Researchers identify patterns of HIV risk among people who inject drugs in Vietnam

February 6, 2018, University of North Carolina Health Care
LEFT: A depiction of the contact patterns by age group in the Thai Nguyen cohort of people who inject drugs. RIGHT: The corresponding estimates of the numbers of new HIV infections expected to be acquired (solid line) or transmitted by (dotted line) each age group, based on observed mixing and HIV prevalence patterns. Credit: Kumi Smith

People who inject drugs (PWID) in Vietnam are disproportionately affected by HIV. While HIV prevalence among the general population aged 15-49 is 0.4 percent, the prevalence of HIV among people who inject drugs is a staggering 11 percent, according to UNAIDS.

In an effort to combat new infections among PWID, researchers at the University of North Carolina at Chapel Hill conducted the first study to explore how this population mixes together. Their results were published in the Journal of Acquired Immune Deficiency Syndromes.

"There is a severe epidemic in Vietnam of HIV among people who inject drugs," said Kumi Smith, PhD, the study's lead author and a at UNC's Institute for Global Health & Infectious Diseases. "Risk of HIV infection is not uniform throughout a population, and depends greatly on the patterns of social contact within a population. We looked at these patterns to see if we could figure out who we should prioritize for prevention services, given that resources are limited."

Smith and her colleagues studied men who inject drugs at UNC Project-Vietnam's site in Thai Nguyen, about 40 miles north of the capital of Hanoi. They found that mixing was assortative in terms of age; that is, these men tend to share needles to inject drugs with other men of the same age. By pairing this information with what they knew about HIV infection rates in each age group, the research team was able to dig deeper to identify which combination of age groups led to the most new infections.

"We are really good at saying who is at risk for acquiring HIV, but we are not good at pinpointing who is transmitting HIV," Smith said. "By looking at how these shared needles, we discovered which groups were most at risk for becoming infected and which were most at risk for transmitting HIV."

The findings from this study can be used to help clinicians identify people who inject drugs who would benefit from pre-exposure prophylaxis, or PrEP, which is a once daily pill to prevent HIV. The results can also inform those living with HIV who should be linked to care and could be prescribed treatment. Treatment not only improves the health of the person living with HIV, but it makes them less contagious to partners with whom they share needles.

"We hope that this information assists health authorities in resource-constrained settings, like where our research took place, make difficult decisions about optimal allocation of limited resources for treatment and prevention of HIV," Smith said.

Explore further: Hepatitis C 'treatment as prevention' strategy examined in new study

More information: M Kumi Smith et al, Using Contact Patterns to Inform HIV Interventions in Persons Who Inject Drugs in Northern Vietnam, JAIDS Journal of Acquired Immune Deficiency Syndromes (2018). DOI: 10.1097/QAI.0000000000001632

Related Stories

Hepatitis C 'treatment as prevention' strategy examined in new study

November 30, 2017
Hepatitis C infection is a global phenomenon that affects millions worldwide, with an estimated 30,500 new cases in the United States alone each year. Expanding treatment, however, could go a long way toward preventing transmission ...

New perspectives on risk of HIV and hepatitis among injecting drug users

October 24, 2017
Reviews of the global prevalence of injecting drug use and of interventions to prevent the spread of blood-borne viruses among people who inject drugs paint a worrying picture.

Emerging HIV epidemics among people who inject drugs in the Middle East and North Africa

June 19, 2014
HIV epidemics are emerging among people who inject drugs in several countries in the Middle East and North Africa. Though HIV infection levels were historically very low in the Middle East and North Africa, substantial levels ...

Daily pill prevents HIV – reaching people who could benefit from PrEP

November 25, 2015
CDC's latest Vital Signs report finds a continuing need to raise awareness of pre-exposure prophylaxis (PrEP) – a daily pill that can prevent HIV infection – among those who are at substantial risk for HIV infection.

HIV PrEP currently too pricey to justify use in people who inject drugs

April 25, 2016
HIV preexposure prophylaxis (PrEP) has individual and population health benefits, but the intervention is currently too expensive to implement in in people who inject drugs. The findings are published in Annals of Internal ...

Interventions for reducing hepatitis C infection in people who inject drugs

September 26, 2017
The first global review to quantify the impact of needle syringe programmes (NSP) and opioid substitution treatment (OST) in reducing the risk of becoming infected with the hepatitis C virus is published in Cochrane Library ...

Recommended for you

Researchers find new way to defeat HIV latency

March 8, 2018
HIV, the virus that causes AIDS, has a secret life. Though anti-retroviral therapy can reduce its numbers, the virus can hide and avoid both treatments and the body's immune response.

Broadly neutralizing antibody treatment may target viral reservoir in monkeys

March 5, 2018
After receiving a course of antiretroviral therapy for their HIV-like infection, approximately half of a group of monkeys infused with a broadly neutralizing antibody to HIV combined with an immune stimulatory compound suppressed ...

HIV begins to yield secrets of how it hides in cells

March 2, 2018
UC San Francisco scientists have uncovered new mechanisms by which HIV hides in infected cells, resting in a latent state that evades the body's immune system and prevents antiviral drugs from flushing it out.

HIV exports viral protein in cellular packages

February 15, 2018
HIV may be able to affect cells it can't directly infect by packaging a key protein within the host's cellular mail and sending it out into the body, according to a new study out of a University of North Carolina Lineberger ...

Can gene therapy be harnessed to fight the AIDS virus?

February 13, 2018
For more than a decade, the strongest AIDS drugs could not fully control Matt Chappell's HIV infection. Now his body controls it by itself, and researchers are trying to perfect the gene editing that made this possible.

Big data methods applied to the fitness landscape of the HIV envelope protein

February 7, 2018
Despite significant advances in medicine, there is still no effective vaccine for the human immunodeficiency virus (HIV), although recent hope has emerged through the discovery of antibodies capable of neutralizing diverse ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.