HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: Implications for HIV prevention, research, and policy

HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: Implications for HIV prevention, research, and policy
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Background: Kazakhstan and other countries in Central Asia are experiencing a rapidly growing HIVepidemic, which has historically been driven by injection drug use, but is more recently being fueled byheterosexual transmission.

Methods: This paper examines HIV and HCV infection, as well as sexual and drug-related risks amongfemale partners of men who inject drugs (MWID), comparing females who inject drugs (FWID) to non-injecting female partners on socio-demographic, relationship context, and structural characteristics.

Results: The prevalence rate of HIV was 30.1% among FWID and 10.4% among non-IDU female partnersof MWID. The prevalence rate of HCV was 89.8% among FWID and 14.8% among female non-IDUs. Lessthan one-fifth of all female participants had access to HIV education and services or harm reductionprograms. Although high rates of non-injection drug use and sexual risk behaviors were found amongboth FWID and non-injecting female partners of MWID, we found that FWID were more likely to be HIVseropositive (aRR = 3.03; 95% CI = 1.78, 5.18) and HCV seropositive than non-IDU females (aRR = 6.05; 95%CI = 4.05, 9.04), were more likely to have used alcohol or drugs before sex (aRR = 1.67; 95% CI = 1.40, 2.00),and were more likely to have used sedatives, barbiturates, tranquilizers, sleeping pills, or painkillers thatwere not prescribed by a physician (aRR = 17.45; 95% CI = 8.01, 38.01).

Conclusion: Given the spread of the HIV epidemic to heterosexual partners in Kazakhstan, more attentionis needed in research, prevention, and policies regarding female partners of male injection drug users.

Published in 2014 by International Journal of Drug Policy