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

• Published in: The International journal of drug policy 2014-11, Vol.25 (6), p.1195-1203
• Main Authors: El-Bassel, Nabila, Gilbert, Louisa, Terlikbayeva, Assel, Beyrer, Chris, Wu, Elwin, Shaw, Stacey A, Ma, Xin, Chang, Mingway, Hunt, Tim, Ismayilova, Leyla, Primbetova, Sholpan, Rozental, Yelena, Zhussupov, Baurzhan
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; Adult; AIDS; Alcohol; Barbiturates; Central Asia; Demographics; Disease transmission; Drug Abuse; Drug Injection; Drug policy; Drug use; Drug users; Drugs; Education; Female; Female partners of men who inject drugs; Females; Harm Reduction; HCV; Health Policy; Hepatitis C - complications; Hepatitis C - epidemiology; Hepatitis C - prevention & control; Heterosexuality; Heterosexuals; HIV; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Seropositivity - complications; HIV Seropositivity - epidemiology; Human immunodeficiency virus; Humans; Injection drug use; Internal Medicine; Kazakhstan; Kazakhstan - epidemiology; Male; Males; Medical Education; Physicians; Prevalence; Prevention; Risk; Risk Factors; Sedatives; Sexual behaviour; Sexual Partners; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Unsafe Sex - statistics & numerical data; Young Adult
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2013.11.009

Abstract Background Kazakhstan and other countries in Central Asia are experiencing a rapidly growing HIV epidemic, which has historically been driven by injection drug use, but is more recently being fueled by heterosexual transmission. Methods This paper examines HIV and HCV infection, as well as sexual and drug-related risks among female 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 partners of MWID. The prevalence rate of HCV was 89.8% among FWID and 14.8% among female non-IDUs. Less than one-fifth of all female participants had access to HIV education and services or harm reduction programs. Although high rates of non-injection drug use and sexual risk behaviors were found among both FWID and non-injecting female partners of MWID, we found that FWID were more likely to be HIV seropositive (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 that were 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 attention is needed in research, prevention, and policies regarding female partners of male injection drug users.