Abstract
Background
Injecting drugs is major driver of human immunodeficiency virus (HIV) infections in Nepal.
Objectives
To estimate the HIV prevalence and to examine factors associated with it among people who inject (illicit) drugs (PWID) in Nepal.
Methods
The present study was based on data secondary to Integrated Biological and Behavioral Surveillance (IBBS) surveys of PWID in Nepal from 2002 to 2015. A χ2 test was used to determine significant risk factors for HIV infection. A logistic regression model was used to identify the most important determinants for HIV infection.
Results
We included cross-sectional data from 7,073 PWID in the surveys from 2002 to 2015 in this retrospective observational study; among these 1,257 (17.8%) had tested HIV positive. The prevalence of HIV infection showed a sharp decrease from 2002 (68%) to 2015 (6.2%). After adjusting each factor for the confounding effects of other factors, year, region, age, education, and duration of injecting drags were significantly associated with HIV (P < 0.001). Prevalence of HIV infection was highest for the following factors: year 2002, Kathmandu Region (30.5%), aged ≥30 years (32%), illiterate (28.5%), and injecting drugs >10 years (35%).
Conclusions
HIV infection shows a steady decreasing trend, but the number of cases remains high. The factors strongly contributing to HIV were advanced age, Kathmandu region, low educational achievement, and longer duration of injecting drags. Intensified and focused programs are needed to reduce the HIV in the region focusing on its associated risk behaviors.