heroin declined (98.6-91.9%), whilst the proportions injecting methamphetamine (16.2-19.6%) and midazolam (9.9-31.9%) increased. HIV incidence was highest amongst participants injecting methamphetamine, 7.1 (95% CI, 5.4-9.2) per 100 person years. Injecting heroin and injecting methamphetamine were independently associated with incident HIV infection. CONCLUSIONS: Amongst AIDSVAX B/E vaccine trial participants who injected drugs during follow-up, the proportion injecting heroin declined whilst the proportion injecting methamphetamine, midazolam, or combinations of these drugs increased. Controlling for heroin use and other risk factors, participants injecting methamphetamine were more likely to become HIV-infected than participants not injecting methamphetamine. Additional HIV prevention tools are urgently needed including tools that address methamphetamine use. Published by Elsevier B.V.
RCT Entities:
BACKGROUND: HIV spread rapidly amongst injecting drug users (IDUs) in Bangkok in the late 1980s. In recent years, changes in the drugs injected by IDUs have been observed. We examined data from an HIV vaccine trial conducted amongst IDUs in Bangkok during 1999-2003 to describe drug injection practices, drugs injected, and determine if drug use choices altered the risk of incident HIV infection. METHODS: The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled trial. At enrolment and every 6 months thereafter, HIV status and risk behaviour were assessed. A proportional hazards model was used to evaluate demographic characteristics, incarceration, drug injection practices, sexual activity, and drugs injected during follow-up as independent predictors of HIV infection. RESULTS: The proportion of participants injecting drugs, sharing needles, and injecting daily declined from baseline to month 36. Amongst participants who injected, the proportion injecting heroin declined (98.6-91.9%), whilst the proportions injecting methamphetamine (16.2-19.6%) and midazolam (9.9-31.9%) increased. HIV incidence was highest amongst participants injecting methamphetamine, 7.1 (95% CI, 5.4-9.2) per 100 person years. Injecting heroin and injecting methamphetamine were independently associated with incident HIV infection. CONCLUSIONS: Amongst AIDSVAX B/E vaccine trial participants who injected drugs during follow-up, the proportion injecting heroin declined whilst the proportion injecting methamphetamine, midazolam, or combinations of these drugs increased. Controlling for heroin use and other risk factors, participants injecting methamphetamine were more likely to become HIV-infected than participants not injecting methamphetamine. Additional HIV prevention tools are urgently needed including tools that address methamphetamine use. Published by Elsevier B.V.
Authors: Marek C Chawarski; Balasingam Vicknasingam; Mahmud Mazlan; Richard S Schottenfeld Journal: Drug Alcohol Depend Date: 2012-01-21 Impact factor: 4.492
Authors: Vu Minh Quan; Nguyen Le Minh; Tran Viet Ha; Nguyen Phuong Ngoc; Pham The Vu; David D Celentano; Tran Thi Mo; Vivian F Go Journal: Addiction Date: 2010-11-04 Impact factor: 6.526
Authors: Christina S Meade; Ryan R Lion; Daniella M Cordero; Melissa H Watt; John A Joska; Hetta Gouse; Warren Burnhams Journal: AIDS Behav Date: 2016-10
Authors: Michael Martin; Suphak Vanichseni; Wanna Leelawiwat; Rapeepan Anekvorapong; Boonyos Raengsakulrach; Thitima Cherdtrakulkiat; Udomsak Sangkum; Philip A Mock; Manoj Leethochawalit; Sithisat Chiamwongpaet; Janet M McNicholl; Somyot Kittimunkong; Marcel E Curlin; Kachit Choopanya Journal: WHO South East Asia J Public Health Date: 2019-04
Authors: Michael Farrell; Natasha K Martin; Emily Stockings; Annick Bórquez; Javier A Cepeda; Louisa Degenhardt; Robert Ali; Lucy Thi Tran; Jürgen Rehm; Marta Torrens; Steve Shoptaw; Rebecca McKetin Journal: Lancet Date: 2019-10-23 Impact factor: 79.321