Predictors of mortality among injecting and non-injecting HIV-negative drug users in northern Thailand

Aims: To estimate mortality rates among HIV-negative injecting drug users (IDUs) and non-injecting drug users (non-IDUs), and to assess predictors for mortality among the IDUs. Design: Prospective cohort study in northern Thailand with 2-year follow-up. Setting: IDUs and non-IDUs who were admitted f...

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Main Authors: Vu Minh Quan, Tasanai Vongchak, Jaroon Jittiwutikarn, Surinda Kawichai, Namtip Srirak, Kanokporn Wiboonnatakul, Myat Htoo Razak, Vinai Suriyanon, David D. Celentano
Format: Journal
Published: 2018
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Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=33846913648&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/61331
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Institution: Chiang Mai University
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Summary:Aims: To estimate mortality rates among HIV-negative injecting drug users (IDUs) and non-injecting drug users (non-IDUs), and to assess predictors for mortality among the IDUs. Design: Prospective cohort study in northern Thailand with 2-year follow-up. Setting: IDUs and non-IDUs who were admitted for detoxification treatment for opiate or amphetamine dependence in a regional drug treatment center were screened. After discharge, HIV-negative individuals were followed-up in the community. Participants: A total of 821 HIV-negative drug users [346 IDUs (42%) and 475 non-IDUs, median age = 32; 51% were ethnic minorities]. Measurements: All-cause mortality. Findings: There were 33 deaths over 1360 person-years of follow-up. The all-cause mortality rate was 39 per 1000 person-years among IDUs [standardized mortality ratio (SMR) = 13.9], and was 14 per 1000 person-years among non-IDUs (SMR = 4.4). Among male IDUs, the hazards for all-cause deaths were ethnic minority status [adjusted hazard ratio (HR) = 2.9, 95% CI = 1.2-7.2], incident HIV infection (HR = 2.8, 95% CI = 1.1-7.7) and longer duration of drug injection (HR = 1.07, 95% CI = 1.01-1.14). Conclusions: The mortality among IDUs is high. Being from an ethnic minority, recent HIV acquisition, and a greater number of years of drug injection are predictors of mortality among the IDUs in this region. © 2007 The Authors.