Objective: To determine the demographic characteristics and risk behaviors associated with HIV positive and negative injection drug users (IDUs) who were screened for inclusion in a prospective cohort study to estimate HIV incidence in Xinjiang, China. Methods: Data analyses were performed on the demographic and risk assessment data collected at screening from high-risk IDUs, defined as anyone who reported injecting drugs at least three times per week in the last month or injected drugs after sharing equipment on at least three occasions in the last three months. Results: HIV antibody prevalence among 781 IDUs at baseline survey was 29%. The following factors were significantly associated with an increase in risk for HIV infection: age ≥26 years (OR = 3.16, 95% CI [2.02;4.94]), lack of college education (OR = 2.32, 95% CI [1.02;5.25]), frequency of heroin use (OR = 1.23, 95% CI [1.02;1.47]) and sharing of rinse water (OR = 1.47, 95% CI [1.18;1.84]). Female gender (OR = 0.44, 95% CI [0.22;0.86]), being Han vs Uighur ethnicity (OR = 0.18, 95% CI [0.11;0.27]), and other race vs Uighur ethnicity (OR = 0.23, 95% CI [0.12;0.44]) were significantly associated with a lower risk of HIV infection. Conclusions: HIV infection among high risk IDUs in Xinjiang, China is high and is associated with older male Uighur IDUs who lack college education, frequently inject heroin, and/or share rinse water. There is a great potential for HIV transmission from IDUs to the general population. Therefore, related risk behaviors in IDUs, especially their sexual behavior, should be closely monitored.
Bibliographical noteFunding Information:
The authors are grateful to the men and women who participated in this study. Special thanks are offered to Shao Hua Wang, Ai Hua Zhang, Jing Gong Hao, Mawlan Mamtimin, Parhat Yadikar, Yongsheng Guan, Minawar Abai, Chun Mei Zhao, Xahadetgul Sulayman, Jing Wang, Gulsum Ghuja, Ben Lai Liu, Abdurahman, Jun Wei, Abdurixit, Dongbao Yu, and Yun Xia Wang. The authors would like to acknowledge support from the Statistical Center for HIV/AIDS Research and Prevention (SCHARP), Seattle, WA and Family Health International, Durham, NC, the Xinjiang Bureau of Health, Urumqi Detoxification Center and Xinjiang Public Security Bureau.
- HIV prevalence
- Risk behaviors