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

Int J Drug Policy. 2014 Nov;25(6):1195-203. doi: 10.1016/j.drugpo.2013.11.009. Epub 2013 Nov 23.

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.

Keywords: Central Asia; Female partners of men who inject drugs; HCV; HIV; Injection drug use.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Seropositivity / complications
  • HIV Seropositivity / epidemiology
  • Harm Reduction*
  • Health Policy*
  • Hepatitis C / complications
  • Hepatitis C / epidemiology
  • Hepatitis C / prevention & control
  • Humans
  • Kazakhstan / epidemiology
  • Male
  • Prevalence
  • Risk Factors
  • Sexual Partners*
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / epidemiology
  • Unsafe Sex / statistics & numerical data*
  • Young Adult