HIV infection among injecting drug users in Kinondoni municipality, Dar es Salaam

The emergency of injecting drug use and the possibility of transmission of human immunodeficiency virus (HIV) among injecting drug users (IDUs), their partners and their children, is a major public health concern. Recent researches have shown that one of the core risk behaviours that is behind the spread of HIV through injecting drug use is the sharing of injecting equipment, which is greatly influenced by drug injecting practices. Most of the studies conducted suggest an extensive occurrence of risk injecting practices and a high potential of escalation of HIV epidemics among injecting drug users. However, available information does not provide exact explanation on HIV risk characteristics of IDUs, levels of risk drug injecting practices and the extent of HIV infection among IDUs. This information is essential in designing appropriate HIV interventions and prevention strategies among IDUs. This study was therefore conducted to investigate drug injecting practices and HIV seropositivity among selected injecting drug users in Kinondoni Municipality, rDar es Salaam. This cross-sectional study was carried out in May, 2004 and involved 201 consenting IDUs who were recruited by snowballing method. Structured interviews covering demographic characteristics, social development of injecting drug use, current HIV risk drug use behaviour in the last 6 months were administered. Serum samples were collected for HIV antibody testing. Respondents ranged from 18 to 48 years of age (mean =29.4) and 84.1% of them were males. The first common substance of abuse reported was cigarette (56.2%). Mean age of injection initiation was 25.5 years. Heroin was the most common used drug by all respondents. Multiple unsafe injecting practices were common. Over 73% of the respondents injected 3 times a day. The reported needles/syringes sharing was high, 40.3% of IDUs reported using a syringe previously used by another IDUs. A great proportion (45.7%) of the respondents shared injecting equipment with 2 to 5 people. Of those who shared 95.1% cleaned the needles/syringes before use, however, the procedure they used was not sufficient to kill any virus present. The overall HIV prevalence among the respondents was 31.3%. Females had a higher HIV seroprevalence of 75% than males who had a seroprevalence of 23.1%. The high HIV prevalence and the existence of high-risk drug injecting practices indicate a potential for rapid HIV spread in IDUs in Kinondoni Municipality. Preventive measures that will target specifically IDUs to reduce the high risk injecting practices are urgently needed to reduce HIV transmission among IDUs and from IDUs to the general population. One would recommend that harm reduction approach be adopted that will involve needle exchange programmes.