Prevalence and correlates of HIV and HCV infection among amphetamine-type stimulant users in 6 provinces in China.

BACKGROUND: China has experienced an epidemic of amphetamine-type stimulant (ATS) use in recent years. The present study explored the status and correlates of HIV and hepatitis C virus (HCV) infection among ATS users in China. METHODS: A multicenter cross-sectional study of HIV and HCV status and associated behaviors among ATS users was conducted in 6 provinces from September 2009 to December 2010. Socioeconomic/behavioral risk factors were measured. Blood samples were collected to test for HIV and HCV antibodies. RESULTS: Of the 1327 ATS users the prevalence of HIV and exposure to HCV were 4.5% and 43.5% respectively with large geographic variations (0%-20.3% and 8.6%-67.1% respectively). HIV infection was independently associated with living in Yunnan province [adjusted odds ratio = 15.8; 95% confidence interval (CI): 2.0 to 125.1) polydrug use (adjusted odds ratio = 2.6; 95% CI: 1.3 to 5.4) increased frequency of sexual behavior (adjusted odds ratio = 2.0; 95% CI: 1.1 to 4.1) history of sex with sexually transmitted infection-positive persons (adjusted odds ratio = 11.4; 95% CI: 1.3 to 98.9) and HCV infection (adjusted odds ratio = 2.8; 95% CI: 1.2 to 6.7). HCV was associated with study site marital status unemployment (adjusted odds ratio = 1.8; 95% CI: 1.3 to 2.4) a longer duration of ATS use and history of injection use of ATS (adjusted odds ratio = 13.3; 95% CI: 1.5 to 116.1). CONCLUSIONS: The prevalence of HIV was high among ATS users in Yunnan province but quite rare elsewhere and the prevalence of exposure to HCV was high in 6 provinces. Risk factors emphasize the need for new prevention strategies toward this population at risk in China.