Blood-borne sexually transmitted infections among substance abuse patients in Jamaica

ABSTRACT

OBJECTIVE: The objective of this study was to determine the prevalence of blood-borne sexually transmitted infections (STI) including the human immunodeficiency virus (HIV), human T-cell lymphotropic virus type-1 (HTLV-1), hepetitis B virus (HBV) and syphillis in residents of a detoxification/rehabilitation unit in Jamaica. METHODS: The records of 301 patients presenting, over a 5-year period, for treatment of substance abuse were reviewed for demographic and laboratory data. The laboratory results were compared with those of 131 blood donors who were used as representative of the general population. The substances used were alcohol, cannabis and cocaine. None of the subjects was an intravenous (IV) drug user. Female substance abusers were at higher risk than males for STI. The prevalence of STI in substance abusers did not differ significantly from that in blood donors (12 percent v 10 percent). The prevalence of syphilis in substance abusers was significantly higher than in blood donors (6 percent v 3 percent; p < 0.05). The prevalence of syphilis was dramatically increased in female substance abusers and female blood donors (30 percent; p < 0.001 and 13 percent; p < 0.05, respectively) compared with males. An increased frequency of HTLV-1 was observed in female compared to male substance abusers. Unemployment was identified as a risk factor for sexually transmitted disease in substance abusers. CONCLUSION: These results support the policy of screening patients in detoxification units for STI and indicate a need for gender specific approaches in the control of substance abuse and STI in Jamaica.(Au)