Prospects for ending the HIV epidemic among persons who inject drugs in Haiphong, Vietnam

Don C. Des Jarlais, Duong Thi Huong, Khuat Thi Hai Oanh, Minh Khuê Pham, Hoang Thi Giang, Nham Thi Tuyet Thanh, Kamyar Arasteh, Jonathan Feelemyer, Theodore Hammett, Marianne Peries, Laurent Michel, Vinh Vu Hai, Marie Jauffret Roustide, Jean Pierre Moles, Didier Laureillard, Nicolas Nagot

Research output: Contribution to journalArticle

Abstract

Background To examine the prospects for “ending the HIV epidemic” among persons who inject drugs (PWID) in Haiphong, Vietnam. Reaching an incidence of <0.5/100 person-years at risk (PY) was used as an operational definition for “ending the epidemic.” Methods A respondent driven sampling study of 603 PWID was conducted from September to October 2014. Current heroin use (verified with urine testing and marks of injection) was an eligibility requirement. A structured questionnaire was administered by trained interviewers to obtain demographic, drug use, and risk behavior data; HIV counseling and testing and HCV testing was also conducted. Two methods (by assuming all new injectors were HIV negative at first injection and by slope of prevalence by years injecting) were used for estimating HIV among persons injecting for <5 years (“new injectors”). Comparisons were made to the HIV epidemic among PWID in New York City and modeling of the HIV epidemic in Can Tho province. Results HIV prevalence was 25% in 2014, down from 68% in 2006 and 48% in 2009; overall HCV prevalence in the study was 67%. Among HIV seropositive PWID, 33% reported receiving antiretroviral treatment. The great majority (83%) of subjects reported pharmacies as their primary source of needles and syringes and self-reported receptive and distributive syringe sharing were quite low (<6%). Estimating HIV incidence among non-MSM male new injectors with the assumption that all were HIV negative at first injection gave a rate of 1.2/100 person-years (95% CI −0.24, 3.4). Estimating HIV incidence by the slope of prevalence by years injecting gave a rate of 0.8/100 person-years at risk (95% CI −0.9, 2.5). Conclusions The current HIV epidemic among PWID in Haiphong is in a declining phase, but estimated incidence among non-MSM new injectors is approximately 1/100 person-years and there is a substantial gap in provision of ART for HIV seropositives. Scaling up interventions, particularly HIV counseling and testing and antiretroviral treatment for all seropositive PWID, should accelerate the decline. Ending the epidemic is an attainable public health goal.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalInternational Journal of Drug Policy
Volume32
DOIs
StatePublished - Jun 1 2016

Keywords

  • HIV
  • Men who have sex with men (MSM)
  • Persons who inject drugs (PWID)
  • Respondent driven sampling (RDS)
  • Sex workers
  • Vietnam

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy

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  • Cite this

    Des Jarlais, D. C., Thi Huong, D., Thi Hai Oanh, K., Khuê Pham, M., Thi Giang, H., Thi Tuyet Thanh, N., Arasteh, K., Feelemyer, J., Hammett, T., Peries, M., Michel, L., Vu Hai, V., Roustide, M. J., Moles, J. P., Laureillard, D., & Nagot, N. (2016). Prospects for ending the HIV epidemic among persons who inject drugs in Haiphong, Vietnam. International Journal of Drug Policy, 32, 50-56. https://doi.org/10.1016/j.drugpo.2016.02.021