The intersection between sex and drugs: A cross-sectional study among the spouses of injection drug users in Chennai, India

Sunil Solomon, Aylur K. Srikrishnan, David D Celentano, Sethulakshmi C. Johnson, Canjeevaram K. Vasudevan, Kailapuri G. Murugavel, Santhanam Anand, M. Suresh Kumar, Suniti Solomon, Shruti Hemendra Mehta

Research output: Contribution to journalArticle

Abstract

Background: It is estimated that there are up to 1.1 million injection drug users (IDUs) in India; the majority are likely married. We characterize HIV, hepatitis B (HBV) and hepatitis C (HCV) prevalence and the risk environment of a sample of spouses of IDUs. Methods. A cohort of 1158 IDUs (99% male) was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV. Results: Median age was 31 years; thirteen percent were widowed and 7% were not currently living with their spouse. Only 4 (1%) reported ever injecting drugs; Twenty-two percent and 25% reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9%) reporting exchanging sex. Only 7% always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5%, 3.8% and 0.5%, respectively; among spouses of HIV+ IDUs (n = 78), HIV prevalence was 10.3%. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p <0.001). Fifty-six percent of women had ever experienced intimate partner violence; Eight-six percent reported sexual violence. Conclusions: Our finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.

Original languageEnglish (US)
Article number39
JournalBMC Public Health
Volume11
DOIs
StatePublished - 2011

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Drug Users
Spouses
India
Cross-Sectional Studies
HIV
Injections
Pharmaceutical Preparations
Sex Offenses
Condoms
Widowhood
Sexual Partners
Hepatitis C
Hepatitis B
Logistic Models
Alcohols
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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The intersection between sex and drugs : A cross-sectional study among the spouses of injection drug users in Chennai, India. / Solomon, Sunil; Srikrishnan, Aylur K.; Celentano, David D; Johnson, Sethulakshmi C.; Vasudevan, Canjeevaram K.; Murugavel, Kailapuri G.; Anand, Santhanam; Kumar, M. Suresh; Solomon, Suniti; Mehta, Shruti Hemendra.

In: BMC Public Health, Vol. 11, 39, 2011.

Research output: Contribution to journalArticle

Solomon, Sunil ; Srikrishnan, Aylur K. ; Celentano, David D ; Johnson, Sethulakshmi C. ; Vasudevan, Canjeevaram K. ; Murugavel, Kailapuri G. ; Anand, Santhanam ; Kumar, M. Suresh ; Solomon, Suniti ; Mehta, Shruti Hemendra. / The intersection between sex and drugs : A cross-sectional study among the spouses of injection drug users in Chennai, India. In: BMC Public Health. 2011 ; Vol. 11.
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abstract = "Background: It is estimated that there are up to 1.1 million injection drug users (IDUs) in India; the majority are likely married. We characterize HIV, hepatitis B (HBV) and hepatitis C (HCV) prevalence and the risk environment of a sample of spouses of IDUs. Methods. A cohort of 1158 IDUs (99{\%} male) was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV. Results: Median age was 31 years; thirteen percent were widowed and 7{\%} were not currently living with their spouse. Only 4 (1{\%}) reported ever injecting drugs; Twenty-two percent and 25{\%} reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9{\%}) reporting exchanging sex. Only 7{\%} always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5{\%}, 3.8{\%} and 0.5{\%}, respectively; among spouses of HIV+ IDUs (n = 78), HIV prevalence was 10.3{\%}. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p <0.001). Fifty-six percent of women had ever experienced intimate partner violence; Eight-six percent reported sexual violence. Conclusions: Our finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.",
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T2 - A cross-sectional study among the spouses of injection drug users in Chennai, India

AU - Solomon, Sunil

AU - Srikrishnan, Aylur K.

AU - Celentano, David D

AU - Johnson, Sethulakshmi C.

AU - Vasudevan, Canjeevaram K.

AU - Murugavel, Kailapuri G.

AU - Anand, Santhanam

AU - Kumar, M. Suresh

AU - Solomon, Suniti

AU - Mehta, Shruti Hemendra

PY - 2011

Y1 - 2011

N2 - Background: It is estimated that there are up to 1.1 million injection drug users (IDUs) in India; the majority are likely married. We characterize HIV, hepatitis B (HBV) and hepatitis C (HCV) prevalence and the risk environment of a sample of spouses of IDUs. Methods. A cohort of 1158 IDUs (99% male) was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV. Results: Median age was 31 years; thirteen percent were widowed and 7% were not currently living with their spouse. Only 4 (1%) reported ever injecting drugs; Twenty-two percent and 25% reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9%) reporting exchanging sex. Only 7% always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5%, 3.8% and 0.5%, respectively; among spouses of HIV+ IDUs (n = 78), HIV prevalence was 10.3%. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p <0.001). Fifty-six percent of women had ever experienced intimate partner violence; Eight-six percent reported sexual violence. Conclusions: Our finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.

AB - Background: It is estimated that there are up to 1.1 million injection drug users (IDUs) in India; the majority are likely married. We characterize HIV, hepatitis B (HBV) and hepatitis C (HCV) prevalence and the risk environment of a sample of spouses of IDUs. Methods. A cohort of 1158 IDUs (99% male) was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV. Results: Median age was 31 years; thirteen percent were widowed and 7% were not currently living with their spouse. Only 4 (1%) reported ever injecting drugs; Twenty-two percent and 25% reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9%) reporting exchanging sex. Only 7% always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5%, 3.8% and 0.5%, respectively; among spouses of HIV+ IDUs (n = 78), HIV prevalence was 10.3%. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p <0.001). Fifty-six percent of women had ever experienced intimate partner violence; Eight-six percent reported sexual violence. Conclusions: Our finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.

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