Risk factors associated with injection initiation among drug users in Northern Thailand

BACKGROUND: Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand. METHODS: A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection. RESULTS: After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation. CONCLUSION: Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection

Flexible dosing of Tincture of Opium in the management of opioid withdrawal: pharmacokinetics and pharmacodynamics

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECTIn parts of South-East Asia, Tincture of Opium (TOP) is a culturally acceptable alternative to methadone in the treatment of opioid withdrawal.We have previously shown that TOP has a therapeutic effect when administered to opioid-dependent patients in Northern Thailand.However, before TOP could be used clinically, an evaluation of the dosing regimen had to be undertaken

Socio-demographic and drug use factors associated with HIV-1 recombinants and dual infections in Northern Thai drug users: Associations of risk with genetic complexity

Background: Dual infection with diverse HIV strains can foster the emergence of recombinants. The resulting increase in viral genetic diversity is a major challenge for vaccine development HIV treatment. In this study we aim to investigate the socio demographic factors associated with an increasing level of genetic diversity among HIV strains in a population of drug-users in Northern Thailand. Methods: From 1999 through 2000, 2231 volunteers were enrolled in the Opiate- Users Research in Chiang Mai, Thailand. HIV subtype analysis was conducted among those HIV-1 seropositive (n = 347) using a multi-region hybridization assay. Social and demographic variables were assessed using a structured questionnaire. Results: Overall, 336/347 (96.8%) of the samples could be typed. 81.8% were CRF01_AE, 3.9% were sub-type B, 9.2% were recombinants (mostly between CRF01_AE and B) and 5.1% were dual infections. Dual infections were more frequent among those with a lower education level (AOR:5.2; 95% Cl 1.4–20.3), those who have initiated injecting in the last 3 years (AOR:3.9; 95% Cl 1.1–14.6), and those reporting frequent needle sharing in the last 3 months (AOR:7.0; 95% Cl 1.5–34.1). Both recombinant strains and dual infection were more frequent among those reporting frequent needle sharing in the last 3months (AOR: 5.3; 95% Cl 1.6–17.1). Conclusion: To limit the expanding complexity of HIV-1 strains, early intervention should be aimed at reduction in needle sharing, especially among new intravenous drug users

Correlates of Incarceration Among Young Methamphetamine Users in Chiang Mai, Thailand

Objectives. We examined correlates of incarceration among young methamphetamine users in Chiang Mai, Thailand in 2005 to 2006