Executive Summary
This report describes the extent of use of medical injections and blood transfusions, characteristics of medical injection users, and associated knowledge and perceptions about how to avoid HIV infection among adult women and men in 10 sub-Saharan African countries. It also examines the association between number of medical injections received and HIV serostatus. The analysis is based on data from eight Demographic and Health Surveys (DHS): Kenya, Ghana, Burkina Faso, Cameroon, Lesotho, Malawi, Ethiopia, and Zimbabwe, and two AIDS Indicator Surveys (AIS): Tanzania and Uganda, conducted between 2003 and 2006.
In most countries studied, receiving multiple medical injections is significantly positively associated with being HIV-infected, for both women and men. Ever having received a blood transfusion also tends to be positively associated with being HIV-infected. The study also finds that knowledge that HIV infection can be avoided by avoiding injections, including medical injections, avoiding having sex with injecting drug users (IDUs), and avoiding blood transfusion remains low in most countries studied. Few adults perceive the risk of HIV infection from having medical injections or blood transfusion.
A considerable proportion of adults reported receiving medical injections. Among women, between 30 percent (in Malawi) and 50 percent (in Uganda) received medical injections in the 12 months preceding the survey. In all countries, men are less likely than women to receive medical injections. Men are also slightly less likely to receive medical injections from health professionals. Urban and more educated women are more likely to receive three or more recent medical injections, but these associations are weaker among men. As expected, adults who were chronically ill or reported having a sexually transmitted infection (STI) in the past year are more likely to have received medical injections. In most countries a large majority of medical injections received by women and men are from new needles, with the notable exception of Lesotho where 27 percent of men did not receive their last medical injection from a new needle. In Uganda and Cameroon, 5 and 6 percent of women and 2 and 4 percent of men, respectively, reported having lifetime exposure to blood transfusions.
The study finds no clear association between HIV serostatus and knowledge about avoiding HIV infection by avoiding injections, or avoiding having sex with IDUs. In some of the countries studied, people who know about avoiding HIV infection by avoiding blood transfusions are more likely to be HIV-positive, but among women in Zimbabwe and men in Lesotho the reverse is true.
The study provides information on the extent of knowledge of injection- related risk of HIV transmission and presents characteristics of people receiving medical injections in selected countries in sub-Saharan Africa. The results show that the knowledge about the risk of HIV infection from unsafe injections and blood transfusions is low despite years of HIV/AIDS education efforts. The results showing a positive association between receiving either medical injections or blood transfusion and being HIV- infected suggest that unsafe medical injections and unsafe blood transfusions as potential modes of HIV transmission deserve continued research and programmatic attention. Program priorities in sub- Saharan Africa may focus on promoting knowledge of potential risks of HIV and other infections from unsafe injections and blood transfusions, rational use of medical injections, implementation of the national injection safety and blood safety guidelines, and further scale up of medical injection safety and blood safety programs.
DHS Comparative Reports No. 21
Vinod Mishra1, Shane Khan1, Li Liu2, Benny Kottiri3
Macro International Inc., Calverton, Maryland, USA
October 2008
Corresponding author: Vinod Mishra, Demographic and Health Research Division, Macro International Inc.,
11785 Beltsville Drive, Suite 300, Calverton, MD 20705;
Phone: 301-572-0220; Fax: 301-572-0999;
Email:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
.
1 Macro International Inc., Calverton, Maryland, USA
2 Johns Hopkins University, Baltimore, Maryland, USA
3 United States Agency for International Development, Washington, DC, USA
__________________________________________________________________________
[1] Vinod Mishra1, Benny Kottiri2, Li Liu3, Rathavuth Hong1, , Shane Khan1, Alex Opio4
October 2008 . Address for correspondence: Vinod Mishra, Demographic and Health Research Division, Macro International Inc., 11785 Beltsville Drive, Calverton, MD 20705, USA; Phone: +1-301-572-0220; Fax: +1- 301-572-0999; Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
1 Macro International Inc., Calverton, Maryland, USA
2 United States Agency for International Development, Washington, DC, USA
3 Johns Hopkins University, Baltimore, Maryland, USA
4 Ministry of Health, Kampala, Uganda
[2] Abstracts are reproduced as published in:
*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK*
Post00478 Injections & HIVs + Abstracts + HCWM + News 07 January 2009
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