A Prevalance and Behavioral Study on HIV, Hepatitis B, Hepatitis C and Tuberculosis among Intravenous Drug Users in Gaziantep 2009

Abstract

Introduction and goal: There is limited data on HIV/AIDS, Hepatitis B (HBV), Hepatitis C (HCV) and Tuberculosis (TB) among injecting drug users (IDUs) in Turkey. This study assessed knowledge, attitude and practice regarding HIV/AIDS, HBV, HCV and TB as well as serological components of these infections among IDUs.

Methods: A questionnaire was applied covering socio-demographic characteristics, knowledge and attitudes  about HIV/AIDS, HBV, HCV and TB. Serological testing was performed after completion of the questionnaire. Chi-square test and t-test statistics were performed.

Results: A total of 168 IDUs were interviewed between January and March 2009. 97.0% of the participants were male. The average age of the respondents was 31.5 years. Almost half (41.1%) had only primary education. The average duration of use of addictive drug(s) was 6.14±3.12 years and the average duration of injecting drug use was 3.03. ±1.94 years while the average of age of first injection was 28.37±4.37. Drug first used was cannabis at 71.4%. Heroin was the first drug injected at 95.8%. Only 31 were using single drug. Sharing needles was 68.5%, mostly shared with friends at 59.5%. Using condom with regular partner was 71.4% and 70.8% with commercial partner.

Overall, 92.9% of IDUs in this study reported that HIV while 89.9% HBV and HCV can be transmitted by a syringe used by someone else. 89.9% reported that HBV or HCV can be transmitted by a syringe used by someone else. 91.9% mentioned that protection from HIV is possible when condom is correctly used during sexual intercourse, 56.5% reported that a healthy looking person can be HIV(+), 82.7% mentioned that a pregnant woman can transmit HIV to her baby, only 5.4% answered that a person will not get HIV from mosquito bites while 25.0% answered that a person will not get HIV by sharing food with someone who is infected.

67 IDUs have been found as susceptible for HBV while 64 were immune due to natural infection, 2 were immune due to vaccination, 9 of them were chronically infected. None of the IDUs was HIV (+), only 9 were HCV (+).

51 IDUs stated that taking TB medication can be stopped whenever feeling better, 149 IDUs stated that if people do not continue TB medication as long as prescribed, treatment will get more difficult. 90 IDUs incorrectly thought that IDUs can keep from getting TB by bleaching their needles or by not sharing needles. Only 4 IDUs thought that TB is not transmitted by sharing food, 4 IDUs thought that TB cannot be transmitted after eating at a restaurant where the cook has TB and only 2 IDUs thought that using public toilets TB cannot be transmitted. 155 IDUs thought that TB can be transmitted by working close to or living with someone infected and 152 IDUs stated that a person cured from TB can get the disease again. Moreover, 88 IDUs thought that persons with HIV or AIDS are at increased risk for developing TB. No IDU stated that there is a new kind of TB around that is not easily treated with available medicines. The majority of respondents (91.1%) recognized that drug therapy is available to cure tuberculosis, 154 stated that TB treatment is usually given in TB dispensaries and 151 mentioned that anti-TB medications are available at no charge.

Conclusions: Education builds up knowledge. Therefore, organisation of sustainable training and educational programmes reaching IDUs, would change and improve their knowledge and attitudes on HIV/AIDS, HBV, HCV and TB.

A statistical correlation has been found between education and knowledge on HIV, HBV, HCV and TB and the same was true for needle sharing and education (Χ2=11.7; P<0.01).

Keywords: Injecting drug user, HIV&AIDS, HCV, HBV, TB, knowledge, attitude, practice.