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A decade of HIV surveillance among injecting drug users in Australia: results from the Australian needle and syringe program survey
Presented by Carolyn Day, Australia.
Day C.1, Topp L.1, Iverson J.1, Maher L.1
1University of New South Wales, National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia
Objectives: HIV prevalence among injecting drug users (IDU) in Australia is approximately 2%. Widespread and early introduction of harm reduction initiatives including needle and syringe programs (NSP) have received widespread bipartisan political and community support. This study aimed to determine the prevalence and correlates of HIV infection among NSP attendees from 1995-2005.
Methods: The Australian NSP Survey takes place annually one week in October at sentinel NSPs across the country. Participants complete a brief questionnaire covering demographics, injecting drug use and blood borne virus transmission risk behaviours; and provide a capillary blood sample. Aggregated data (1995-2005) were used to determine factors independently associated with HIV infection using multiple logistic regression.
Results: Data were available for 24,457 NSP attendees over 11 year and across 48 sites. The majority of participants were male (65%), with a median age 30 years (13-87), been injecting drugs a median of 9 years (<1-71), and 77% were born in Australia. Seventy-eight percent reported their sexual preference as heterosexual, 10% as bisexual and 6% as homosexual. Serology was available for 22,983 (94%) participants, 273(1.2%) of whom tested HIV antibody positive. HIV prevalence varied across the study years from 2.1% in 1995 to 0.9% in 2005 (range 2.1%-0.8%). Compared to HIV negative participants, HIV positive participants were more likely to be older (AOR1.05; 95%CI 1.03-1.06), male (AOR: 4.37; 95%CI 2.96-6.46), identify as homosexual (AOR 32.11; 95%CI 23.69-43.54) or bisexual (AOR 4.44; 95%CI 2.76-7.15), but less likely to report daily injecting (AOR 0.74; 95%CI 0.56-0.98).
Conclusions: These data confirm that HIV prevalence among NSP attendees in Australia has been consistently low and suggest that the epidemiology of HIV in this group mirrors that evident in the broader Australian population, where the majority of exposures are attributed to male-to-male sexual contact. NSPs are a crucial component of Australia’s successful HIV surveillance mechanism.
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