Open Access Research article

High risk behavior for HIV transmission among former injecting drug users: a survey from Indonesia

Shelly Iskandar12*, Diba Basar2, Teddy Hidayat1, Ike MP Siregar1, Lucas Pinxten23, Reinout van Crevel24, Andre JAM Van der Ven24 and Cor AJ De Jong5

Author Affiliations

1 Department of Psychiatry, Faculty of Medicine, Padjajaran University/Hasan Sadikin Hospital, Bandung, Indonesia

2 Health Research Unit, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung, Indonesia

3 Department of Health Education and Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

4 Department of General Internal Medicine and Nijmegen Institute for Inflammation, Infection and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

5 Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, the Netherlands

For all author emails, please log on.

BMC Public Health 2010, 10:472  doi:10.1186/1471-2458-10-472

Published: 10 August 2010



Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs) are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs) in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use.


Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test.


Ninety-two out of 210 participants (44%) were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66%) and current (60%) IDUs.


Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.