The prevalence of people who inject drugs among those with HIV late presentation: a meta-analysis

BACKGROUND: One of the most important routes of HIV transmission is through injections of drugs, and this group, due to unawareness of their infection, causes the spread of HIV. The coexistence of other opportunistic infections and diseases with HIV among people who inject drugs (PWID) imposes healthcare costs and is associated with high morbidity/mortality rates. Early detection of HIV among PWID is essential to prevent and control the spread of the disease. OBJECTIVES: This study aimed to determine the prevalence of PWID among those with late presentation (LP). METHODS: Three electronic databases of PubMed, Scopus, and Web of science were searched using appropriate keywords. Besides the prevalence data reported for PWID among LP, the other outcomes of interest were LP defined as having CD4 count < 350 cells/μL or HIV or advanced disease defined with CD4 count < 200 cells/μL or HIV at the time of diagnosis. RESULTS: Of the 160 studies found, only eight met the inclusion criteria. Among those presented late, 36.5% were PWID (95% CI = 24.88–48.17). Compared with men who have sex with men (MSM), HIV-infected PWID had a higher risk of LP [OR = 1.51; 95% CI = 0.96–2.06]. CONCLUSION: The results of this study show that HIV is diagnosed late in the majority of PWID when CD4 is less than 350 cells/μL. Targeted interventions/strategies are highly required to reduce LP among HIV-infected PWID.