Publication: Was the 1988 HIV epidemic among Bangkok's injecting drug users a common source outbreak?
Issued Date
1994-04-01
Resource Type
ISSN
02699370
Other identifier(s)
2-s2.0-0028343982
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
AIDS. Vol.8, No.4 (1994), 529-532
Suggested Citation
Nicholas H. Wright, Suphak Vanichseni, Pasakorn Akarasewi, Chantapong Wasi, Kachit Choopanya Was the 1988 HIV epidemic among Bangkok's injecting drug users a common source outbreak?. AIDS. Vol.8, No.4 (1994), 529-532. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/9570
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Title
Was the 1988 HIV epidemic among Bangkok's injecting drug users a common source outbreak?
Abstract
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 heterogenous 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), 1.31-2.531 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.