Abstract:
Background: HIV and drug overdose continue to be the leading causes of death among people who inject drugs (PWID). Mizoram, a small state in the northeast of India, has the highest prevalence of HIV in India and a high HIV prevalence among PWID. Objective: To estimate the mortality among HIV-positive and HIV-negative PWID and to describe its associated factors. Methods: Cross-sectional datasets from the 2007-2021 Mizoram State AIDS Control Society (MSACS) data comprising 14626 PWID were analyzed. Logistic regression analysis was conducted to examine the factors associated with mortality among HIV-negative and HIV-positive PWID after adjusting for potential confounding factors. Results: Mortality among HIV-negative PWID declined by 59% between 2007 and 2021. The mortality rate among HIV-positive PWID also declined by 41% between 2007 and 2021. The multiple logistic regression analysis revealed that being divorced/separated/widowed (AOR = 1.41, 95% CI 1.03-1.94) remained positively associated with mortality among HIV-positive PWID. Mortality among HIV-negative PWID remained positively associated with ages of 24-34 years (AOR = 1.54, 95% CI 1.29-1.84) and above 35 years (AOR = 2.08, 95% CI 1.52-2.86), being divorced/separated/widowed (AOR = 1.28, 95% CI 1.02-1.61), and the sharing of needles/syringes (AOR = 1.28, 95% CI 1.34-2.00). Mortality among HIV-negative PWID was negatively associated with being married (AOR = 0.72, 95% CI 0.57-0.90), being employed (AOR = 0.77, 95% CI 0.64-0.94), and having a monthly income. Conclusions: The mortality rate among HIV-negative and HIV-positive PWID declined significantly between 2007 and 2021 in Mizoram. To further reduce mortality among PWID, interventions should target those sharing needles/syringes, those above 24 years of age, and unmarried participants.
摘要:
背景:艾滋病毒和药物过量仍然是注射毒品(PWID)人群死亡的主要原因。米佐拉姆,印度东北部的一个小州,印度艾滋病毒感染率最高,PWID中艾滋病毒感染率高。目的:评估HIV阳性和HIV阴性PWID的死亡率并描述其相关因素。方法:分析了2007-2021年Mizoram州艾滋病控制协会(MSACS)数据的横截面数据集,包括14626PWID。在校正潜在混杂因素后,进行Logistic回归分析,以检查与HIV阴性和HIV阳性PWID死亡率相关的因素。结果:2007年至2021年间,HIV阴性PWID的死亡率下降了59%。在2007年至2021年期间,艾滋病毒阳性PWID的死亡率也下降了41%。多元Logistic回归分析显示,在HIV阳性PWID中,离婚/分居/丧偶(AOR=1.41,95%CI1.03-1.94)与死亡率呈正相关。HIV阴性PWID的死亡率与24-34岁(AOR=1.54,95%CI1.29-1.84)和35岁以上(AOR=2.08,95%CI1.52-2.86)的年龄呈正相关,离婚/分居/丧偶(AOR=1.28,95%CI1.02-1.61),和共用针头/注射器(AOR=1.28,95%CI1.34-2.00)。HIV阴性PWID的死亡率与已婚呈负相关(AOR=0.72,95%CI0.57-0.90),被雇用(AOR=0.77,95%CI0.64-0.94),每月有收入。结论:2007年至2021年,MizoramHIV阴性和HIV阳性PWID的死亡率显着下降。为了进一步降低PWID的死亡率,干预措施应针对那些共用针头/注射器的人,24岁以上的人,未婚参与者