Factors Influencing a Self-Limiting HIV Outbreak Among Ethnic Vietnamese Injecting Drug Users in Melbourne, Australia

Abstract

Successful HIV prevention programs-such as sterile needle and syringe programs-have ensured that incidence and prevalence of HIV among people who inject drugs remains low in Australia. However, between 1999 and 2006, 20 of the 46 injecting-related HIV notifications in Melbourne (Australia's second-largest city) were ethnic Vietnamese heroin users. Through in-depth interviews we explored and documented the coping tactics and strategies of 9 ethnic Vietnamese heroin injectors. We explored their experiences of living with HIV, and in this article identify factors that appear to have contributed to limiting the spread of HIV beyond this cluster of people. The data reveal factors associated with this self-limiting outbreak, including consciously avoiding opioid withdrawal and having closed injecting networks. Early and effective engagement with participants by health care workers also appears to have played an important role in containing the transmission of HIV within this group of ethnic Vietnamese heroin injectors.

Injection Drug Users’ Access to a Supervised Injection Facility in Vancouver, Canada: The Influence of Operating Policies and Local Drug Culture

“…Drug sharing practices are common among IDUs in many different locales (Grund et al, 1996;Higgs, Yohannes, Hellard, & Maher, 2009;Koester, Glanz, & Baron, 2005;Needle et al, 1998), and when multiple individuals reuse injection paraphernalia (e.g., cookers, filters, water), this creates opportunities for blood-borne virus transmission. In particular, collective preparation can increase risk for hepatitis C transmission when previously utilized syringes are employed to prepare or divide drug solutions (Koester, Booth, & Zhang, 1996;Koester et al, 2005).…”

The effectiveness of harm reduction in preventing HIV among injecting drug users

“…46 Moreover, if an HIV epidemic were to eventuate among IDUs in Australia, it is likely that this would involve one or more vulnerable populations with poor HIV prevention access and coverage. This includes IDUs from Aboriginal and Torres Strait Islander communities 24 and culturally and linguistically diverse backgrounds, especially ethnic Vietnamese, 47 and incarcerated IDUs. 48 Despite evidence of major benefits of prison NSPs in the absence of significant negative consequences and ample documentation of injecting drug use in Australian prisons, repeated efforts to establish these facilities have proved unsuccessful.…”

HIV treatment outcomes among people who inject drugs in Victoria, Australia

“…Our dataset only included individuals who accessed services at two urban clinics, and we did not have access to treatment data from other sites. It has been reported that some HIV-positive PWID in Melbourne may be reluctant to access HIV therapy [ 22 ]. Others have reported that PWID residing near drug using areas are less likely to access HIV treatment even when it is available [ 23 ].…”