E Gutiérrez-Velilla, S E Schulz-Medina, V M Dávila-Conn, N P Caballero-Suárez, S Ávila-Ríos
{"title":"Characterization of People Living with HIV Who Inject Drugs in Mexico City: Importance for Transmission and Detection.","authors":"E Gutiérrez-Velilla, S E Schulz-Medina, V M Dávila-Conn, N P Caballero-Suárez, S Ávila-Ríos","doi":"10.1089/apc.2024.0235","DOIUrl":null,"url":null,"abstract":"<p><p>People who inject drugs (PWID) face a heightened risk of acquiring/transmitting HIV, enhanced by stigma and limited health care access. In Mexico, studies on PWID have focused on the north of the country. This study aimed to delineate characteristics of PWID living with HIV in Mexico City, identify profiles based on the substance injected, and evaluate variables associated with forming transmission clusters. A cross-sectional study was conducted with data from 2019 to 2023. Participants completed a questionnaire on sociodemographic, clinical, and behavioral variables. Bivariate and multi-variate logistic regression analyses were made. Among PWID, 96.3% were male (<i>n</i> = 437), of which 90.1% were men who have sex with men, 1.5% were cisgender females (<i>n</i> = 7), and 2.2% were transgender females (<i>n</i> = 10). PWID were more likely to use drugs during sex (adjusted odds ratio [aOR] = 3.3, 95% confidence interval [CI]: 1.7-6.4, <i>p</i> < 0.001), have more sexually transmitted diseases (aOR = 1.7, 95% CI: 1.1-2.9, <i>p</i> = 0.035), and have less condom use (aOR = 0.5, 95% CI: 0.3-0.8, <i>p</i> = 0.002). The most frequently injected substance was crystal meth, and those who injected it were more likely to have syphilis (aOR = 2.9, 95% CI: 1.2-7.1, <i>p</i> = 0.021), use Grindr (aOR = 3.6, 95% CI: 1.5-8.9, <i>p</i> < 0.001), and engage in high-risk practices (aOR = 6.9, 95% CI: 2.1-22.7, <i>p</i> < 0.001) in the last 3 months. Those under 25 years (<i>p</i> = 0.002), recently infected (<i>p</i> < 0.001), and who practiced insertive anal sex (<i>p</i> < 0.001) were more likely to be part of a cluster. These findings, and the increasing use of crystal meth, underscore the critical need to implement targeted risk-reduction strategies for PWID living with HIV and to design interventions responsive to specific profiles associated with different substances, taking into account not only their risk practices but also protective behaviors such as HIV testing.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS patient care and STDs","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/apc.2024.0235","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
People who inject drugs (PWID) face a heightened risk of acquiring/transmitting HIV, enhanced by stigma and limited health care access. In Mexico, studies on PWID have focused on the north of the country. This study aimed to delineate characteristics of PWID living with HIV in Mexico City, identify profiles based on the substance injected, and evaluate variables associated with forming transmission clusters. A cross-sectional study was conducted with data from 2019 to 2023. Participants completed a questionnaire on sociodemographic, clinical, and behavioral variables. Bivariate and multi-variate logistic regression analyses were made. Among PWID, 96.3% were male (n = 437), of which 90.1% were men who have sex with men, 1.5% were cisgender females (n = 7), and 2.2% were transgender females (n = 10). PWID were more likely to use drugs during sex (adjusted odds ratio [aOR] = 3.3, 95% confidence interval [CI]: 1.7-6.4, p < 0.001), have more sexually transmitted diseases (aOR = 1.7, 95% CI: 1.1-2.9, p = 0.035), and have less condom use (aOR = 0.5, 95% CI: 0.3-0.8, p = 0.002). The most frequently injected substance was crystal meth, and those who injected it were more likely to have syphilis (aOR = 2.9, 95% CI: 1.2-7.1, p = 0.021), use Grindr (aOR = 3.6, 95% CI: 1.5-8.9, p < 0.001), and engage in high-risk practices (aOR = 6.9, 95% CI: 2.1-22.7, p < 0.001) in the last 3 months. Those under 25 years (p = 0.002), recently infected (p < 0.001), and who practiced insertive anal sex (p < 0.001) were more likely to be part of a cluster. These findings, and the increasing use of crystal meth, underscore the critical need to implement targeted risk-reduction strategies for PWID living with HIV and to design interventions responsive to specific profiles associated with different substances, taking into account not only their risk practices but also protective behaviors such as HIV testing.
期刊介绍:
AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world.
AIDS Patient Care and STDs coverage includes:
Prominent AIDS medications, therapies, and antiretroviral agents
HIV/AIDS-related diseases, infections, and complications
Challenges of medication adherence
Current prevention techniques for HIV
The latest news and developments on other STDs
Treatment/prevention options, including pre- and post-exposure prophylaxis