Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia

Abstract Introduction National surveillance data in Malaysia has observed a marked reduction in the number of new HIV cases among people who inject drugs (PWID) in the past decade. This study sought to estimate the current prevalence and associated risk factors of HIV and hepatitis C virus (HCV) amo...

Full description

Saved in:
Bibliographic Details
Main Authors: Joselyn Pang, Mahmoud Danaee, Vicknasingam Balasingam Kasinather, Don Des Jarlais, Adeeba Kamarulzaman, NA Mohd Salleh
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Journal of the International AIDS Society
Subjects:
Online Access:https://doi.org/10.1002/jia2.26420
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849696545320992768
author Joselyn Pang
Mahmoud Danaee
Vicknasingam Balasingam Kasinather
Don Des Jarlais
Adeeba Kamarulzaman
NA Mohd Salleh
author_facet Joselyn Pang
Mahmoud Danaee
Vicknasingam Balasingam Kasinather
Don Des Jarlais
Adeeba Kamarulzaman
NA Mohd Salleh
author_sort Joselyn Pang
collection DOAJ
description Abstract Introduction National surveillance data in Malaysia has observed a marked reduction in the number of new HIV cases among people who inject drugs (PWID) in the past decade. This study sought to estimate the current prevalence and associated risk factors of HIV and hepatitis C virus (HCV) among PWID in suburban areas of Klang Valley, Malaysia. Methods Between September 2021 and March 2022, a cross‐sectional, respondent‐driven sampling survey was conducted. Participants completed rapid HIV and HCV testing as well as social and behavioural assessments. Factors associated with HIV‐ and HCV‐positive results were estimated using logistic regression. Results Four‐hundred individuals were recruited in the study, of whom 382 (94%) were men. The prevalence of HIV and HCV was 5.5% (95% confidence interval [95% CI]: 3.6–8.3) and 40.5% (95% CI: 35.7–45.5), respectively. Current heroin and amphetamine‐type stimulant (ATS) use, regardless of injection or non‐injection use, were reported by 340 (85.0%) and 328 (82.0%) individuals, respectively. Past exposure to the criminal justice system (lock‐ups, prison and compulsory drug detention centres) was associated with both HIV (Adjusted odds ratio [aOR] = 3.47, 95% CI: 1.33–10.2) and HCV (aOR = 3.32, 95% CI: 2.06–5.39)‐positive results. Additionally, HIV‐positive results were associated with current ATS use (aOR = 0.31, 95% CI: 0.12–0.86). Meanwhile, HCV‐positive results were associated with current heroin use (aOR = 2.44, 95% CI: 1.16–5.48), lifetime enrolment in methadone treatment (aOR = 2.30, 95% CI: 1.23–4.27), current methadone treatment (aOR = 0.46, 95% CI: 0.23–0.92) and current mixing of drugs through injection use (aOR = 1.80, 95% CI: 1.08–3.03). Conclusions This study observed low HIV prevalence among PWID, primarily associated with ATS use, while HCV prevalence, linked to heroin use, remained high. Higher odds of being HCV positive among PWID who reported to have ever but not currently enrolled in methadone programmes indicate that treatment may not be continuous once initiated, potentially due to exposure to the criminal justice system. These findings underscore the need for a dual approach: enhanced harm reduction programmes for PWID and a legal reform to address potential barriers posed by criminalization.
format Article
id doaj-art-e1fde4102b4e4dada878ca10e15c7855
institution DOAJ
issn 1758-2652
language English
publishDate 2025-05-01
publisher Wiley
record_format Article
series Journal of the International AIDS Society
spelling doaj-art-e1fde4102b4e4dada878ca10e15c78552025-08-20T03:19:25ZengWileyJournal of the International AIDS Society1758-26522025-05-01285n/an/a10.1002/jia2.26420Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of MalaysiaJoselyn Pang0Mahmoud Danaee1Vicknasingam Balasingam Kasinather2Don Des Jarlais3Adeeba Kamarulzaman4NA Mohd Salleh5Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysiaDepartment of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysiaCentre for Drug ResearchUniversiti Sains MalaysiaPenangMalaysiaNew York University School of Global Public HealthNew YorkNew YorkUSADepartment of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysiaDepartment of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysiaAbstract Introduction National surveillance data in Malaysia has observed a marked reduction in the number of new HIV cases among people who inject drugs (PWID) in the past decade. This study sought to estimate the current prevalence and associated risk factors of HIV and hepatitis C virus (HCV) among PWID in suburban areas of Klang Valley, Malaysia. Methods Between September 2021 and March 2022, a cross‐sectional, respondent‐driven sampling survey was conducted. Participants completed rapid HIV and HCV testing as well as social and behavioural assessments. Factors associated with HIV‐ and HCV‐positive results were estimated using logistic regression. Results Four‐hundred individuals were recruited in the study, of whom 382 (94%) were men. The prevalence of HIV and HCV was 5.5% (95% confidence interval [95% CI]: 3.6–8.3) and 40.5% (95% CI: 35.7–45.5), respectively. Current heroin and amphetamine‐type stimulant (ATS) use, regardless of injection or non‐injection use, were reported by 340 (85.0%) and 328 (82.0%) individuals, respectively. Past exposure to the criminal justice system (lock‐ups, prison and compulsory drug detention centres) was associated with both HIV (Adjusted odds ratio [aOR] = 3.47, 95% CI: 1.33–10.2) and HCV (aOR = 3.32, 95% CI: 2.06–5.39)‐positive results. Additionally, HIV‐positive results were associated with current ATS use (aOR = 0.31, 95% CI: 0.12–0.86). Meanwhile, HCV‐positive results were associated with current heroin use (aOR = 2.44, 95% CI: 1.16–5.48), lifetime enrolment in methadone treatment (aOR = 2.30, 95% CI: 1.23–4.27), current methadone treatment (aOR = 0.46, 95% CI: 0.23–0.92) and current mixing of drugs through injection use (aOR = 1.80, 95% CI: 1.08–3.03). Conclusions This study observed low HIV prevalence among PWID, primarily associated with ATS use, while HCV prevalence, linked to heroin use, remained high. Higher odds of being HCV positive among PWID who reported to have ever but not currently enrolled in methadone programmes indicate that treatment may not be continuous once initiated, potentially due to exposure to the criminal justice system. These findings underscore the need for a dual approach: enhanced harm reduction programmes for PWID and a legal reform to address potential barriers posed by criminalization.https://doi.org/10.1002/jia2.26420amphetamine‐type stimulantharm reductionhepatitis Cheroin useHIV preventionpeople who inject drugs
spellingShingle Joselyn Pang
Mahmoud Danaee
Vicknasingam Balasingam Kasinather
Don Des Jarlais
Adeeba Kamarulzaman
NA Mohd Salleh
Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
Journal of the International AIDS Society
amphetamine‐type stimulant
harm reduction
hepatitis C
heroin use
HIV prevention
people who inject drugs
title Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
title_full Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
title_fullStr Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
title_full_unstemmed Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
title_short Current drug use patterns and HIV and HCV prevalence among people who inject drugs in suburban areas of Malaysia
title_sort current drug use patterns and hiv and hcv prevalence among people who inject drugs in suburban areas of malaysia
topic amphetamine‐type stimulant
harm reduction
hepatitis C
heroin use
HIV prevention
people who inject drugs
url https://doi.org/10.1002/jia2.26420
work_keys_str_mv AT joselynpang currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia
AT mahmouddanaee currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia
AT vicknasingambalasingamkasinather currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia
AT dondesjarlais currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia
AT adeebakamarulzaman currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia
AT namohdsalleh currentdrugusepatternsandhivandhcvprevalenceamongpeoplewhoinjectdrugsinsuburbanareasofmalaysia