AEGiS-14IAC: The emergence of midazolam injection and its association with needle sharing among injecting drug users (IDUs) in Bangkok, Thailand.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

The emergence of midazolam injection and its association with needle sharing among injecting drug users (IDUs) in Bangkok, Thailand.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1396)

Vanichseni S, van Griensven F, Suntharasamai P, Sangkum U, Tappero J, Heyward W, Choopanya K
Bangkok Vaccine Evaluation Group, Bangkok, Thailand

BACKGROUND: Monitoring risk behavior in HIV vaccine efficacy trials is necessary to identify changing patterns and to formulate prevention messages. In response to reports of injection of midazolam (a sedative), we evaluated its use and association with needle sharing among participants in the AIDSVAX é «B/E vaccine efficacy trial in Bangkok, Thailand.

METHODS: From March 1999 - August 2000, 2,545 IDUs were enrolled. Demographic and HIV risk behavior data were collected at baseline, and every 6 months thereafter. Generalized estimation logistic regression analysis was used to evaluate trends and assess independent risk factors.

RESULTS: 93.4% of participants were male, the median age was 26 years, 95.0% had ≥primary education. At baseline, 2,388 (93.8%) reported injection drug use. At 12 months follow-up, overall injection drug use decreased to 72.1% (p <0.001) and needle sharing from 33.0% to 16.3% (p <0.001). Among those injecting at baseline, 98.5%, 15.8% and 12.4% reported injecting heroin, methamphetamine and midazolam, respectively. Among those injecting at 12 month follow-up, these were 96.6% (-1.9%, p <0.6), 17.4% (+10%, p <0.1) and 19.1% (+54%, p <0.001). In multivariate analysis, younger age (< 40 yrs), higher education (≥grade 9), daily injection and not being in methadone treatment at baseline were independently associated with midazolam injection (all p <0.0001). Injection of midazolam, methamphetamine, younger age, daily injection and not being in methadone treatment at baseline were independently associated with needle sharing (all p < 0.0001).

CONCLUSION: Overall, injection drug use risk decreased significantly over the first 12 months of the trial; however a marked increase in midazolam injection was observed., which was independently associated with needle sharing. Surveillance of drug use practices is important to target those at highest behavioral risk and formulate prevention messages.

Keywords: AEGIS, Needle Sharing, HIV Infections, Risk-Taking, AIDS Vaccines, Thailand, Risk Factors, Injections, Heroin, Midazolam, Association, AIDSVAX, Male

020707
ThOrC1396