Document 0958
 DOCN  M9470958
 TI    Was the 1988 HIV epidemic among Bangkok's injecting drug users a common
       source outbreak?
 DT    9409
 AU    Wright NH; Vanichseni S; Akarasewi P; Wasi C; Choopanya K; UMD-Robert
       Wood Johnson Medical School, Piscataway, New Jersey; 08854.
 SO    AIDS. 1994 Apr;8(4):529-32. Unique Identifier : AIDSLINE MED/94280727
 AB    OBJECTIVE: To describe and understand the genesis of the explosive 1988
       HIV epidemic among Thai injecting drug users (IDU) in Bangkok. DESIGN:
       Two cross-sectional HIV seroprevalence sample surveys (SP-1 and SP-2) of
       drug users, including IDU at various stages of treatment. SP-1, a
       10-week estimate of prevalence, was conducted by the Bangkok
       Metropolitan Administration (BMA) in their detoxification clinics from 5
       January to 7 March 1988. SP-2 estimated prevalence in 1 week, 12-15
       September 1988, in the same 18 BMA clinics. Both surveys included an
       administered questionnaire that gathered demographic and behavioral
       information. METHODS: Analysis of HIV prevalence by clinic in both SP-1
       and SP-2, and the relationships between demographic data, behavioral
       variables, arrest history and HIV positivity in SP-1. RESULTS: Data from
       individual clinics in SP-1 show significant increases in HIV prevalence
       among IDU sampled from early February 1988. Of IDU sampled in five
       'early' clinics before 9 February, 2% were positive; in the 13 'late'
       clinics sampled from 9 February until 7 March, 27% were positive. By
       September 1988, however, the early and late clinics were no longer
       heterogeneous for HIV prevalence. For current IDU, HIV-positivity was
       associated with the sharing of injection equipment in SP-1 [odds ratio
       (OR), 1.82; 95% confidence limits (CL), 1.31-2.53] and recent jail or
       prison stay (OR, 2.15; 95% CL, 1.18-3.98). CONCLUSIONS: The behavioral
       factors associated with the HIV epidemic among Bangkok's IDU are similar
       to those described elsewhere. The monthly incidence of 5% from February
       to September 1988 suggests extensive needle or injection equipment
       sharing networks among IDU in Bangkok. Additionally, the pattern of
       HIV-positivity by detoxification clinic over time in early 1988, and
       then in September 1988 is consistent with a relationship to the prison
       amnesty of early December 1987. Shortly after that date, an undisclosed
       number of former IDU, a substantial number of whom were still injecting,
       and may have become HIV-positive while in custody, returned to resume
       injecting within existing drug-using networks throughout Bangkok and
       elsewhere in Thailand.
 DE    Adolescence  Adult  Cross-Sectional Studies  *Disease Outbreaks  Female
       Human  HIV Infections/COMPLICATIONS/*EPIDEMIOLOGY  HIV Seroprevalence
       Incidence  Male  Middle Age  Substance Abuse, Intravenous/*COMPLICATIONS
       Thailand/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).