Patterns of drug use among people who inject drugs (PWID) and their implications for sexually transmitted infections in northern Nigeria

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Article (peer-reviewed)

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Background: Drug use impairs judgment and leads to sexual risk behaviours. The prevalence of HIV among PWID in Kano (4.8%) and Kaduna (5.8%) respectively are higher than the national HIV prevalence among PWID (4.2%). However the national prevalence of sexually transmitted infections (STI) among PWID is about 6%. In this study we sought to determine drug use profile, prevalence and correlates of STIs among PWID in northern Nigeria. Methods: Data of drug use, sexual and injecting risk behaviors were collected from structured risk assessment forms between May and October 2013 and evaluated in a cross sectional study. Chi-square test was used to compare differences between categorical variables and logistic regression analysis was conducted to identify factors associated with patterns of drug use and sexual risk behaviour. Results: A total of 385 drug users (9% females and 91% males) with mean age of 30 years were interviewed. More than 94% injected drugs in the last 12 months. Mean age of drug use debut was 15.4 years, while mean duration of drugs use was 15 years. Types of drugs injected included heroine (30%), cocaine (24%), amphetamine (8%), crack (10.4%) and pentazocine (39.2%). Over 80% of heroin users and 72.3% of cocaine users, had unprotected sex with casual partner in the last 6 months. About 28% of drug users experienced one form of sexually transmitted infection in the last 6 months. Logistic regression analysis showed that amphetamine users were 11 times more likely to have STI (Adjusted OR=11.52, 95%CI=4.27-31.10) followed by heroin users (Adjusted OR=4.99, 95%CI=2.46-10.13) and pentazocine users (Adjusted OR=2.86, 95%CI=1.41-5.81). Conclusions: This study strongly suggested that drug use significantly predisposes PWID to sexual risk behaviours and STIs. In addition, exposure to STIs seems to significantly vary with the type of drugs used. Therefore, there is a need for appropriate HIV/STI prevention programing for PWID in northern Nigeria.