Socio-demographic, injection drug use, sexual behaviour and other characteristics of injection drug users in selected cities of Pakistan, 2006 (round 2) and 2011 (round 4)
| Punjab province | Sindh province | Other province | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lahore | Other Punjab | Karachi | Other Sindh | Quetta | Peshawar | All cities | ||||||||
| Year of survey | 2006 | 2011 | 2006 | 2011 | 2006 | 2011 | 2006 | 2011 | 2006 | 2011 | 2006 | 2011 | 2006 | 2011 |
| Sample size | (400) (%) | (365) (%) | (1200) (%) | (1441) (%) | (399) (%) | (354) (%) | (798) (%) | (730) (%) | (190) (%) | (359) (%) | (180) (%) | (260) (%) | (3167) (%) | (3509) (%) |
| HIV prevalence | 6.5 | 30.7*** | 21.5 | 42.1*** | 30.1 | 43.2*** | 10.9 | 18.9*** | 9.5 | 7.2 | 2.2 | 20*** | 16.2 | 31.0*** |
| Used a dirty syringe, last injection | ||||||||||||||
| No | 92.0 | 58.1 | 68.3 | 54.7 | 91.1 | 79.4 | 49.6 | 71.4 | 82.3 | 61.6 | 90.5 | 60.3 | 71.6 | 62.1 |
| Yes | 8.0 | 41.9*** | 31.7 | 45.3*** | 8.9 | 20.6*** | 50.4 | 28.6*** | 17.7 | 38.4*** | 9.5 | 39.7*** | 28.4 | 37.9*** |
| Socio-demographic characteristics | ||||||||||||||
| Age group | ||||||||||||||
| <20 | 1.3 | 0.8 | 1.8 | 1.8 | 3.0 | 5.1 | 2.6 | 2.2 | 1.1 | 1.9 | 3.9 | 10.4 | 2.2 | 2.8 |
| 20–24 | 10.0 | 19.2 | 14.6 | 23.2 | 12.8 | 24.3 | 13.9 | 8.4 | 14.3 | 19.8 | 21.2 | 31.2 | 14.0 | 20.1 |
| 25–29 | 16.3 | 17.8 | 29.5 | 29.4 | 17.9 | 28.0 | 22.4 | 16.0 | 22.2 | 29.5 | 26.8 | 21.9 | 24.0 | 24.7 |
| 30–34 | 18.8 | 17.3 | 17.4 | 20.7 | 17.4 | 18.1 | 17.3 | 21.6 | 16.9 | 20.3 | 11.7 | 16.5 | 17.2 | 19.9 |
| 35–39 | 19.3 | 18.6 | 15.3 | 9.5 | 18.1 | 11.0 | 21.8 | 32.2 | 16.9 | 17.0 | 15.6 | 9.6 | 17.9 | 16.1 |
| 40+ | 34.5 | 26.3 | 21.4 | 15.3 | 30.7 | 13.6 | 22.0 | 19.6 | 28.6 | 11.4 | 20.7 | 10.4 | 24.8 | 16.4 |
| Mean | 34.7 | 33.5 | 31.7 | 30.4 | 33.4 | 29.4 | 32.1 | 33.2 | 32.7 | 29.8 | 30.6 | 28.0 | 32.4 | 31.0 |
| Education level | ||||||||||||||
| Illiterate | 64.8 | 57.3 | 62.0 | 59.9 | 59.5 | 61.5 | 51.5 | 50.8 | 49.2 | 18.7 | 64.2 | 45.4 | 58.7 | 52.6 |
| Primary school only | 13.0 | 20.3 | 20.8 | 22.9 | 18.2 | 11.3 | 32.0 | 27.8 | 20.1 | 31.8 | 14.0 | 20.8 | 21.9 | 23.2 |
| Middle school or more | 22.3 | 22.5 | 17.3 | 17.2 | 22.3 | 27.2 | 16.5 | 21.4 | 30.7 | 49.6 | 21.8 | 33.8 | 19.4 | 24.2 |
| Marital status | ||||||||||||||
| Unmarried | 49.0 | 55.1 | 41.5 | 53.0 | 58.4 | 61.3 | 55.9 | 47.4 | 54.5 | 47.6 | 60.9 | 64.6 | 50.1 | 53.2 |
| Currently married | 47.8 | 36.4 | 52.8 | 30.5 | 39.3 | 33.1 | 41.8 | 50.1 | 40.7 | 52.4 | 38.0 | 26.2 | 46.2 | 37.4 |
| Separated/divorced/widowed | 3.3 | 8.5 | 5.7 | 16.5 | 2.3 | 5.6 | 2.3 | 2.5 | 4.8 | 0.0 | 1.1 | 9.2 | 3.8 | 9.4 |
| Place currently living | ||||||||||||||
| Home | 44.0 | 31.8 | 73.1 | 56.9 | 65.1 | 30.3 | 58.6 | 43.4 | 72.5 | 82.0 | 50.6 | 68.7 | 63.4 | 52.2 |
| Hostel/hotel, etc | 24.5 | 19.2 | 14.7 | 14.4 | 10.6 | 2.0 | 17.6 | 13.4 | 14.3 | 5.9 | 12.2 | 14.5 | 16.0 | 12.6 |
| Street/lane | 31.5 | 49.0 | 12.2 | 28.7 | 24.4 | 67.7 | 23.8 | 43.2 | 13.2 | 12.1 | 37.2 | 16.9 | 20.6 | 35.3 |
| Who currently living with | ||||||||||||||
| Alone | 29.3 | 46.0 | 10.3 | 20.0 | 29.1 | 10.7 | 11.0 | 21.1 | 8.9 | 5.0 | 11.1 | 14.3 | 15.2 | 20.0 |
| Relatives/family | 43.0 | 30.7 | 74.8 | 56.5 | 57.1 | 32.8 | 54.8 | 42.9 | 71.6 | 79.9 | 51.1 | 64.5 | 62.0 | 51.6 |
| Friends/other | 27.8 | 23.3 | 14.8 | 23.5 | 13.8 | 56.5 | 34.2 | 36.0 | 19.5 | 15.1 | 37.8 | 21.2 | 22.8 | 28.4 |
| Injecting drug | ||||||||||||||
| Duration of injecting habit | ||||||||||||||
| 1 year or less | 9.8 | 15.3 | 12.8 | 21.0 | 7.6 | 18.4 | 10.3 | 2.2 | 14.4 | 16.8 | 52.5 | 25.1 | 13.5 | 16.1 |
| 2–4 years | 34.8 | 28.2 | 51.5 | 52.3 | 46.9 | 40.1 | 39.2 | 27.8 | 39.4 | 65.0 | 29.6 | 47.5 | 43.7 | 44.4 |
| 5–9 years | 35.0 | 31.5 | 25.0 | 20.8 | 29.5 | 26.3 | 29.5 | 32.8 | 26.6 | 15.7 | 11.2 | 20.4 | 27.3 | 24.4 |
| 10+ years | 20.5 | 24.9 | 10.7 | 6.0 | 16.1 | 15.3 | 20.9 | 37.2 | 19.7 | 2.5 | 6.7 | 7.1 | 15.5 | 15.1 |
| How often inject per day, last month | ||||||||||||||
| Once a day | 4.0 | 6.0 | 6.8 | 2.4 | 10.6 | 1.4 | 9.2 | 8.4 | 34.4 | 13.9 | 23.6 | 39.2 | 10.1 | 7.8 |
| 2–3 times a day | 69.8 | 62.7 | 66.6 | 68.0 | 72.2 | 79.7 | 78.6 | 74.9 | 58.2 | 67.4 | 64.4 | 52.3 | 70.1 | 68.9 |
| 4+ | 26.3 | 31.2 | 26.5 | 29.6 | 17.2 | 18.9 | 12.2 | 16.7 | 7.4 | 18.7 | 12.1 | 8.5 | 19.8 | 23.3 |
| Always used clean syringe, last month | ||||||||||||||
| No | 56.9 | 72.8 | 56.4 | 78.5 | 16.4 | 46.3 | 85.5 | 80.7 | 44.4 | 95.2 | 31.2 | 73.7 | 56.7 | 76.5 |
| Yes | 43.1 | 27.2 | 43.6 | 21.5 | 83.6 | 53.7 | 14.5 | 19.3 | 55.6 | 4.8 | 68.8 | 26.3 | 43.3 | 23.5 |
| Injected by professional injector, last month | ||||||||||||||
| No | 97.0 | 32.7 | 58.2 | 21.7 | 90.2 | 30.2 | 83.2 | 42.0 | 85.3 | 53.7 | 55.2 | 32.2 | 74.8 | 31.9 |
| Yes | 3.0 | 67.3 | 41.8 | 78.3 | 9.8 | 69.8 | 16.8 | 58.0 | 14.7 | 46.3 | 44.8 | 67.8 | 25.2 | 68.1 |
| Frequency of injection, yesterday | ||||||||||||||
| 0 times | 3.8 | 0.8 | 25.0 | 0.5 | 22.0 | 1.1 | 0.9 | 0.4 | 11.9 | 0.6 | 19.8 | 1.9 | 14.7 | 0.7 |
| 1–2 time | 50.5 | 34.5 | 36.6 | 33.1 | 50.1 | 44.4 | 48.6 | 22.5 | 75.1 | 53.5 | 49.7 | 70.4 | 46.1 | 37.0 |
| 3+ times | 45.8 | 64.7 | 38.4 | 66.4 | 27.8 | 54.5 | 50.5 | 77.1 | 13.0 | 46.0 | 30.5 | 27.7 | 39.2 | 62.3 |
| Where you last injected | ||||||||||||||
| Non-public space | 26.1 | 8.8 | 31.8 | 14.0 | 8.2 | 1.1 | 53.0 | 18.2 | 13.3 | 13.1 | 19.8 | 26.5 | 31.7 | 13.9 |
| Public space | 73.9 | 91.2 | 68.2 | 86.0 | 91.8 | 98.9 | 47.0 | 81.8 | 86.7 | 86.9 | 80.2 | 73.5 | 68.3 | 86.1 |
| Who you last injected with | ||||||||||||||
| No one | 60.0 | 34.5 | 21.4 | 26.2 | 26.7 | 5.6 | 33.0 | 20.7 | 42.3 | 22.6 | 27.5 | 16.2 | 31.5 | 22.7 |
| Somebody else | 40.0 | 65.5 | 78.6 | 73.8 | 73.3 | 94.4 | 67.0 | 79.3 | 57.7 | 77.4 | 72.5 | 83.8 | 68.5 | 77.3 |
| Professional injector, last injection | ||||||||||||||
| No | 94.5 | 60.3 | 83.5 | 56.8 | 94.7 | 46.3 | 93.9 | 77.4 | 91.0 | 80.4 | 78.7 | 74.8 | 89.1 | 64.1 |
| Yes | 5.5 | 39.7 | 16.5 | 43.2 | 5.3 | 53.7 | 6.1 | 22.6 | 9.0 | 19.6 | 21.3 | 25.2 | 10.9 | 35.9 |
| Inject avil | ||||||||||||||
| No | 15.5 | 2.7 | 28.7 | 12.5 | 10.5 | 1.4 | 7.0 | 15.3 | 44.2 | 18.9 | 5.0 | 5.0 | 18.9 | 11.1 |
| Yes | 84.5 | 97.3 | 71.3 | 87.5 | 89.5 | 98.6 | 93.0 | 84.7 | 55.8 | 81.1 | 95.0 | 95.0 | 81.1 | 88.9 |
| Inject heroin | ||||||||||||||
| No | 86.5 | 69.3 | 66.2 | 20.9 | 23.8 | 3.1 | 40.5 | 12.9 | 23.7 | 18.9 | 83.9 | 90.8 | 55.4 | 27.4 |
| Yes | 13.5 | 30.7 | 33.8 | 79.1 | 76.2 | 96.9 | 59.5 | 87.1 | 76.3 | 81.1 | 16.1 | 9.2 | 44.6 | 72.6 |
| Inject diazepam | ||||||||||||||
| No | 30.0 | 19.5 | 64.8 | 83.8 | 85.2 | 94.9 | 68.2 | 92.6 | 87.9 | 57.7 | 96.7 | 71.5 | 67.0 | 76.5 |
| Yes | 70.0 | 80.5 | 35.2 | 16.2 | 14.8 | 5.1 | 31.8 | 7.4 | 12.1 | 42.3 | 3.3 | 28.5 | 33.0 | 23.5 |
| Inject tamgesic | ||||||||||||||
| No | 36.3 | 42.5 | 65.3 | 87.0 | 81.0 | 100.0 | 88.2 | 99.3 | 94.2 | 99.4 | 99.4 | 86.9 | 73.0 | 87.5 |
| Yes | 63.7 | 57.5 | 34.8 | 13.0 | 19.0 | 0.0 | 11.8 | 0.7 | 5.8 | 0.6 | 0.6 | 13.1 | 27.0 | 12.5 |
| Sexual behaviours | ||||||||||||||
| Age at first sex | ||||||||||||||
| 10–14 | 17.9 | 19.2 | 11.9 | 14.7 | 7.3 | 26.3 | 1.6 | 20.4 | 7.3 | 1.3 | 10.4 | 16.5 | 9.9 | 16.2 |
| 15–19 | 54.5 | 62.8 | 61.5 | 59.8 | 44.1 | 55.2 | 64.1 | 65.8 | 31.8 | 44.6 | 68.8 | 45.1 | 58.9 | 58.4 |
| 20+ | 27.6 | 18.0 | 26.5 | 25.5 | 48.6 | 18.4 | 34.3 | 13.8 | 60.9 | 54.2 | 20.8 | 38.3 | 31.2 | 25.4 |
| Paid FSW for sex, last 6 months | ||||||||||||||
| No | 78.4 | 82.4 | 69.0 | 81.7 | 75.9 | 95.5 | 90.6 | 80.3 | 90.2 | 46.0 | 82.6 | 80.1 | 77.6 | 79.3 |
| Yes | 21.6 | 17.6 | 31.0 | 18.3 | 24.1 | 4.5 | 9.4 | 19.7 | 9.8 | 54.0 | 17.4 | 19.9 | 22.4 | 20.7 |
| Used condom at last paid sex with FSW | ||||||||||||||
| No | 57.8 | 74.1 | 86.1 | 83.8 | 72.7 | 37.5 | 94.4 | 57.1 | 97.9 | 85.1 | 73.1 | 84.0 | 85.3 | 76.8 |
| Yes | 42.2 | 25.9 | 13.9 | 16.3 | 27.3 | 62.5 | 5.6 | 42.9 | 2.1 | 14.9 | 26.9 | 16.0 | 14.7 | 23.2 |
| Paid MSW/HSW for sex, last 6 months | ||||||||||||||
| No | 86.8 | 92.3 | 81.1 | 92.4 | 91.4 | 97.7 | 93.3 | 84.3 | 93.1 | 89.4 | 86.5 | 90.6 | 87.2 | 90.8 |
| Yes | 13.3 | 7.7 | 18.9 | 7.6 | 8.6 | 2.3 | 6.7 | 15.7 | 6.9 | 10.6 | 13.5 | 9.4 | 12.8 | 9.2 |
| Used condom at last sex with MSW/HSW | ||||||||||||||
| No | 75.0 | 76.0 | 93.2 | 83.6 | 76.5 | 71.4 | 98.1 | 77.4 | 92.9 | 83.8 | 60.0 | 87.0 | 88.0 | 80.8 |
| Yes | 25.0 | 24.0 | 6.8 | 16.4 | 23.5 | 28.6 | 1.9 | 22.6 | 7.1 | 16.2 | 40.0 | 13.0 | 12.0 | 19.2 |
| Exchanged sex for money/gifts | ||||||||||||||
| No | 75.1 | 73.8 | 88.3 | 83.1 | 92.9 | 93.8 | 72.2 | 92.2 | 94.2 | 85.8 | 87.1 | 89.4 | 83.5 | 85.8 |
| Yes | 24.9 | 26.2 | 11.7 | 16.9 | 7.1 | 6.2 | 27.8 | 7.8 | 5.8 | 14.2 | 12.9 | 10.6 | 16.5 | 14.2 |
| Awareness of government programmes for IDU | ||||||||||||||
| No | 70.5 | 94.8 | 66.2 | 83.8 | 70.2 | 15.6 | 68.3 | 77.6 | 67.9 | 18.3 | 61.2 | 93.0 | 67.6 | 70.8 |
| Yes | 29.5 | 5.2 | 33.8 | 16.2 | 29.8 | 84.4 | 31.7 | 22.4 | 32.1 | 81.7 | 38.8 | 7.0 | 32.4 | 29.2 |
*p<0.05; **p<.01; ***p<0.0001, based on χ2 tests of association.
Because of multiple comparisons (n=7), and using the Bonferonni correction, p<0.007 was considered statistically significant at the 95% CI level.
FSW, female sex worker; HSW, hijra sex worker; IDU, injecting drug user; MSW, male sex worker.