The Mortality and its Related Factors among HIV Positive People Who Inject Drugs (PWID) in Malaysia.
Keywords:HIV-positive people who inject drugs, protective factors, mortality rate
Introduction: People who inject drugs (PWID) has long been associated with HIV transmission in the community. In Malaysia, the government has adopted Methadone Maintenance Therapy (MMT) Program since 2006 as one of the harm reduction approaches to reduce the HIV seroprevalence rates. In many countries, MMT has been regarded as a critical platform to ensure HIV positive PWIDs receive appropriate antiretroviral treatment. Abstinent patients, however, may also enrol to the Infectious Disease Clinic in the tertiary public hospital. Despite treatment, mortality was nevertheless quite extensively observed in the population, and the contributing factors are still scarcely investigated. This study aimed to investigate the factors affecting mortality among HIV positive PWID from Malaysia's two mainstream treatment settings.
Method: This was a retrospective cohort study where the data was collected from one HIV Clinic of a tertiary hospital and six (6) MMT programs of primary care clinics in the district of Kuantan, Pahang from 2006-2019. The patients were categorised into three different subgroups. The mortality was recorded throughout until the end of the study period. The survival rate was analysed using one-way ANOVA, and the associated factors were analysed using Cox proportional hazard regression analysis.
Results: In total, 141 records were found to have met the inclusion and exclusion criteria. There were 15 HIV-related mortalities recorded throughout the study period. Patients who were started on ART and received ART counselling were associated with protective factors for mortality of all PWID in the study. Among those who have initiated with ART, the time to treatment initiation was the crucial and significant factor for survival.
Conclusion: In conclusion, ART initiation has significantly contributed to HIV positive PWID survival, and the sooner it's started can significantly improve the mortality rate among them.
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