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ORIGINAL ARTICLE
Year : 2008  |  Volume : 30  |  Issue : 2  |  Page : 105-107 Table of Contents   

HIV seroprevalence among IV drug abusers and role of risk behaviors


1 Department of Psychiatry, Government Stanley Medical College and Hospital, Chennai-600 001, India
2 Department of Immunology, Government Stanley Medical College and Hospital, Chennai-600 001, India

Correspondence Address:
R Ponnudurai
24/3-B-T. T. K. Road, Chennai-600 018
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7176.48485

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   Abstract 

Among the various risk behaviors that are identified to cause HIV infection, intravenous drug abuse is also included. Besides aiming to evaluate the prevalence of HIV infection among the male IV drug abusers, this study was also designed to assess their risk taking behaviors. ELISA test for HIV infection was carried out in all 27 IV drug abusers who consented to participate in the study. Of them, 11 (40.74%) turned out to be HIV seropositive. All participants had history of needle sharing. Three of them indulged in homosexuality and inclusive of them six had contact with commercial sex workers. Additionally, two patients confessed to extramarital contact. Most of the HIV infected individuals were below 25 years of age when they commenced the IV drug abuse. In view of the coexistence of deviant sexual behaviors among most of the IV drug abusers, it is difficult to say that IV drug abuse alone is the causative factor for HIV seropositivity in all of them. Further research on IV drug abusers is indicated in order to ascertain whether the HIV transmission in them is through IV route or through their sexual contact, and also the differences, if any, in the nature of these two types of transmissions.

Keywords: Deviant sexual contact, HIV infection, intravenous drug abuse


How to cite this article:
Ponnudurai R, Shantha S, Uma T S, Rajarathinam S, Krishnan V S. HIV seroprevalence among IV drug abusers and role of risk behaviors. Indian J Psychol Med 2008;30:105-7

How to cite this URL:
Ponnudurai R, Shantha S, Uma T S, Rajarathinam S, Krishnan V S. HIV seroprevalence among IV drug abusers and role of risk behaviors. Indian J Psychol Med [serial online] 2008 [cited 2019 Sep 17];30:105-7. Available from: http://www.ijpm.info/text.asp?2008/30/2/105/48485


   Introduction Top


Intravenous (IV) drug use and multiple sexual partners - both homosexual and heterosexual - are the major risk factors among the mentally ill for HIV infection. [1] Yet another factor which promotes this group's vulnerability is the comorbid antisocial personality disorder. Globally, considerable importance is being given to the newly acquired HIV infection in the 16-20 age groups. Not surprisingly, in India too the adolescent group has been noted to have become more susceptible to the abuse of drugs. [2],[3]

Inevitably, studies on neuropsychiatric profile exclude IV drug abusers from the samples in order to avoid confounding variables. [4],[5] Such methodological procedures deprive us of comprehensive information on IV abusers. Hence, it becomes increasingly important to undertake studies exclusively on IV abusers to assess the factors related to the HIV infection in them. The present study sought to elucidate the prevalence of HIV infection among IV drug abusers and the potentially causative risk behaviors manifested by them.


   Methodology Top


All new male patients who were abusing drugs intravenously irrespective of the frequency, duration, or type of the substances and had reported to the research and treatment center for alcohol and drug dependence, Government Stanley Hospital, Chennai, for deaddiction management from January to September 2002 were chosen. Of the 34 patients selected, only 27 were willing to participate in the study. ELISA test for HIV was carried out in all these patients. Testing was done as per the guidelines of National AIDS control organization (NACO) under supervised pre- and post-test counseling. The results of all serum samples were reconfirmed in three immunoassays as per NACO guidelines.

Information provided by the subjects were confirmed and supplemented by the history obtained from one of their close relatives. Besides the demographic details, data regarding the date of commencement of their IV abuse, the type, frequency, method, and duration of the abuse of substances were obtained. Also, the pattern of their sexual relationships was elicited.


   Results Top


Out of the 27 IV drug abusers tested, 40.74% turned out to be seropositive for HIV. Interestingly, all of them had a history of needle sharing. However, sharing of needles was also detected in most of the HIV-negative individuals. It is of relevance to note that three of the HIV-positive subjects were also exposed to homosexuality and inclusive of them six had contact with commercial sex workers. Furthermore, two patients confessed to extramarital contact, although it was not with commercial sex workers. All the homosexuals had been active partners.

Most of the HIV-infected individuals were below the age of 25 years (81.81%) when they had first resorted to drug abuse [Table 1].


   Discussion Top


Our rate of 40.74% seropositivity among the IV abusers is higher than the rate in the general population which is about 2%. [6] From the results of our study, it is difficult to say that IV drug abuse alone is the causative factor for the HIV seropositivity in all these drug abusers, for, barring three of HIV-positive subjects, the rest had sexual contacts with homosexuals or commercial sex workers or with other women. Also, the individuals refrained from using condoms on many instances of their sexual rendezvous. Noteworthy is the observation that the chances of a person indulging in harmful unprotected sex are greater when any substance is abused. [7],[8],[9],[10]

Such a group of HIV-seropositive individuals could be more prone to develop, apart from various general medical problems, psychiatric complications, including neurocognitive impairments. Mania and acute psychosis have been reported in literature in patients with neurological infections and in the acute seroconversion stages. [11],[12],[13] However, no such psychotic behavior was detectable in our sample.

It is distressing to note that the abuse of IV substance had started in the prime youth in our HIV-seropositive samples. Also, their vulnerability to comorbid deviant sexual behavior indicates the necessity to target the adolescent groups in the psychoeducation programs under our national AIDS control schemes.

In conclusion, the small sample was a limitation of the present study. At any rate, our observations related to the commencement of IV drug abuse along with aberrant sexual behaviors in the very-young age group, might be a pointer to the policy planners of AIDS control programs in India. Our study is also an indicator for further research on IV drug abusers in order to ascertain whether the HIV transmission in them is only through IV route or through their sexual contacts or both. Also, further studies are warranted to ascertain the difference, if any, in the nature and consequences of these two types of transmissions.

 
   References Top

1.Sacks M, Dermatis H, Looser-Ott S, Perry S. Seroprevalence of HIV and risk factors for AIDS in psychiatric in patients. Hosp Community Psychiatry 1992;43:736-7.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Ponnudurai R, Jayakar J, Raju B, Pattamuthu R. A psychodemographic study of the patients of a deaddiction centre in Madras. Indian J Psychiatry 1993;35:167-8.  Back to cited text no. 2    Medknow Journal
3.Hazarika NC, Biswas D, Phukan RK, Hazarika D, Mahanta J. Prevalence and pattern of substance abuse at Bandardewa: A border area of Assam and Arunachal Pradesh. Indian J Psychiatry 2000;42:262-6.  Back to cited text no. 3    Medknow Journal
4.Edwin T, Nammalwar N, Sabhesan S, Ganesh R, Devarajan H. Neurocognitive impairments in HIV infection. Indian J Psychiatry 1999;41:30-6.  Back to cited text no. 4    Medknow Journal
5.Singh H, Sharma CS, Chakraborty PK, Sattar FA. Cognitive dysfunction in Clinically asymptomatic HIV seropositive individuals. Indian J Psychiatry 2001;43:162-70.  Back to cited text no. 5    
6.Naco. Published in Nexus, population services international. New Delhi, India: 1997.  Back to cited text no. 6    
7.Leigh BC. The relationship of sex-related alcohol expectancies to alcohol consumption and sexual behavior. Br J Addict 1990;85:919-28.  Back to cited text no. 7  [PUBMED]  
8.Stall R. The prevention of HIV infection associated with drug and alcohol use during sexual activity. Adv Alcohol Substance Abuse 1988;7:73-8.  Back to cited text no. 8    
9.Howard J, Taylor JA, Ganiakos ML. An overview of prevention research: Issues, answers and new agendas. Public Health Rep 1988;103:674-83.  Back to cited text no. 9    
10.McEwan RT, McCallum A, Bhopal RS, Madhok R. Sex and the risk of HIV Infection-the role of alcohol. Br J Addict 1992;87:577-84.  Back to cited text no. 10  [PUBMED]  
11.Schmidt U, Miller D. Two cases of hypomania in AIDS. Br J Psychiatry 1988;152:839-42.  Back to cited text no. 11  [PUBMED]  
12.Harris MJ, Jeste DV, Gleghorn A, Sewell DD. New onset psychosis in HIV infected patients. J Clin Psychiatry 1991;52:369-76.  Back to cited text no. 12  [PUBMED]  
13.Sabhesan S, Edwin T, Nammalwar N, Nageshwari A. New onset psychosis in AIDS. Indian J Psychiatry 1998;40:383-5.  Back to cited text no. 13    



 
 
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