AEGiS-14IAC: HIV Knowledge and Risk Behaviors among Pakistani and Afghan Heroin Users in Quetta, Pakistan.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

HIV Knowledge and Risk Behaviors among Pakistani and Afghan Heroin Users in Quetta, Pakistan.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrE1359)

Zafar ST, Brahmbhatt H, ul Hassan S, Strathdee SA
Nai Zindagi, Islamabad, Pakistan

BACKGROUND: Situated on the Pakistan-Afghan border, Quetta is home to a growing number of Afghan refugees. Data on drug use behaviors in the region are sparse. We described HIV knowledge and risk behaviors among Pakistani and Afghan heroin users accessing services provided by Nai Zindagi, a non-profit organization assisting drug users (DUs) in Quetta.

METHODS: Between 07/01 and 11/01, DUs registering for services at Nai Zindagi's drop-in center run underwent an interviewer-administered survey on sociodemographics, injection and non-injection drug use, sexual behaviors and HIV knowledge. Chi-square tests were used to compare Afghan drug users vs. those of other nationalities.

RESULTS: Of 956 DUs, all were male and used heroin regularly. A total of 143 (14.9%) were Afghans; the rest were Pakistani (84.8%) or of other origin (0.3%). Relative to other DUs, a higher proportion of Afghans reported no education (66% vs. 51%, p<0.001). Compared to other DUs, Afghans were more likely to have used an opiate as their first illicit drug (16% vs. 7%, p<0.001), to have ever injected (19% vs 12%, p=0.04), to report needle sharing (71% vs. 51%, p=0.08) or report a family member as a DU (p=0.08). Among sexually active DUs, 0% of Afghans had ever used a condom, vs. 5% among other DUs (p=0.01). Pakistanis were more likely to report sex with CSWs (46.1% vs. 35.0%, p=0.01). Only 4% of Afghans had ever heard of HIV/AIDS vs. 18% among other DUs (p<0.001).

CONCLUSIONS: These data show extremely low levels of HIV awareness and high HIV risks among DUs in Quetta, among whom Afghans are especially vulnerable. The fall of the Taliban regime offers a new opportunity to provide interventions to Afghan DUs, an increasing proportion of whom are refugees living in Pakistan. The relatively low proportion of injectors among heroin users in Quetta offers a vital window of opportunity for interventions to prevent transition to injection, drug treatment, and supportive services.

Keywords: AEGIS, Risk-Taking, HIV Infections, Heroin Dependence, Needle Sharing, HIV Seropositivity, AIDS Dementia Complex, Sex Behavior, Knowledge, Condoms, Acquired Immunodeficiency Syndrome, Ethnic Groups, Substance-Related Disorders, Health Knowledge, Attitudes, Practice, Pakistan, Male

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WeOrE1359