Evidence map›Paper›PMID 34911554›Full record

ArticleHarm reduction journal2021

Injection drug use practices and HIV infection among people who inject drugs in Kigali, Rwanda: a cross-sectional study.

Jean Olivier Twahirwa Rwema, Vianney Nizeyimana, Neia M Prata, Nneoma E Okonkwo, Amelia A Mazzei, Sulemani Muhirwa, Athanase Rukundo, Lisa Lucas, Audace Niyigena, Jean Damascene Makuza and 3 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Harm reduction journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 4 countries.

Jean Olivier Twahirwa RwemaDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133, Baltimore, MD, 21205, USA. jtwahir1@jhmi.edu.ORCID http://orcid.org/0000-0002-7954-1736
Vianney NizeyimanaHealth Development Initiative, Kigali, Rwanda.
Neia M PrataDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133, Baltimore, MD, 21205, USA.
Nneoma E OkonkwoSchool of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Amelia A MazzeiEmory University School of Medicine, Atlanta, GA, USA.
Sulemani MuhirwaHealth Development Initiative, Kigali, Rwanda.
Athanase RukundoHealth Development Initiative, Kigali, Rwanda.
Lisa LucasDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133, Baltimore, MD, 21205, USA.
Audace NiyigenaDépartement de Psychiatrie, Service d'addictologie, Hôpitaux Universitaire de Genève, Geneva, Switzerland.
Jean Damascene MakuzaSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Chris BeyrerDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133, Baltimore, MD, 21205, USA.
Stefan D BaralDepartment of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133, Baltimore, MD, 21205, USA.
Aflodis KagabaHealth Development Initiative, Kigali, Rwanda.
Johns Hopkins University · USRwanda Development Board · RWEmory University · USHôpital Beau-Séjour · CHUniversity of British Columbia · CA

Funding

Johns Hopkins HIV Epidemiology and Prevention Sciences Training ProgramT32AI102623 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Shruti H Mehta · 2013 to 2026
$5.3M
Validation of Stigma Metrics for Marginalized Men R01MH110358 · NIMH · JOHNS HOPKINS UNIVERSITY · PI BARAL, STEFAN DAVID · 2017 to 2021
$3.6M
NIAID NIH HHS T32 AI102623NIMH NIH HHS R01 MH110358
6 · The paper itself

Abstract

backgroundIn Rwanda, epidemiological data characterizing people who inject drugs (PWID) and their burden of HIV are limited. We examined injection drug use (IDU) history and practices, and HIV infection in a sample of PWID in Kigali.

methodsFrom October 2019 to February 2020, 307 PWID aged ≥ 18 were enrolled in a cross-sectional study using convenience sampling in Kigali. Participants completed interviewer-administered questionnaires on IDU history and practices and HIV testing. We used Poisson regression with robust variance estimation to assess IDU practices associated with HIV infection and assessed factors associated with needle sharing in the six months preceding the study.

resultsThe median age was 28 years (IQR 24-31); 81% (251) were males. Female PWID were more likely to report recent IDU initiation, selling sex for drugs, and to have been injected by a sex partner (p < 0.05). In the prior six months, heroin was the primary drug of choice for 99% (303) of participants, with cocaine and methamphetamine also reported by 10% (31/307) and 4% (12/307), respectively. In total, 91% (280/307) of participants reported ever sharing needles in their lifetime and 43% (133) knew someone who died from a drug-related overdose. HIV prevalence was 9.5% (95% CI 8.7-9.3). Sharing needles at least half of the time in the previous six months was positively associated with HIV infection (adjusted prevalence ratio (aPR) 2.67; 95% CI 1.23-5.78). Overall, 31% (94/307) shared needles and 33% (103/307) reused needles in the prior six months. Female PWID were more likely to share needles compared to males (aPR 1.68; 95% CI 1.09-2.59). Additionally, bisexual PWID (aPR 1.68; 95% CI 1.09-2.59), those who shared needles at the first injection (aPR 2.18; 95% CI 1.59-2.99), reused needles recently (aPR 2.27; 95% CI 1.51-3.43) and shared other drug paraphernalia (aPR 3.56; 95% CI 2.19-5.81) were more likely to report recent needle sharing.

conclusionHIV infection was common in this study. The high prevalence of needle reuse and sharing practices highlights significant risks for onward transmission and acquisition of HIV and viral hepatitis. These data highlight the urgent need for PWID-focused harm reduction services in Rwanda, including syringe services programs, safe injection education, naloxone distribution, and substance use disorder treatment programs and optimizing these services to the varied needs of people who use drugs in Rwanda.

Indexed as

Drug UsersHIV InfectionsPharmaceutical PreparationsSubstance Abuse, IntravenousAdultCross-Sectional StudiesFemaleHumansMaleNeedle SharingRwandaPharmaceutical PreparationsHIVInjection drug useKigaliPeople who inject drugsRwanda

Identifiers

PMID34911554
PMCPMC8672501
OpenAlexW4200449793

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.