HIV prevalence and risk behaviors among people who inject drugs in Songkhla, Thailand: A respondent-driven sampling survey.

Background: Songkhla has one of the most serious provincial HIV epidemics among people who inject drugs (PWID). However there remains a lack of systematic data on drug use patterns HIV risk behaviors and access to interventions. To address the gap we conducted an integrated bio-behavioral survey in 2010. Methods: Respondent-driven sampling (RDS) was used to recruit PWID who reported injecting in the last six months. Participants were interviewed and tested for HIV and sexually transmitted infections (STIs). RDS Analysis Tool (RDSAT) was used to generate adjusted proportion estimates. Results: Of 202 participants almost all were men 90% injected heroin followed by methamphetamine (22%). One-third (37%) injected multiple drugs. HIV prevalence was high (22%). Seven percent reported needle sharing at last injection and 27% reported using a condom at last sex. Nearly half (42%) were currently on methadone treatment. Few participants received new needles (10%) and condoms (11%) from drop-in centers and/or peer outreach workers. Conclusion: This RDS survey informs the understanding of the HIV epidemic and the programmatic response among PWID in Songkhla. It was effective at recruiting PWID who were currently out-of-treatment. Given the increasing trend of poly-drug injecting use documented a comprehensive and integrated combination intervention approach for HIV services is recommended. Copyright © 2016 Elsevier B.V.