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This week’s issue of SIGNPOST, the Safe Injection Global Network newsletter reports on new studies indicating a relationship between HIV status and number of health care injections received. The reports confirm what this author said for many years with David Gisselquist and others “HIV is a two way street: look one way, get killed the other way!”
SafeObserver, SOI Cameroon, Safehealthcare Africa, SidAlerte Guinea, and many other NGOs involved in HIV prevention throughout Africa, as did the late journalist and founder of Journalists Against AIDS Nigeria, Omololu Falobi have said time and again: HIV spread in sub Saharan Africa is related to very unsafe practices in health care. Garance Upham
“The Association between Medical Injections and Prevalent HIV Infection: Evidence from a National Sero-Survey in Uganda (English)” [1]
Abstract [2]
Background. The contribution of unsafe medical injections to HIV transmission in sub-Saharan Africa has been debated. In this study we examine the relationship between the number of medical injections and HIV serostatus among men and women in Uganda.
Methods. Data are from the 2004-05 Uganda HIV/AIDS Sero-Behavioural Survey (UHSBS), involving self- report data on medical injections and HIV testing among 8,298 men and 10,227 women age 15-59. The association between the number of medical injections a respondent received in previous 12 months and HIV serostatus was examined using multivariate logistic regression, accounting for possible reverse causation by excluding HIV-positive men and women who reported to be sick for at least 3 months in the previous 12 months, and adjusting for several risk factors and potential confounders, including self-reported sexually transmitted infections (STIs).
Results. Thirty- eight percent of men and 50% of women received at least one injection from a healthcare provider in the previous 12 months. The average number of medical injections per person per year was 1.9 for men and 2.5 for women. HIV prevalence was much higher among men (10.8%) and women (11.4%) who received five or more medical injections in the past year than among those who received no injections (4.0% among men and 6.3% among women). Men and women who received 3-4 injections also had higher HIV prevalence (6.6% among men and 8.3% among women) than those who had no injections. Even after accounting for several risk factors and potential confounders, men and women who received five or more injections were significantly more likely to be HIV-positive than those who had no injections (aOR=2.35, 95%CI:1.78-3.11 for men; aOR=1.55, 95%CI:1.24-1.94 for women). Excluding HIV-infected adults who were chronically ill in the past 12 months reduced the magnitude slightly, but the relationship remained significant (aOR= 2.25, 95%CI:1.68-3.01 for men; aOR=1.47, 95%CI:1.17-1.85 for women).
Conclusions. Receiving frequent medical injections is associated with significantly higher probability of being HIV infected among Ugandan adults. Medical injection as a potential mode of HIV transmission deserves continued research and programmatic attention.
KEY WORDS: medical injections, injection safety, non-sexual transmission, HIV, AIDS, prevalence, Uganda
Unsafe Medical Injections Linked to HIV Infection, New Study Finds
To download a free copy of "Medical Injections Use and HIV in Sub-Saharan Africa" by Vinod Mishra, Shane Khan, Li Liu, and Benny Kottiri, go to http://www.measuredhs.com/pubs/pdf/CR21/CR21.pdf.
The report's executive Summary follows below.
MEASURE DHS http://www.measuredhs.com Press Release December 22, 2008
Calverton, MD - A new Macro International/MEASURE DHS study of 10 sub-Saharan African countries finds that, in most countries, receiving multiple medical injections is significantly linked to being HIV-infected, for both women and men. Having ever received a blood transfusion also tends to be positively associated with being HIV-infected.
The study is based on eight Demographic and Health Surveys: Burkina Faso, Cameroon, Ethiopia, Ghana, Kenya, Lesotho, Malawi, and Zimbabwe; and two AIDS Indicator Surveys: Tanzania and Uganda. The surveys were conducted between 2003 and 2006.
Between 30 and 50 percent of adults report receiving medical injections in the 12 months preceding the survey.
Knowledge about the risk of HIV infection from unsafe medical injections and blood transfusion is low, according to the study. Despite years of HIV/AIDS education efforts, few women or men surveyed perceive themselves to be at risk of HIV infection due to medical injections or blood transfusion.
These findings suggest that medical injections and blood transfusion as potential modes of HIV transmission deserve more attention from HIV/AIDS programs and medical providers. Health education programs in sub-Saharan Africa can promote knowledge of potential risks of HIV infection from unsafe injections and blood transfusion. Health care systems can strengthen national injection safety and blood safety guidelines and expand medical injection safety and blood safety programs.
The Demographic and Health Surveys and AIDS Indicator Surveys are funded by the United States Agency for International Development through the MEASURE DHS project.
To download a free copy of Medical Injections Use and HIV in Sub-Saharan Africa by Vinod Mishra, Shane Khan, Li Liu, and Benny Kottiri, go to http://www.measuredhs.com/pubs/pdf/CR21/CR21.pdf.
For additional information about the study or MEASURE DHS project, please visit http://www.measuredhs.com
__________________________________________________________________________
DHS Comparative Reports No. 21
Medical Injection Use and HIV in Sub-Saharan Africa
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:
Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir.
.
1 Macro International Inc., Calverton, Maryland, USA
2 Johns Hopkins University, Baltimore, Maryland, USA
3 United States Agency for International Development, Washington, DC, USA
__________________________________________________________________________
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.
[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: vinod.mishra AT macrointernational.com
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
http://uqconnect.net/signfiles/Archives/SIGN-POST00478.txt
Results. Thirty- eight percent of men and 50% of women received at least one injection from a healthcare provider in the previous 12 months. The average number of medical injections per person per year was 1.9 for men and 2.5 for women. HIV prevalence was much higher among men (10.8%) and women (11.4%) who received five or more medical injections in the past year than among those who received no injections (4.0% among men and 6.3% among women). Men and women who received 3-4 injections also had higher HIV prevalence (6.6% among men and 8.3% among women) than those who had no injections. Even after accounting for several risk factors and potential confounders, men and women who received five or more injections were significantly more likely to be HIV-positive than those who had no injections (aOR=2.35, 95%CI:1.78-3.11 for men; aOR=1.55, 95%CI:1.24-1.94 for women). Excluding HIV-infected adults who were chronically ill in the past 12 months reduced the magnitude slightly, but the relationship remained significant (aOR= 2.25, 95%CI:1.68-3.01 for men; aOR=1.47, 95%CI:1.17-1.85 for women).
Conclusions. Receiving frequent medical injections is associated with significantly higher probability of being HIV infected among Ugandan adults. Medical injection as a potential mode of HIV transmission deserves continued research and programmatic attention.
KEY WORDS: medical injections, injection safety, non-sexual transmission, HIV, AIDS, prevalence, Uganda
Unsafe Medical Injections Linked to HIV Infection, New Study Finds
To download a free copy of "Medical Injections Use and HIV in Sub-Saharan Africa" by Vinod Mishra, Shane Khan, Li Liu, and Benny Kottiri, go to http://www.measuredhs.com/pubs/pdf/CR21/CR21.pdf.
The report's executive Summary follows below.
MEASURE DHS http://www.measuredhs.com Press Release December 22, 2008
Calverton, MD - A new Macro International/MEASURE DHS study of 10 sub-Saharan African countries finds that, in most countries, receiving multiple medical injections is significantly linked to being HIV-infected, for both women and men. Having ever received a blood transfusion also tends to be positively associated with being HIV-infected.
The study is based on eight Demographic and Health Surveys: Burkina Faso, Cameroon, Ethiopia, Ghana, Kenya, Lesotho, Malawi, and Zimbabwe; and two AIDS Indicator Surveys: Tanzania and Uganda. The surveys were conducted between 2003 and 2006.
Between 30 and 50 percent of adults report receiving medical injections in the 12 months preceding the survey.
Knowledge about the risk of HIV infection from unsafe medical injections and blood transfusion is low, according to the study. Despite years of HIV/AIDS education efforts, few women or men surveyed perceive themselves to be at risk of HIV infection due to medical injections or blood transfusion.
These findings suggest that medical injections and blood transfusion as potential modes of HIV transmission deserve more attention from HIV/AIDS programs and medical providers. Health education programs in sub-Saharan Africa can promote knowledge of potential risks of HIV infection from unsafe injections and blood transfusion. Health care systems can strengthen national injection safety and blood safety guidelines and expand medical injection safety and blood safety programs.
The Demographic and Health Surveys and AIDS Indicator Surveys are funded by the United States Agency for International Development through the MEASURE DHS project.
To download a free copy of Medical Injections Use and HIV in Sub-Saharan Africa by Vinod Mishra, Shane Khan, Li Liu, and Benny Kottiri, go to http://www.measuredhs.com/pubs/pdf/CR21/CR21.pdf.
For additional information about the study or MEASURE DHS project, please visit http://www.measuredhs.com
__________________________________________________________________________
DHS Comparative Reports No. 21
Medical Injection Use and HIV in Sub-Saharan Africa
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:
Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir.
.
1 Macro International Inc., Calverton, Maryland, USA
2 Johns Hopkins University, Baltimore, Maryland, USA
3 United States Agency for International Development, Washington, DC, USA
__________________________________________________________________________
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.
[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: Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir.
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
http://uqconnect.net/signfiles/Archives/SIGN-POST00478.txt
