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Open Access Highly Accessed Research article

The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China

Yi-Biao Zhou123*, Song Liang45, Qi-Xing Wang6, Yu-Han Gong6, Shi-Jiao Nie123, Lei Nan6, Ai-Hui Yang123, Qiang Liao6, Xiu-Xia Song123 and Qing-Wu Jiang123*

Author Affiliations

1 Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China

2 Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), 138 Yi Xue Yuan Road, Shanghai 200032, China

3 Tropical Disease Research Center, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China

4 Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA

5 Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA

6 Center for Disease Prevention and Control of Liangshan Prefecture, Sichuan, China

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BMC Infectious Diseases 2014, 14:134  doi:10.1186/1471-2334-14-134

Published: 10 March 2014

Abstract

Background

HIV-, HCV- and HIV/HCV co-infections among drug users have become a rapidly emerging global public health problem. In order to constrain the dual epidemics of HIV/AIDS and drug use, China has adopted a methadone maintenance treatment program (MMTP) since 2004. Studies of the geographic heterogeneity of HIV and HCV infections at a local scale are sparse, which has critical implications for future MMTP implementation and health policies covering both HIV and HCV prevention among drug users in China. This study aimed to characterize geographic patterns of HIV and HCV prevalence at the township level among drug users in a Yi Autonomous Prefecture, Southwest of China.

Methods

Data on demographic and clinical characteristics of all clients in the 11 MMTP clinics of the Yi Autonomous Prefecture from March 2004 to December 2012 were collected. A GIS-based geographic analysis involving geographic autocorrelation analysis and geographic scan statistics were employed to identify the geographic distribution pattern of HIV-, HCV- and co-infections among drug users.

Results

A total of 6690 MMTP clients was analyzed. The prevalence of HIV-, HCV- and co-infections were 25.2%, 30.8%, and 10.9% respectively. There were significant global and local geographic autocorrelations for HIV-, HCV-, and co-infection. The Moran’s I was 0.3015, 0.3449, and 0.3155, respectively (P < 0.0001). Both the geographic autocorrelation analysis and the geographic scan statistical analysis showed that HIV-, HCV-, and co-infections in the prefecture exhibited significant geographic clustering at the township level. The geographic distribution pattern of each infection group was different.

Conclusion

HIV-, HCV-, and co-infections among drug users in the Yi Autonomous Prefecture all exhibited substantial geographic heterogeneity at the township level. The geographic distribution patterns of the three groups were different. These findings imply that it may be necessary to inform or invent site-specific intervention strategies to better devote currently limited resource to combat these two viruses.

Keywords:
HIV; HCV; Co-infection; Geographic distribution; Geographic autocorrelation analysis; Geographic scan statistic