The intersection between sex and drugs: a cross-sectional study among the spouses of injection drug users in Chennai, India

Abstract

BackgroundIt is estimated that there are up to 1.1 million injection drug users (IDUs) in India; the majority are likely married. We characterize HIV, hepatitis B (HBV) and hepatitis C (HCV) prevalence and the risk environment of a sample of spouses of IDUs.MethodsA cohort of 1158 IDUs (99% male) was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV.ResultsMedian age was 31 years; thirteen percent were widowed and 7% were not currently living with their spouse. Only 4 (1%) reported ever injecting drugs; Twenty-two percent and 25% reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9%) reporting exchanging sex. Only 7% always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5%, 3.8% and 0.5%, respectively; among spouses of HIV+ IDUs (n = 78), HIV prevalence was 10.3%. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p < 0.001). Fifty-six percent of women had ever experienced intimate partner violence; Eight-six percent reported sexual violence.ConclusionsOur finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

“…104 Sexual transmission of HCV has been shown to be infrequent (0.68%) in sexually transmitted disease clinics in Pune, Maharashtra. 105 Solomon et al 106 also found that heterosexual transmission of HCV is infrequent (0.5%).…”

“…There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission. ( J CLIN EXP HEPATOL 2014;4: [106][107][108][109][110][111][112][113][114][115][116] understand the risk factors associated with transmission of this infection. This would also allow appropriate choice and targeting of efforts to prevent the spread of this disease, and thereby reduce the burden of chronic liver disease in the country.…”

Risk Factors and Associations for Hepatitis C Infection among Hispanic/Latino Intravenous Drug Users in Miami-Dade County, Florida

“…There are several cases on record where HCV infection could only be attributed to an HCV-infected sexual partner, as no other risk factor existed (Matthews et al, 2007). Most of this research was conducted in Europe, and to date there Evidence continues to accumulate in support of the sexual transmission of HCV (Solomon et al, 2011). There are several cases on record where HCV infection could only be attributed to an HCV-infected sexual partner (Matthews et al, 2007).…”

“…Sexual behavior has been theorized to be associated with HCV infection as well (Solomon et al, 2011). There are several cases on record where HCV infection could only be attributed to an HCV-infected sexual partner, as no other risk factor existed (Matthews et al, 2007).…”

“…The most efficient means of transmission of HCV occurs through percutaneous exposure to HCV infected blood (APHA, 2008 (Alter, 1997;Burt et al, 2007;CDC, 2008;CDC, 1998;Rhoads, 2003;Solomon et al, 2011;Hand & Vazquez, 2005). IDU however, is by far the most reliable factor for HCV infection (Hagan et al, 2011).…”