ArticlePathogens and global health2023
Risk factors of HIV and variation in access to clean needles among people who inject drugs in Pakistan.
Article in Pathogens and global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Factors affecting the enrolment of men into a community adherence group in Kavango East Region, Namibia.African journal of primary health care & family medicine · 2026Article
- Notable transmitted HIV drug resistance among people who inject drugs in Pakistan.The Journal of antimicrobial chemotherapy · 2026Article
- HIV and syphilis seroprevalence and related unsafe sexual behaviours among people who inject drugs in Georgia: a cross-sectional study.BMJ open · 2025Article
- Genetic polymorphism of CCR5 (59029A/G) and CCR2 (-64I A/G) promoters in HIV infected patients.Pakistan journal of medical sciences · 2025Article
- "Sharing is my only option": an ethnographic analysis of the underlying contexts of needle and syringe sharing among people who inject drugs using the socio-ecological framework.Frontiers in public health · 2025Article
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
We identified key risk factors for HIV among people who inject drugs (PWID) in Pakistan and explored access to free clean needles. Multivariable logistic regression was used to investigate associations between HIV prevalence and demographic, behavioral, and socio-economic characteristics of PWID. Data came from the Government of Pakistan's Integrated Biological and Behavioral Surveillance (IBBS) Round 5 (2016-17; 14 cities). A secondary analysis investigated associations with reported access to clean needles. Unweighted HIV prevalence among 4,062 PWID (99% male) was 21.0%. Longer injecting duration (Odds ratio [OR] 1.06 [95% confidence interval: 1.02-1.10]; per year), higher injecting frequency (OR 1.67 [1.30-2.13]; per unit increase), and injecting heroin (OR 1.90 [1.11-3.25]) were positively associated with HIV prevalence. There was no association between using a used syringe at last injection and HIV. Having>10 years of education had lower odds of HIV than being illiterate (OR 0.58 [0.35-0.95]). Having a regular sexual partner (OR 0.74 [0.57-0.97]) or paying for sex with the opposite sex (OR = 0.62 [0.45-0.85]) had lower odds of HIV than not. Conversely, PWID paying a man/hijra for sex had higher odds of HIV (OR 1.20 [1.00-1.43]). Receipt of clean needles varied by city of residence (0-97% coverage), whilst PWID with knowledge of HIV service delivery programs had higher odds of receiving clean needles (OR 4.58 [3.50-5.99]). Injecting behaviors were associated with HIV prevalence among PWID, though risks related to paying for sex remain complicated. Geographical variation in access to clean needles suggests potential benefits of more widely spread public health services.
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