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

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Abstract

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.

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