Patterns of drug and sexual HIV transmission risk behaviors: A latent class analyses of men and women who inject drugs and are living with HIV in Kazakhstan

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-05-11 DOI:10.1016/j.drugalcdep.2025.112707

Trena I. Mukherjee , Tara McCrimmon , Sholpan Primbetova , Meruyert Darisheva , Assel Terlikbayeva , Nabila El-Bassel

{"title":"Patterns of drug and sexual HIV transmission risk behaviors: A latent class analyses of men and women who inject drugs and are living with HIV in Kazakhstan","authors":"Trena I. Mukherjee , Tara McCrimmon , Sholpan Primbetova , Meruyert Darisheva , Assel Terlikbayeva , Nabila El-Bassel","doi":"10.1016/j.drugalcdep.2025.112707","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Central Asia has one of the fastest-growing HIV epidemics globally. Suboptimal anti-retroviral treatment (ART) coverage and viral suppression among people who inject drugs (PWID) and are living with HIV increase transmission risk to injection and sexual partners. Men and women may have distinct patterns of HIV transmission risk behaviors, but little is known about how these behaviors co-occur. This paper identifies HIV transmission risk typologies among PWID and examines associated health outcomes by sex.</div></div><div><h3>Methods</h3><div>Between February 2017 and June 2019, we recruited 450 men and 166 women (N = 616) PWID living with HIV in Kazakhstan. Latent class analysis identified heterogenous patterns of injection and sexual risk behaviors. Multinomial logistic regression examined how criminal-justice involvement, drug use and health outcomes varied by risk patterns.</div></div><div><h3>Results</h3><div>ART coverage was 71 % and viral suppression was 43 %, with little variation by sex. Among men, latent classes included: No injection & Low Sexual Risk (41.8 %), Injection & Sexual Risk (36.4 %), and Low Injection & High Injection Risk (21.8 %) behaviors. Both injection risk classes were associated with higher odds of detention, drug use, and overdose. Among women, classes included: Low Injection & Sexual Risk (60.7 %), Sex Work Behaviors & Injection Risk (8.4 %), High Injection & Sexual Risk (30.7 %) behaviors. Sex Work Behaviors & Injection Risk was associated with higher odds of detention, heroin use, and verbal police harassment.</div></div><div><h3>Conclusion</h3><div>PWID living with HIV in Kazakhstan exhibit high-risk behaviors and low viral suppression. Distinct patterns by sex underscore the need for tailored harm reduction strategies and retention in HIV care.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112707"},"PeriodicalIF":3.9000,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol dependence","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0376871625001607","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Central Asia has one of the fastest-growing HIV epidemics globally. Suboptimal anti-retroviral treatment (ART) coverage and viral suppression among people who inject drugs (PWID) and are living with HIV increase transmission risk to injection and sexual partners. Men and women may have distinct patterns of HIV transmission risk behaviors, but little is known about how these behaviors co-occur. This paper identifies HIV transmission risk typologies among PWID and examines associated health outcomes by sex.

Methods

Between February 2017 and June 2019, we recruited 450 men and 166 women (N = 616) PWID living with HIV in Kazakhstan. Latent class analysis identified heterogenous patterns of injection and sexual risk behaviors. Multinomial logistic regression examined how criminal-justice involvement, drug use and health outcomes varied by risk patterns.

Results

ART coverage was 71 % and viral suppression was 43 %, with little variation by sex. Among men, latent classes included: No injection & Low Sexual Risk (41.8 %), Injection & Sexual Risk (36.4 %), and Low Injection & High Injection Risk (21.8 %) behaviors. Both injection risk classes were associated with higher odds of detention, drug use, and overdose. Among women, classes included: Low Injection & Sexual Risk (60.7 %), Sex Work Behaviors & Injection Risk (8.4 %), High Injection & Sexual Risk (30.7 %) behaviors. Sex Work Behaviors & Injection Risk was associated with higher odds of detention, heroin use, and verbal police harassment.

Conclusion

PWID living with HIV in Kazakhstan exhibit high-risk behaviors and low viral suppression. Distinct patterns by sex underscore the need for tailored harm reduction strategies and retention in HIV care.

查看原文本刊更多论文

毒品和性艾滋病毒传播风险行为的模式：对哈萨克斯坦注射毒品并感染艾滋病毒的男性和女性的潜在类别分析

中亚是全球艾滋病毒流行速度最快的地区之一。在注射吸毒者和艾滋病毒感染者中，抗逆转录病毒治疗（ART）覆盖面欠佳和病毒抑制增加了向注射者和性伴侣传播的风险。男性和女性可能有不同的艾滋病毒传播风险行为模式，但人们对这些行为如何共同发生知之甚少。本文确定了PWID中艾滋病毒传播风险类型，并按性别检查了相关的健康结果。方法2017年2月至2019年6月，我们在哈萨克斯坦招募了450名男性和166名女性（N = 616）感染艾滋病毒的PWID患者。潜在类分析确定了注射和性危险行为的异质性模式。多项逻辑回归研究了刑事司法介入、药物使用和健康结果如何随风险模式而变化。结果art覆盖率为71%，病毒抑制率为43%，性别差异不大。在男性中，潜在类别包括：未注射；低性风险（41.8%），注射&；性风险（36.4%）和低注射率；高注射风险行为（21.8%）。两种注射风险等级都与较高的拘留、吸毒和过量的几率相关。在妇女中，课程包括：低注射；性风险（60.7%），性工作行为；注射风险（8.4%），高注射率；性危险行为（30.7%）。性工作行为& &；注射风险与拘留、海洛因使用和口头警察骚扰的几率较高有关。结论哈萨克斯坦艾滋病毒感染者存在高危行为，病毒抑制程度较低。按性别划分的不同模式强调了有必要制定有针对性的减少危害战略并坚持艾滋病毒护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.