Correction to: Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

O’Brien, Sally; Kyaw, Khine Wut Yee; Jaramillo, Margarita Marin; Roberts, Bayard; Bijl, Murdo; Platt, Lucy

doi:10.1186/s13031-023-00506-z

Cited by 1 publication

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[21, 24-26] Research among people who inject heroin in borderland areas in remote parts of Shan State document frequent injection (at least daily) and high levels of sharing of needles/syringes. [7] Other evidence from Ruili immediately across the border in China, found that injecting drugs in both China and Myanmar was associated with increased odds of sharing injecting equipment and weaker evidence of an association with testing positive for HIV. [15] Elevated ATS use in borderland cities in proximity to ATS distribution has been observed both in the region and in border cities between Mexico and the United States.…”

Section: Discussionmentioning

confidence: 99%

“…[20, 21] Evidence shows elevated opium, heroin or ATS use among those working in mining industries in Myanmar as a strategy to cope with difficult working conditions. [7] Borderland and mining areas are characterized by high levels of sex work and population mobility.…”

Section: Methodsmentioning

confidence: 99%

“…[5] Increased availability of drugs in producer countries or along trafficking routes alongside political instability and reduced enforcement has been linked to elevated drug use and outbreaks of HIV infection. [6, 7] Within Myanmar, drug production areas such as Kachin State, Northern Shan State, and the Sagaing region have the highest prevalence of drug use among the population. [1]…”

Section: Introductionmentioning

confidence: 99%

“…[12] In Myanmar, people using methamphetamines in Shan State frequently reported inconsistent condom use and multiple sex partners pointing to the potential for sexual transmission of HIV. [7]…”

Section: Introductionmentioning

confidence: 99%

“…[13-15] Migration to and from rural and borderland areas is common with people migrating for work in agriculture, mining, sex work, or as a result of forced displacement. [7] Some evidence suggests higher risk sexual practices including condomless sex, multiple partners or history of sexually transmitted infections, are more common among migrating women using drugs in Muse, Myanmar on the border with China. [16] The ‘risk environment’ concept, developed to understand drug-related harms examines different types (physical, social, economic and political) and levels of influence (e.g.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The effect of migration, location in mining or borderland areas on HIV incidence among people who use drugs attending a harm reduction programme in Myanmar, 2014-2021: a retrospective cohort study

Platt,

Wut Yee Kyaw,

Rathod

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundHigh HIV prevalence has been documented among people who use drugs (PWUD) in Myanmar particularly in mining and borderland areas. We estimated incidence of HIV among PWUD (via injecting and other routes) and examine associations between location in mining or borderland areas, migration and risk of infection.Methods and findingsAnalysis of data among PWUD registered at harm reduction programmes across Sagaing region, Kachin, and Northern Shan States between 2014-2021. Data on sociodemographic, drug use characteristics and clinic-level data on borderland or mining locations were collected at time of registration. Characteristics, repeat HIV testing and HIV seroconversion were analysed using a cohort approach and Poisson regression models examining associations between location in a borderland or mining area, migration and incidence of HIV, adjusting for confounders. Data were available from 85093 clients, 52526 reported HIV tests and 20.0% were seropositive. 38670 clients had no or only one recorded HIV result. The median time between HIV tests was 1.1 years. Among 13,359 clients with 2 or more HIV tests the HIV seroconversion rate was 3.8 per 100 person years (pyrs) (95% CI 3.6-4.0). Incidence among those who injected drugs was 6.9 per 100/pyrs, 8.9 among those aged ≤ 25 years, 2.3 among women, 2.3 among those who had migrated, 5.6 among those located in border areas, and 3.7 among those in mining areas. After adjusting for confounders HIV incidence remained higher for people located in borderland areas (Incidence Rate Ratio 1.67 95% CI 1.13-2.45) and lower among those who had migrated (IRR 0.56, 95% CI (0.39-0.82). There was no evidence of association between location in a mining area and HIV seroconversion.ConclusionsFindings highlight the need to intensify harm reduction interventions with a focus on cross-border interventions. Increasing uptake of HIV testing alongside the scale up of evidenced based interventions to address sexual and injecting risk practices including PrEP, distribution of condoms, needles/syringe distribution and opioid agonist therapies is urgently needed to curb the high rates of HIV transmission among PWUD particularly among young people.Author summaryWhy was this study done?Increased availability of drugs in producer countries or along trafficking routes alongside political instability and reduced enforcement has been linked to elevated drug use and outbreaks of HIV infection.Few studies focus on the extent to which structural factors, that is, political, social, or physical aspects of the environment, are associated with HIV infection in Myanmar though elevated HIV prevalence has been observed in rural and borderland areas.This study contributes to the limited evidence base on HIV incidence in South East Asia and Myanmar specifically.What did the researchers do and find?This study measures HIV incidence among people who use drugs using routine programmatic data and provides estimates of differential HIV risk associated with location in borderland and mining areas and experience of migration.We estimate HIV incidence to be 3.8 per 100 person years among people who use drugs, with higher incidence among those who inject and younger ages (<25 years)We identify people who use drugs registered at services in borderland areas to be at elevated risk of HIV acquisition and migrants at decreased risk.What do the findings mean?Findings point to the imperative for expanding HIV prevention interventions among PWUD, with a focus on cross-border interventions and addressing injecting and sexual risk practices.Findings support the emerging body of evidence highlighting the utility of programmatic data to estimate HIV incidence among key populations.Understanding differential risk in infections among people who use drugs and structural determinants is key to creating enabling environments through which effective HIV treatment and prevention interventions can be delivered.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effect of migration, location in mining or borderland areas on HIV incidence among people who use drugs attending a harm reduction programme in Myanmar, 2014-2021: a retrospective cohort study

Platt,

Wut Yee Kyaw,

Rathod

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Correction to: Determinants of health among people who use illicit drugs in the conflict-affected countries of Afghanistan, Colombia and Myanmar: a systematic review of epidemiological evidence

Cited by 1 publication

References 0 publications

The effect of migration, location in mining or borderland areas on HIV incidence among people who use drugs attending a harm reduction programme in Myanmar, 2014-2021: a retrospective cohort study

The effect of migration, location in mining or borderland areas on HIV incidence among people who use drugs attending a harm reduction programme in Myanmar, 2014-2021: a retrospective cohort study

Contact Info

Product

Resources

About