Prevalence and factors associated with HIV infection among injection drug users at methadone clinics in Taipei, Taiwan

BACKGROUND Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program for injection drug users (IDUs), among whom HIV was endemic. We examined the association of HIV serostatus with demographic characteristics, substance use, and sexual behaviors among IDUs at methadone clinics in Taipei, Taiwan. METHODS During 2012-2013, IDUs at methadone clinics in Taipei were recruited to complete a risk assessment interview and undergo serologic testing for HIV infection. Correlates of HIV infection were identified by multivariate logistic regression. RESULTS Of the 827 eligible participants, 85.9% were male, median age was 45 years, and mean years of injecting was 18.0 (range 1-56). The prevalence of HIV infection was 17.7%. In multivariate analysis, HIV infection was significantly associated with age ≤ 45 years (adjusted odds ratio [AOR] = 1.62, 95% confidence interval [CI] 1.01-2.62), being divorced (AOR = 1.67, 95% CI 1.06-2.62), deriving the majority of income during the previous 6 months from temporary jobs or other noncriminal sources (AOR = 1.53, 95% CI 1.02-2.30), unstable housing during the previous 6 months (AOR = 1.47, 95% CI 1.003-2.15), higher number of incarcerations (AOR = 1.14, 95% CI 1.03-1.26), and a history of overdose (AOR = 1.51, 95% CI 1.01-2.28). CONCLUSIONS Taiwanese IDUs at methadone clinics have a relatively high HIV prevalence, which was associated with younger age and history of overdose. It is imperative to educate IDUs' about HIV transmission, particularly for the younger and overdosed IDUs.