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Hotel Booking       Mahidol University Annual Research Abstracts 2000 565 Incarceration as a Continuing HIV Risk Factor among Injecting Drug Users (IDUs) in Bangkok Suwanee Raktham¹, D. Kitayaporn² , S. Vanichseni¹, K. Hiranras¹, K. Choopanya¹, D.C. Des Jarlais³, W. Subhachaturas¹, P. Mock⁴, T.D. Mastro^{4 1} Bangkok Metropolitan Administration, ² Mahidol University, Bangkok, Thailand, ³ Beth Israel Medical Center, NY, USA^{, 4} The HIV/AIDS Collaboration, Nonthaburi, Thailand

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Travel Agency                     Background: Bangkok experienced very rapid spread of HIV among IDUs in 1988, followed by stable seroprevalence at approximately 30-40% with continued high incidence. Estimated incidence from a prospective cohort of IDUs attending 15 Bangkok Metropolitan Administration methadone clinics during 05/95-05/98 was 6.3 per 100 personyears at risk. Previous cross-sectional surveys have shown that having been incarcerated was significantly associated with being HIV seropositive, with odds ratios in the range of 2 to 3. We evaluated risk factors for incarceration among cohort enrollees.

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Many studies have evaluated risk factors for chronic diseases separately while others have used novel statistics to weigh factors and to summarize the risk into one risk factor (2).

Flight Booking                     Methods: HIV-negative IDUs were offered enrollment after informed consent; data were obtained from enrollment and follow-up questionnaires. HIV testing and counseling and interviews on demographics, drug use, and sexual behaviors were conducted at enrollment and scheduled every 4 months.

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The research study also demonstrates that travel agents are increasing their reliance on GDS systems for hotel information. Nearly 90% of travel agents say that they use their GDS and GDS shopping displays as much or more today than two years ago. Travel agents also report increased use of hotel property Web sites compared to two years ago. Travel agents are less likely now to use printed hotel directories, direct mail, fax, and the phone to gather information about hotels.

Hotel Chicago                     Results: Of 1,209 HIV-negative IDUs enrolled, 133 seroconverted through 12/98. A proportional hazard model demonstrated factors associated (p < 0.01) with HIV infection in Bangkok IDU include: daily injection of heroin (RR=2.4), daily injection of heroin plus sharing of equipment (RR=3.2), being incarcerated since last visit (RR=2.0), drug injection while being incarcerated since last visit (RR=4.5), and having average monthly income of ?5,000 Baht (US$ 140, RR=1.6). Sixtyfive percent of cohort members had been incarcerated prior to enrollment, and 38% of cohort members were incarcerated at least once during followup. Factors associated with being incarcerated, using logistic regression, included: age < 25 years old (RR 2.3, 95% CI = 1.6 - 3.2, referent: age 40+ years), having secondary school education or less (RR = 1.5, 95% CI=1.1 - 2.1, referent: higher education), being in the methadone maintenance program (RR = 0.6, 95% CI = 0.4 - 0.8, referent: 45-day detoxification program), and daily use of heroin plus sharing drugs (RR = 3.1, 95% CI = 2.3 - 4.2, referent: no use).

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Travel Health Insurance                     Conclusions: Drug use while being incarcerated is a strong risk factor for incident HIV infection in Bangkok IDUs. Frequent heroin injection and lower socio-economic status lead to higher probability of being incarcerated. Additional measures are needed to reduce the risk of HIV transmission related to incarceration.

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London Hotel Booking (This study was supported by The HIV/AIDS Collaboration (A Joint Activity of the Thailand Ministry of Public Health & the U.S. Centers for Disease Control and Prevention) Published in The Fifth International Congress on AIDS in Asia and the Pacific, Kuala Lumpur, 1999.)

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