Role of direct and indirect social and spatial ties in the diffusion of HIV and HCV among people who inject drugs: A cross-sectional community-based network analysis in New Delhi, India
- Johns Hopkins University School of Medicine, United States
- Johns Hopkins Bloomberg School of Public Health, United States
- YR Gaitonde Centre for AIDS Research and Education, India
Abstract
Background:People who inject drugs (PWID) account for some of the most explosive HIV and hepatitis C virus (HCV) epidemics globally. While individual drivers of infection are well understood, less is known about network factors, with minimal data beyond direct ties.
Methods:2,512 PWID in New Delhi, India were recruited in 2017-19 using a sociometric network design. Sampling was initiated with 10 indexes who recruited named injection partners (people who they injected with in the prior month). Each recruit then recruited their named injection partners following the same process with cross-network linkages established by biometric data. Participants responded to a survey, including information on injection locations, and provided a blood sample. Factors associated with HIV/HCV infection were identified using logistic regression.
Results:Median age was 26; 99% were male. Baseline HIV prevalence was 37.0% and 46.8% were actively infected with HCV (HCV RNA positive). The odds of prevalent HIV and active HCV infection decreased with each additional degree of separation from an infected alter (HIV AOR: 0.87; HCV AOR: 0.90) and increased among those who injected at a specific location (HIV AOR: 1.50; HCV AOR: 1.69) independent of individual-level factors (p<0.001). Additionally, sociometric factors e.g., network distance to an infected alter, were statistically significant predictors even when considering immediate egocentric ties.
Conclusions:These data demonstrate an extremely high burden of HIV and HCV infection and a highly interconnected injection and spatial network structure. Incorporating network and spatial data into the design/implementation of interventions may help interrupt transmission while improving efficiency.
Funding:National Institute on Drug Abuse and the Johns Hopkins University Center for AIDS Research.
Data availability
An interactive version of the sociospatial network and underlying data are available from: https://github.com/sclipman/sociospatial-baseline.
Article and author information
Author details
Funding
National Institute on Drug Abuse (R01DA041736)
- Sunil S Solomon
National Institute on Drug Abuse (DP2DA040244)
- Sunil S Solomon
National Institute on Drug Abuse (R01DA041034)
- Shruti H Mehta
- Gregory M Lucas
National Institute on Drug Abuse (K24DA035684)
- Gregory M Lucas
National Institute of Allergy and Infectious Diseases (P30AI094189)
- Shruti H Mehta
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: The study protocol was approved by institutional review boards at Johns Hopkins Medicine (IRB00110421) and the YR Gaitonde Centre for AIDS Research and Education in India (YRG292). All participants provided written informed consent.
Copyright
© 2021, Clipman et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
Metrics
-
- 1,003
- views
-
- 110
- downloads
-
- 5
- citations
Views, downloads and citations are aggregated across all versions of this paper published by eLife.
Download links
A two-part list of links to download the article, or parts of the article, in various formats.
Downloads (link to download the article as PDF)
Open citations (links to open the citations from this article in various online reference manager services)
Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)
Role of direct and indirect social and spatial ties in the diffusion of HIV and HCV among people who inject drugs: A cross-sectional community-based network analysis in New Delhi, India
eLife 10:e69174.
https://doi.org/10.7554/eLife.69174
