Female Sexual Partners of Male People Who Inject Drugs in Vietnam Have Poor Knowledge of Their Male Partners' HIV Status

Hammett, Theodore M.; Phan, Son; Nguyen, Phong Anh; Kieu, Binh Thanh; Dang, Son; Nguyen, Diu; Kling, Ryan; Oanh, Khuat Thi Hai

doi:10.1097/qai.0000000000000512

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…Compared to men, women had less advanced disease, with higher CD4 cell counts and fewer complications, probably because women were mostly tested because of their husband’s illness (Table 1 ). Testing of sexual partners of PWID is important in this setting; a cross-sectional study in a similar setting showed that this particular subgroup have a very high HIV risk [ 33 ]. Screening of women in antenatal care is not routinely done in Indonesia; indeed only one out of the 43 pregnant women in this cohort was referred from an obstetric care.…”

Section: Discussionmentioning

confidence: 99%

Women with HIV in Indonesia: are they bridging a concentrated epidemic to the wider community?

et al. 2015

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BackgroundMale injecting drug users drove the onset of the HIV epidemic in Indonesia but over time more women have been diagnosed. We examined the relative proportion of female patients in an HIV cohort and characterized their probable transmission route and reproductive profile.DesignsProspective cohort study in a referral hospital in West Java.MethodsInterviews with standardized questionnaires, physical and laboratory examinations were done for 2622 individuals enrolled in HIV care between 2007 and 2012. The proportion of women in this cohort was compared with national estimates. The general characteristics of HIV-infected women and men as well as the sexual and reproductive health of HIV-infected women were described.ResultsThe proportion of female patients enrolled in HIV care increased from 22.2 % in 2007 to 38.3 % in 2012, in line with national estimates. Women were younger than men, fewer reported a history of IDU (16.1 vs. 73.8 %, p < 0.001) and more were tested for HIV because of a positive partner (25.5 vs. 4.0 %, p < 0.001). The majority of women were in their reproductive age, had children, and were not using contraceptives at the time of enrolment.ConclusionHIV-infected women in Indonesia have specific characteristics that differ them from women in the general population. Further research to elucidate the characteristics of women exposed to HIV, their access to testing and care and sexual and reproductive needs can help reduce transmission to women and children in the context of concentrated HIV epidemic in Indonesia.

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Section: Discussionmentioning

confidence: 99%

Women with HIV in Indonesia: are they bridging a concentrated epidemic to the wider community?

et al. 2015

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“…21 A study of 403 female IDUs found that only 50% of women in Hanoi and 63% in Ho Chi Minh City had ever heard of NSPs 22 , and only 17% and 24% in each city, respectively, had received a free needle in the last 6 months. 22 …”

Section: Country Case Studiesmentioning

confidence: 99%

HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective

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Philbin

Parish

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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The paper reviews data on HIV testing, treatment, and care outcomes for women who use drugs in five countries across five continents. We chose countries in which the HIV epidemic has, either currently or historically, been fueled by injection and non-injection drug use, and that have considerable variation in social structural and drug policies: Argentina, Vietnam, Australia, Ukraine, and the United States. There is a dearth of available HIV care continuum outcome data (i.e., testing, linkage, retention, ART provision, viral suppression) among women drug users, particularly among non-injectors. While some progress has been made in increasing HIV testing in this population, HIV-positive women drug users in four of the five countries have not fully benefitted from ART nor are they regularly engaged in HIV care. Issues such as the criminalization of drug users, HIV-specific criminal laws, and the lack of integration between substance use treatment and HIV primary care play a major role. Strategies that effectively address the pervasive factors that prevent women drug users from engaging in HIV care and benefitting from ART and other prevention services are critical. Future success in enhancing the HIV continuum for women drug users should consider structural and contextual level barriers and promote social, economic and legal policies that overhaul the many years of discrimination and stigmatization faced by women drug users worldwide. Such efforts must emphasis the translation of policies into practice and approaches to implementation that can help HIV-infected women who use drugs engage at all points of the HIV Care Continuum.

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“…For PWID in Vietnam, low levels of education may serve as a barrier for HIV and substance use treatment . We believe the limited number of females in Indonesia and Vietnam accurately reflects the population of PWID in these countries based on culture and historic precedence . The gender distribution in Ukraine is similar to the distribution in Russia and the Baltic States .…”

Section: Discussionmentioning

confidence: 85%

Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis

et al. 2018

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IntroductionPeople who inject drugs (PWID) experience high HIV incidence and face significant barriers to engagement in HIV care and substance use treatment. Strategies for HIV treatment as prevention and substance use treatment present unique challenges in PWID that may vary regionally. Understanding differences in the risk structure for HIV transmission and disease progression among PWID is essential in developing and effectively targeting intervention strategies of HIV treatment as prevention.MethodsWe present a baseline analysis of HIV Prevention Trials Network (HPTN) 074, a two‐arm, randomized controlled trial among PWID in Indonesia (n = 258), Ukraine (n = 457) and Vietnam (n = 439). HPTN 074 was designed to determine the feasibility, barriers and uptake of an integrated intervention combining health systems navigation and psychosocial counselling for the early engagement of antiretroviral therapy (ART) and substance use treatment for PWID living with HIV. Discordant PWID networks were enrolled, consisting of an HIV‐positive index and their HIV‐negative network injection partner(s). Among the enrolled cohort of 1154 participants (502 index participants and 652 network partners), we examine regional differences in the baseline risk structure, including sociodemographics, HIV and substance use treatment history, and injection and sexual risk behaviours.ResultsThe majority of participants were male (87%), with 82% of the enrolled females coming from Ukraine. The overall mean age was 34 (IQR: 30, 38). Most commonly injected substances included illegally manufactured methadone in Ukraine (84.2%), and heroin in Indonesia (81.8%) and Vietnam (99.5%). Injection network sizes varied by region: median number of people with whom participants self‐reported injecting drugs was 3 (IQR: 2, 5) in Indonesia, 5 (IQR: 3, 10) in Ukraine and 3 (IQR: 2, 4) in Vietnam. Hazardous alcohol use, assessed using the Alcohol Use Disorders Identification Test – Alcohol Consumption Questions (AUDIT‐C), was prominent in Ukraine (54.7%) and Vietnam (26.4%). Reported sexual risk behaviours in the past month, including having two or more sex partners and giving/receiving money or drugs in exchange for sex, were uncommon among all participants and regions.ConclusionsWhile regional differences in risk structure exist, PWID particularly in Ukraine need immediate attention for risk reduction strategies. Substantial regional differences in risk structure will require flexible, tailored treatment as prevention interventions for distinct PWID populations.

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Female Sexual Partners of Male People Who Inject Drugs in Vietnam Have Poor Knowledge of Their Male Partners' HIV Status

Cited by 7 publications

References 20 publications

Women with HIV in Indonesia: are they bridging a concentrated epidemic to the wider community?

Women with HIV in Indonesia: are they bridging a concentrated epidemic to the wider community?

HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective

Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis

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