Theme: Epidemiology and Public Health Research Year: 2021
Background Myanmar is a major market for both the production and consumption of heroin and amphetaminetype stimulants (ATS). Drug use is predominantly a phenomenon in hard-to-reach rural areas. The prevalence of HIV and HCV infections among people who inject drugs (PWID) is high, respectively 35% and 56%. We aimed to assess HIV and HCV testing conditions and the prevalence of dual infections (HIV and HCV) among clients with diverse poly-drug use patterns. Methods This is a cross-sectional study using project data, routinely collected between January 2017 and December 2019, at fourteen AHRN projects in Kachin, Shan States, and Sagaing region. Results Of 30,729 clients, 1,221 (3.9%) were female, 3,369 (11.0%) were ≤24 years old and 14,566 (47.4%) injected drugs. Among them, 20,710 (67.4%) used both opium and ATS (poly-drugs users), 8,976 (29.2%) used opioid only and 1,043 (3.4%) used oral ATS only. Half, 15,608 (50.8%) received HIV test with 20.8% positivity and 3,029 (9.9%) received HCV test with 54.1% positivity. Dual infections tested 2,832/30,729 (9.2%) and 722/2,832 (25.5%)showed both infections. The prevalence of dual infections was highest among opioid mono-users, with 27.9%, followed by poly-drug users (25.3%) and ATS mono-users (3.5%). Dual infections were prevalent among those who injected and smoked drugs (38.8%) and injected drugs (34.8%). Conclusion More than half of the clients were poly-drugs users. A significant difference in the number of rural clients tested for HIV and HCV infections justifies the urgent need to strengthen access to HCV testing and HCV treatmentservices. HIV and HCV testing services should be integrated into the mobile setting to increase access to the unreached and marginalized rural population. ATS harm reduction efforts should be made to mitigate the impact of high dual HIV and HCV infection rates among smoking polydrug users. A Disclosure of Interest Statement No funding was received in the development of this study
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