HIV risk behavior and practices among heroin addicts in Lahore, Pakistan

While the numbers of reported and estimated cases of HIV are still relatively low in Pakistan, behavioral patterns that could lead to an HIV epidemic are reported to exist among injection drug users. Therefore, this cross sectional study was conducted to estimate the prevalence of injection drug use and to assess the level of HIV knowledge and practices among male heroin addicts in Lahore, Pakistan. A total number of 660 male heroin addicts were recruited from 22 drug user sites in the city; data were collected using a pre-tested structured questionnaire. Analysis revealed a poor knowledge of the disease, its modes of transmission and ways to limit transmission with only 30% of the respondents considering them at risk for acquiring the disease. A prevalence of 23.3% of injection drug use was noted. HIV risk injection practices included: group injecting (83.2%), sharing syringes (58.7%), and re-using used syringes (78%). Various risky sexual practices included multiple partners (24%), homosexuality (10.8%), sexual contacts with commercial sex workers (CSW) (20.8%), and with transvestites (3.3%). Condom use was low (11-50%). Of the subjects, 5.5% reported trading sex for drugs or money. We recommend HIV/STD prevention programs encompassing health education and health promotion strategies based on harm reduction techniques be used for drug users.