Gender Disparities in HIV Prevalence and Risk Behaviors among People Who Inject Drugs in Tajikistan

Gender Disparities in HIV Prevalence and Risk Behaviors among People Who Inject Drugs in Tajikistan

By: William Zule, David Otiashvili, Alisher Latypov, Steffani Bangel, Wendee Wechsberg
Publication: Drug and Alcohol DependenceFeb. 2017; 171: e225. DOI: 10.1016/j.drugalcdep.2016.08.614.

Abstract

Aims

HIV among people who inject drugs (PWID) is a serious public health problem in Tajikistan and other Central Asian Republics, yet relatively few studies have been conducted among PWID in Tajikistan and almost nothing is known about females who inject drugs. This presentation will examine gender differences in HIV status, injection risk behaviors and sex risk behaviors among PWID in Tajikistan.

Methods

Needle and syringe program staff recruited 200 PWID in two Tajikistan cities, Khudjand (n = 100) and Kulob (n = 100), in 2015. All participants completed a brief interview and were tested for HIV. We conducted bivariate analyses to assess gender differences in the sample. We conducted multiple logistic regression analyses to determine if gender was independently associated with HIV status, injection risk, sex risk, and a history of substance abuse treatment.

Results

The sample included 27 females and 173 males. HIV prevalence was 44% among females and 24% among males. Among participants who tested positive for HIV, 83% of females and 63% of males were unaware that they were infected with HIV. In multivariable models, female gender was associated with increased odds of testing positive for HIV (odds ratio [OR] = 2.71; 95% confidence interval [CI] = 1.08, 6.80), reporting any direct or indirect needle sharing in the past year (OR = 9.08; 95% CI = 2.31, 35.71), and reporting unprotected sex in the past 30 days (OR = 3.40; 95% CI = 1.08, 10.70). Gender was not significantly associated with a history of substance abuse treatment in the models.

Conclusions

Efforts are needed to increase HIV testing among PWID in Tajikistan and to reduce risk behaviors, particularly among females.