JMIR Publications

ABSTRACT

Background:

Drug users (DUs) are considered one of the high-risk groups for HIV infection and play a crucial role in the transmission of HIV.

Objective:

Under the emerging of new drugs, we aim to explore the drug using behaviors currently, HIV infections and the correlation between drug using behaviors and HIV infection risk among drug users between 2014 and 2021.

Methods:

Our data was collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou from 2014 to 2021, which included sociodemographic characteristics, HIV awareness, drug using, risky sexual behavior and HIV infection status. Multivariate logistic regression method was used to identify the influencing factors of HIV infection and risky sexual behaviors among drug users.

Results:

In total, 5623 drug users were incorporated in the data analysis, with males accounting for 84.19%, the average age was (38.38±9.94) years old. New drugs dominated the participants (65.34%). The main mode of drug use was non-injection(84.58%). Among the participants, 27.45% injected drugs in the last month before the investigation with the average injection frequency was 3.10±8.24. Meanwhile, 3.43% of participants shared needles with others. The incidence of having sexual behaviors after drug use was 33.13%, and 35.75% of them using condom every time. From 2014 to 2021, 105 out of 5623 participants were tested positive for HIV antibodies, with an infection rate of 1.87%. New type of drug users have a higher sexual behavior incidence than traditional drug users(OR=4.109, 95%CI:3.457-4.885,P<0.001). Compared with non injecting drug users, injecting drug users (OR=0.292, 95% CI: 0.209-0.407,P<0.001) have a lower sexual behavior incidence. Those who shared needles have a higher risk of engaging in sexual behavior (OR=4.568, 95% CI:1.666-12.527, P=0.0032). Drug users with higher HIV awareness were more likely to engage in risky sexual behavior(OR=6.905, 95%CI:5.881-8.106, P<0.001). Use of new type of drugs(OR=6.314, 95%CI=2.794-14.271, P<0.001), having sexual behaviors in the last month after druging(OR=0.582, 95%CI=0.316-0.885, P=0.0153), without condom using in the last month after druging(OR=0.287, 95%CI=0.132-0.624, P=0.0016) and HIV related knowledge(OR=2.785, 95%CI=1.333-5.817, P=0.0064) were significantly associated with HIV infection.

Conclusions:

New type of drugs and non-injection were main pattern in last eight years, but injecting drug users had a relatively higher injection frequency. Using new type of drugs was associated with increased risk of HIV infection compared with the traditional drugs. HIV awareness among drug users was high, but the incidence of risky sexual behavior was also still high with the low condoms use. Therefore, it is particularly important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.