HIV-1 incidence among opiate users in northern Thailand

David D Celentano, Matthew J. Hodge, Myat Htoo Razak, Christopher Beyrer, Surinda Kawichai, J. Peter Cegielski, Kenrad Edwin Nelson, Jaroon Jittiwutikarn

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Abstract

The incidence of human immunodeficiency virus type 1 (HIV-1) infection among opiate users was determined in a retrospective cohort of 436 patients with multiple admissions to the only inpatient drug treatment program in northern Thailand between October 1993 and September 1995. During 323.4 person-years of follow-up, 60 patients presenting for detoxification acquired HIV-1 infection, for a crude incidence rate of 18.6 per 100 person-years (95% confidence interval 14.4-23.9). All seroconverters were male. HIV-1 incidence varied by the current route of drug administration: 31.3 per 100 person- years for injectors and 2.8 per 100 person-years for noninjectors (smoking and ingestion). Significant differences were found by ethnicity: HIV-1 incidence was 29.3 per 100 person-years for Thai lowlanders and 8.5 per 100 person-years for hilltribes. Multivariate relative risk estimates showed that injecting opiates (vs. use by other routes), being unmarried, being under age 40 years, being a Thai lowlander, having a primary and secondary education, and being employed in the business sector were each independently associated with human immunodeficiency virus seroconversion. This HIV-1 incidence rate is double that reported for Bangkok and suggests that prevention and control programs for drug users need to be expanded throughout Thailand. Improved availability of more-effective treatment regimens and increased access to sterile injection equipment are needed to confront the HIV-1 epidemic among opiate users in northern Thailand.

Original languageEnglish (US)
Pages (from-to)558-564
Number of pages7
JournalAmerican Journal of Epidemiology
Volume149
Issue number6
StatePublished - Mar 15 1999

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Keywords

  • Drug utilization
  • Ethnic groups
  • HIV-1
  • Incidence

ASJC Scopus subject areas

  • Epidemiology

Cite this

Celentano, D. D., Hodge, M. J., Razak, M. H., Beyrer, C., Kawichai, S., Cegielski, J. P., Nelson, K. E., & Jittiwutikarn, J. (1999). HIV-1 incidence among opiate users in northern Thailand. American Journal of Epidemiology, 149(6), 558-564.