Impact of sex work on risk behaviours and their association with HIV positivity among people who inject drugs in Eastern Central Canada: cross-sectional results from an open cohort study

Campeau, Laurence; Blouin, Karine; Leclerc, Pascale; Alary, Michel; Morissette, Carole; Blanchette, Caty; Serhir, Bouchra; Roy, Élise

doi:10.1136/bmjopen-2017-019388

Cited by 8 publications

(6 citation statements)

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“…Additionally, although there was no statistical association between biological sex and HIV infection, female PWID in our study reported a higher prevalence of selling sex for drugs consistent with other studies among female PWID [ 33 , 34 ]. PWID who also report sex work are at a higher risk of HIV acquisition compared to other PWID [ 7 ]. Furthermore, one in three female PWID was injected by a sexual partner the first time they injected a drug, which demonstrates the complex interplay of sexual and IDU practices.…”

Section: Discussionmentioning

confidence: 99%

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Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study

et al. 2021

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Background In Rwanda, epidemiological data characterizing people who inject drugs (PWID) and their burden of HIV are limited. We examined injection drug use (IDU) history and practices, and HIV infection in a sample of PWID in Kigali. Methods From October 2019 to February 2020, 307 PWID aged ≥ 18 were enrolled in a cross-sectional study using convenience sampling in Kigali. Participants completed interviewer-administered questionnaires on IDU history and practices and HIV testing. We used Poisson regression with robust variance estimation to assess IDU practices associated with HIV infection and assessed factors associated with needle sharing in the six months preceding the study. Results The median age was 28 years (IQR 24–31); 81% (251) were males. Female PWID were more likely to report recent IDU initiation, selling sex for drugs, and to have been injected by a sex partner (p < 0.05). In the prior six months, heroin was the primary drug of choice for 99% (303) of participants, with cocaine and methamphetamine also reported by 10% (31/307) and 4% (12/307), respectively. In total, 91% (280/307) of participants reported ever sharing needles in their lifetime and 43% (133) knew someone who died from a drug-related overdose. HIV prevalence was 9.5% (95% CI 8.7–9.3). Sharing needles at least half of the time in the previous six months was positively associated with HIV infection (adjusted prevalence ratio (aPR) 2.67; 95% CI 1.23–5.78). Overall, 31% (94/307) shared needles and 33% (103/307) reused needles in the prior six months. Female PWID were more likely to share needles compared to males (aPR 1.68; 95% CI 1.09–2.59). Additionally, bisexual PWID (aPR 1.68; 95% CI 1.09–2.59), those who shared needles at the first injection (aPR 2.18; 95% CI 1.59–2.99), reused needles recently (aPR 2.27; 95% CI 1.51–3.43) and shared other drug paraphernalia (aPR 3.56; 95% CI 2.19–5.81) were more likely to report recent needle sharing. Conclusion HIV infection was common in this study. The high prevalence of needle reuse and sharing practices highlights significant risks for onward transmission and acquisition of HIV and viral hepatitis. These data highlight the urgent need for PWID-focused harm reduction services in Rwanda, including syringe services programs, safe injection education, naloxone distribution, and substance use disorder treatment programs and optimizing these services to the varied needs of people who use drugs in Rwanda.

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Section: Discussionmentioning

confidence: 99%

“…PWID additionally face significant social and economic challenges, as often demonstrated by their high burdens of homelessness, unstable housing, and incarceration rates [ 1 ]. Finally, PWID have overlapping sexual risks with high levels of inconsistent condom use and sex work [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study

et al. 2021

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“…Additionally, the fact that some PWID in the sample self-identify as MSM suggest existence of groups of PWID who may have substantial sexual risk of HIV and other STI compared to other PWID in Rwanda. For instance, PWID who also engage in sex work have been found to be at higher risk of HIV compared to other PWID 8 . Thus, programs should be cognizant of this complex interplay of sexual identities; and sexual and IDU practices to offer optimal interventions to all members of KP groups.…”

Section: Discussionmentioning

confidence: 99%

“…PWID additionally face significant social and economic challenges with high burden of homelessness or unstable housing and high incarceration rates 2 . Finally, PWID have overlapping sexual risks with high levels of inconsistent condom use and sex work 8 .…”

Section: Introductionmentioning

confidence: 99%

Injection Drug use Practices and HIV infection among People Who Inject Drugs in Kigali, Rwanda

Rwema

Nizeyimana

Menezes

et al. 2021

Preprint

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Background In Rwanda, epidemiological data characterizing people who inject drugs (PWID) and their burden of HIV are limited. We examined injecting drug use (IDU) history, practices, and HIV infection in a sample of PWID in Kigali. Methods From October 2019–February 2020, 322 PWID aged >18 were enrolled in a cross–sectional study using convenience sampling in Kigali. Participants underwent a structured interview and HIV testing. We used Poisson regression with robust variance estimation to assess IDU practices associated with HIV infection. Results The median age was 28 years(IQR:24–31) and 81%(248) were male. The median age at first injection was 23 years (IQR:20–27). HIV prevalence was 9.5%(95%CI:8.7–9.3). In the six months preceding the study, heroin was the primary drug of choice for 99%(303); but cocaine and methamphetamine were also reported by 10%(31) and 4%(12) respectively. Furthermore, 31%(94) and 33%(103) of participants, shared or reused needles in the previous six months, respectively. Up to 43%(133) knew someone who died from a drug–related overdose. PWID reporting sharing needles at least half the time in the previous six months had increased likelihood of HIV infection, compared to those who did not (aPR: 2.67; 95%CI:1.23–5.78). Conclusion HIV infection was common in this sample of PWID in Kigali. The high prevalence of needle reuse and sharing practices highlight significant risk for onward transmission and acquisition of HIV and hepatitis B and C. PWID–focused harm reduction services, including needle and syringe programs, safer injection education, naloxone distribution, and substance use disorder treatment programs, are needed in Rwanda.

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“…A growing number of personal information files (PIF) are stored on the servers of universities, hospitals and public health research centres. This information is collected for public health activities, such as the surveillance of cancers or infectious diseases [17] or for research purposes [18], sometimes with and at other times without individual consent [8,10,12,19]. In Québec, public health stakeholders or researchers may have access to personal information without individual consent, with permission granted by institutional actors such as the Director of Professional Services of a hospital [20,Art.…”

Section: An Inequitable Transparency Requirementmentioning

confidence: 99%

Access to Personal Information for Public Health Research: Transparency Should Always Be Mandatory

et al. 2019

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This document is protected by copyright law. Use of the services of Érudit (including reproduction) is subject to its terms and conditions, which can be viewed online.https://apropos.erudit.org/en/users/policy-on-use/ This article is disseminated and preserved by Érudit.Érudit is a non-profit inter-university consortium of the Université de Montréal, Université Laval, and the Université du Québec à Montréal. Its mission is to promote and disseminate research. Abstract Au Québec, la Loi sur l'accès aux documents des organismes publics et sur la protection des renseignements personnels offre une exception en matière de transparence à la plupart des institutions publiques où la recherche en santé publique est menée en leur permettant de ne pas divulguer leurs utilisations de données à caractère personnel (souvent collectées sans le consentement des personnes étudiées). Cette exception est éthiquement problématique en raison de préoccupations importantes (ex. : la protection de la vie privée et les inconvénients potentiels des utilisations secondaires de données) et nous soutenons que tous ceux qui mènent des recherches doivent être transparents et responsables du travail qu'ils accomplissent dans l'intérêt public.In Québec, the Act Respecting Access to Documents Held by Public Bodies and the Protection of Personal Information provides an exception to transparency to most public institutions where public health research is conducted by allowing them to not disclose their uses of personal data (often collected without the consent of those being studied). This exceptionalism is ethically problematic due to important concerns (e.g., protection of privacy and potential harms of secondary uses of data) and we argue that all those who conduct research should be transparent and accountable for the work they do in the public interest. Mots clés

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Impact of sex work on risk behaviours and their association with HIV positivity among people who inject drugs in Eastern Central Canada: cross-sectional results from an open cohort study

Cited by 8 publications

References 25 publications

Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study

Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study

Injection Drug use Practices and HIV infection among People Who Inject Drugs in Kigali, Rwanda

Access to Personal Information for Public Health Research: Transparency Should Always Be Mandatory

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