Abstract:
Background: People who inject drugs (PWID) face significant global health challenges especially in Africa driven by overlapping conditions such as extreme poverty, high prevalence of infectious diseases, and limited access to healthcare In Ethiopia, the burden of HIV, syphilis and hepatitis C among PWID is a growing public health issue. Despite known risks, there is limited research on the prevalence of HIV, Hepatitis B and C virus (HBV & HCV) and its determinants among PWID engaging in risky sexual behavior in Ethiopia.
Objective: This study aimed to determine the prevalence and determinants of HIV, HBV, HCV, and Syphilis among PWIDs engaging in risky sexual behavior in Ethiopia.
Methods: A secondary data analysis was employed; the study participants were PWIDs engaging in Risky Sexual Behavior who participated in the 2023 EPHI cross sectional survey. For the analysis, descriptive statistics was used to summarize the characteristics of the participants. A multivariate logistic regression was employed to identify significant factors. An association was declared by using an adjusted odds ratio with 95% CI.
Result: The prevalence of HIV, HBV, HCV and syphilis was 3.74%, 3.67%, 4.99% and 0.26%, respectively among PWID engaging in risky sexual behavior in Ethiopia. HIV infection was significantly associated with being female, beginning age 31+, having a history of incarceration, and injecting drugs often. Early injectable drug use, early sexual initiation, and older age (31+) were linked to HBV infection. Lastly, syphilis was more common in participants under 25 years and those who inject drugs twice or more per month.
Conclusion and recommendation: Among PWIDs engaging in risky sexual behavior in Ethiopia, Among PWIDs engaging in risky sexual behavior in Ethiopia, HIV, HBV and syphilis share a common constellation of drivers female gender specific vulnerabilities, early initiation of both injection and sexual activity, high-frequency drug use and a history of incarceration and addressing these intersecting risks will require an integrated, evidence-driven response. First, harm-reduction packages must be expanded to combine sterile injection equipment, condom provision and on-site STI screening in both community and prison settings. Second, outreach efforts should be tailored by gender and age to ensure that women and younger injectors receive prevention, testing and counseling services suited to their needs. Finally, strengthening surveillance through longitudinal cohort studies and in-depth qualitative research will generate the actionable insights needed to refine policies and interventions over time.
Keywords: PWIDs, HIV, HBV, HCV, Syphilis, associated factors, Ethiopia