Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China

Meizhen Liao, Dianmin Kang, Xiaorun Tao, Catherine Cox, Yuesheng Qian, Guoyong Wang, Cui Yang, Xiaoyan Zhu, Na Zhang, Zhenqiang Bi, Yujiang Jia

Research output: Contribution to journalArticle

Abstract

Background: An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China. Methods. A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection. Results: Of 805 eligible participants, 0.2% were infected with HIV, 3.7% with HCV, and 9.6% with syphilis. Of the participants, 96.6% were methamphetamine users, 11.9% reported ever having used ≥2 types of these drugs, and 11.4% reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95% CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95% CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95% CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95% CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95% CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95% CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95% CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95%CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95% CI:2.4-7.4). Conclusions: Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.

Original languageEnglish (US)
Article number172
JournalBMC Public Health
Volume14
Issue number1
DOIs
StatePublished - Feb 17 2014

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Methamphetamine
Virus Diseases
Syphilis
Hepacivirus
China
Odds Ratio
Confidence Intervals
Pharmaceutical Preparations
Unsafe Sex
Drug Users
HIV
Heroin
Sexual Behavior
Cross-Sectional Studies
Logistic Models
Regression Analysis
Demography
Education

Keywords

  • Drug user
  • HCV
  • Methamphetamine
  • Sexual behavior
  • Syphilis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China. / Liao, Meizhen; Kang, Dianmin; Tao, Xiaorun; Cox, Catherine; Qian, Yuesheng; Wang, Guoyong; Yang, Cui; Zhu, Xiaoyan; Zhang, Na; Bi, Zhenqiang; Jia, Yujiang.

In: BMC Public Health, Vol. 14, No. 1, 172, 17.02.2014.

Research output: Contribution to journalArticle

Liao, M, Kang, D, Tao, X, Cox, C, Qian, Y, Wang, G, Yang, C, Zhu, X, Zhang, N, Bi, Z & Jia, Y 2014, 'Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China', BMC Public Health, vol. 14, no. 1, 172. https://doi.org/10.1186/1471-2458-14-172
Liao, Meizhen ; Kang, Dianmin ; Tao, Xiaorun ; Cox, Catherine ; Qian, Yuesheng ; Wang, Guoyong ; Yang, Cui ; Zhu, Xiaoyan ; Zhang, Na ; Bi, Zhenqiang ; Jia, Yujiang. / Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China. In: BMC Public Health. 2014 ; Vol. 14, No. 1.
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abstract = "Background: An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China. Methods. A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection. Results: Of 805 eligible participants, 0.2{\%} were infected with HIV, 3.7{\%} with HCV, and 9.6{\%} with syphilis. Of the participants, 96.6{\%} were methamphetamine users, 11.9{\%} reported ever having used ≥2 types of these drugs, and 11.4{\%} reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95{\%} confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95{\%} CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95{\%} CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95{\%} CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95{\%} CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95{\%} CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95{\%} CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95{\%} CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95{\%}CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95{\%} CI:2.4-7.4). Conclusions: Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.",
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T1 - Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China

AU - Liao, Meizhen

AU - Kang, Dianmin

AU - Tao, Xiaorun

AU - Cox, Catherine

AU - Qian, Yuesheng

AU - Wang, Guoyong

AU - Yang, Cui

AU - Zhu, Xiaoyan

AU - Zhang, Na

AU - Bi, Zhenqiang

AU - Jia, Yujiang

PY - 2014/2/17

Y1 - 2014/2/17

N2 - Background: An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China. Methods. A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection. Results: Of 805 eligible participants, 0.2% were infected with HIV, 3.7% with HCV, and 9.6% with syphilis. Of the participants, 96.6% were methamphetamine users, 11.9% reported ever having used ≥2 types of these drugs, and 11.4% reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95% CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95% CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95% CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95% CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95% CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95% CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95% CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95%CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95% CI:2.4-7.4). Conclusions: Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.

AB - Background: An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China. Methods. A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection. Results: Of 805 eligible participants, 0.2% were infected with HIV, 3.7% with HCV, and 9.6% with syphilis. Of the participants, 96.6% were methamphetamine users, 11.9% reported ever having used ≥2 types of these drugs, and 11.4% reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95% CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95% CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95% CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95% CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95% CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95% CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95% CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95%CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95% CI:2.4-7.4). Conclusions: Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.

KW - Drug user

KW - HCV

KW - Methamphetamine

KW - Sexual behavior

KW - Syphilis

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