ArticleJournal of the International AIDS Society2019
Young people who inject drugs in India have high HIV incidence and behavioural risk: a cross-sectional study.
Article in Journal of the International AIDS Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis.The lancet. Gastroenterology & hepatology · 2023Pooled it
- Trial
- Evaluating spatially targeted HIV interventions and harm reduction services among people who inject drugs in a high-burden setting.Nature communications · 2026Article
- Evaluating Spatially Targeted HIV Interventions and Harm Reduction Services Among People Who Inject Drugs in a High-Burden Setting.medRxiv : the preprint server for health sciences · 2026Article
- Expanding single-venue services to better engage young people who inject drugs: insights from India.Harm reduction journal · 2024Review
- Modeling the impact of the COVID-19 pandemic on achieving HCV elimination amongst young and unstably housed people who inject drugs in San Francisco.The International journal on drug policy · 2024Article
- Injection network drivers of HIV prevention service utilization among people who inject drugs: results of a community-based sociometric network cohort in New Delhi, India.Journal of the International AIDS Society · 2024Article
- Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India.Addiction (Abingdon, England) · 2024Observational
- HIV and its associated factors among people who inject drugs in Mizoram, Northeast India.PloS one · 2023Article
- Combating illicit fentanyl: Will increased Chinese regulation generate a public health crisis in India?Frontiers in public health · 2022Article
- Young and invisible: a qualitative study of service engagement by people who inject drugs in India.BMJ open · 2021Article
- Young people who inject drugs in India have high HIV incidence and behavioural risk: a cross-sectional study.Journal of the International AIDS Society · 2019Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionThere are limited data on young people who inject drugs (PWID) from low- and middle-income countries where injection drug use remains a key driver of new HIV infections. India has a diverse injection drug use epidemic and estimates suggest that at least half of PWID are ≤30 years of age. We compared injection and sexual risk behaviours and HIV incidence between younger and older PWID and characterized uptake of HIV testing and harm reduction services to inform targeted HIV prevention efforts.
methodsWe analysed cross-sectional data from 14,381 PWID recruited from cities in the Northeast and North/Central regions of India in 2013 using respondent driven sampling (RDS). We compared "emerging-adult" (18 to 24 years, 26% of sample) and "young-adult" PWID (25 to 30 years, 30% of sample) to older PWID (>30 years, 44% of sample) using logistic regression to evaluate factors associated with three recent risk behaviours: needle-sharing, multiple sexual partners and unprotected sex. We estimated age-stratified cross-sectional HIV incidence using a validated multi-assay algorithm.
resultsCompared to older adults, emerging-adults in the Northeastern states were significantly more likely to share needles (males adjusted odds ratio [aOR] 1.82; females aOR 2.29, p < 0.01), have multiple sexual partners (males aOR 1.56; females aOR 3.75, p < 0.01), and engage in unprotected sex (males aOR 2.29, p < 0.01). In the North/Central states, young-adult males were significantly more likely to needle-share (aOR 1.23, p < 0.05) while emerging-adult males were significantly more likely to have multiple sexual partners (aOR 1.74, p < 0.05). In both regions, emerging-adults had the lowest HIV testing. Participation in harm reduction services was low across all age groups. Annual HIV incidence was higher in emerging- and young-adult PWID in the North/Central region: emerging-adults: 4.3% (95% confidence interval [CI] 3.0, 5.6); young-adults: 4.9% (95% CI 3.7, 6.2); older adults: 2.1% (95% CI 1.4, 2.8).
conclusionsHigher HIV incidence and engagement in risky behaviours among younger PWID compared to older PWID, coupled with low utilization of harm reduction services highlight the importance of targeting this population in HIV programming. Age-specific interventions focused on addressing the needs of young PWID are urgently needed to curb the HIV epidemic in this vulnerable population.
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