Rapid increase of HIV infection among injection drug users in Taiwan

Background: There has been a rapid increase in the number of reported cases of HIV-positive injection drug users (IDUs) since 2004. Purpose: To explore the possible reasons for the rapid increase of HIV infection and the modes of HIV transmission. Method: In 2006, all HIV infected male inmates, selected by a stratified sampling methodology, were surveyed using a self-administered anonymous questionnaire in group settings directed by trained interviewers. A total of 540 male subjects were recruited in this study. Results: About 85% of the subjects were IDUs, and 90% were infected with HIV after 2003. Based on multiple responses, 72 % of the subjects said they had contracted HIV through sharing needles with other HIV-positive IDUs, 64% said they were infected through sharing drug solution with others, another 17% said they contracted HIV from prostitutes. The number of IDUs sharing paraphernalia is increasing in direct relation to a decrease in the drug supply over the last three years. When asked about changes in the drug scene after 2003, the year of the Severe Acute Respiratory Syndrome (SARS) outbreak, 28% reported a decrease in drug supply, 21% reported a steep increase in drug prices, 10% reported a rise in the number of IDUs sharing solution and 10% reported an increase in the number of IDUs sharing needles. Conclusion: Sharing drug paraphernalia with HIV infected IDUs were the key factors related to the increase of HIV infection rather than a rise in the number of IDUs sharing needles.