{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:25:37Z","timestamp":1791887137165,"version":"4.3.4"},"reference-count":30,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,2,29]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The rapid expansion of the recreational drug market becomes a global health concern. It is worrying that the bacterial and viral infection epidemics linking to drug use may worsen accordingly. This study aimed to estimate the impacts of changing trend and behaviours of using heroin only, synthetic drug (SD) only and polydrug (using SD and heroin concurrently) on HIV, hepatitis C virus (HCV) and syphilis epidemics among people who use drugs in China by 2035.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We constructed a compartmental model to estimate HIV, HCV and syphilis epidemics in the dynamic drug-use trend by three scenarios: SD-only use, heroin-only use and polydrug use based on Monte Carlo simulations. The parameters for the model were collected from a comprehensive literature search.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our model estimated that polydrug use led to the highest HIV and HCV prevalence among three drug-use patterns. The prevalences were projected to increase from 10.9% (95% CI 10.2% to 11.5%) and 61.7% (95% CI 59.4% to 62.5%) in 2005 to 19.0% (95% CI 17.3% to 20.7%) and 69.1% (95% CI 67.3% to 69.5%), respectively, in 2035 among people using polydrug. Similarly, HIV and HCV prevalence in the SD-only group were projected to increase from 0.4% (95% CI 0.3% to 0.4%) and 19.5% (95% CI 19.4% to 21.7%) to 1.8% (95% CI 1.4 to 2.1%) and 33.7% (95% CI 33.2% to 34.9%) in 2005\u20132035. Conversely, HIV prevalence in the heroin-only group was projected to decrease from 8.0% (95% CI 7.6% to 8.1%) to 2.2% (95% CI 2.0% to 2.3%) in 2005\u20132035. Syphilis prevalence was estimated to remain unchanged in all population groups within this time frame. It was projected that the proportion of HIV transmitted by sexual transmission will increase compared with unsafe injection transmission in all people who use drugs from 2005 to 2035.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our modelling suggests that polydrug use is projected to lead to the highest HIV and HCV disease burden by 2035, and the proportion of HIV transmitted by sexual transmission will increase. Current HIV intervention among people using heroin seems effective according to our estimation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054360","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T21:15:52Z","timestamp":1584566152000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Estimation of the impact of changing drug-use trend on HIV, hepatitis C and syphilis epidemics among people who use synthetic drug-only, polydrug and heroin-only during 2005\u20132035 in China: modelling study"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-237X","authenticated-orcid":false,"given":"Shu","family":"Su","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-5789","authenticated-orcid":false,"given":"Limin","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Medland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingwang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guihua","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,3,18]]},"reference":[{"key":"2024092304051011000_96.8.608.1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2174\/157015911795017245","article-title":"Understanding the global problem of drug addiction is a challenge for IDARS scientists","volume":"9","author":"Ali","year":"2011","journal-title":"Curr Neuropharmacol"},{"key":"2024092304051011000_96.8.608.2","unstructured":"United Nations . World drug report, 2019."},{"key":"2024092304051011000_96.8.608.3","unstructured":"China's National Narcotics Control Commission and the Ministry of Public Security . Annual drug report on drug control in China. Beijing: Ministry of Public Security, 2019."},{"key":"2024092304051011000_96.8.608.4","unstructured":"Sheldon X , Zhang KC . A people's war: China's struggle to contain its illicit drug problem, 2015."},{"key":"2024092304051011000_96.8.608.5","first-page":"111","article-title":"Population specific sentinel surveillance for HIV infection, syphilis and HCV infection in China, during 2010-2015]","volume":"32","author":"Ge Lin","year":"2017","journal-title":"Disease Surveillance"},{"key":"2024092304051011000_96.8.608.6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.addbeh.2019.01.022","article-title":"Estimates of the National trend of drugs use during 2000-2030 in China: a population-based mathematical model","volume":"93","author":"Su","year":"2019","journal-title":"Addict Behav"},{"key":"2024092304051011000_96.8.608.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9432-y"},{"key":"2024092304051011000_96.8.608.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-019730","article-title":"Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study","volume":"8","author":"Su","year":"2018","journal-title":"BMJ Open"},{"key":"2024092304051011000_96.8.608.9","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.pbb.2011.04.014","article-title":"Powerful behavioral interactions between methamphetamine and morphine","volume":"99","author":"Trujillo","year":"2011","journal-title":"Pharmacol Biochem Behav"},{"key":"2024092304051011000_96.8.608.10","first-page":"1819","article-title":"Sexual behaviour among male methamphetamine and heroin Dependents in selected areas in Malaysia","volume":"42","author":"Fadzli","year":"2013","journal-title":"Sains Malaysiana"},{"key":"2024092304051011000_96.8.608.11","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-25038-y","article-title":"Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China","volume":"8","author":"Su","year":"2018","journal-title":"Sci Rep"},{"key":"2024092304051011000_96.8.608.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-017-1346-7","article-title":"Comparison of demographic characteristics and psychiatric comorbidity among methamphetamine-, heroin- and methamphetamine-heroin CO- dependent males in Hunan, China","volume":"17","author":"Dong","year":"2017","journal-title":"BMC Psychiatry"},{"key":"2024092304051011000_96.8.608.13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1080\/10550887.2011.581989","article-title":"Comparing injection and non-injection routes of administration for heroin, methamphetamine, and cocaine users in the United States","volume":"30","author":"Novak","year":"2011","journal-title":"J Addict Dis"},{"key":"2024092304051011000_96.8.608.14","first-page":"119","article-title":"Correlates of injection use of synthetic drugs among drug users in Pakistan: a case controlled study","volume":"56","author":"Emmanuel","year":"2006","journal-title":"J Pak Med Assoc"},{"key":"2024092304051011000_96.8.608.15","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960130)15:2<221::AID-SIM148>3.0.CO;2-Q"},{"key":"2024092304051011000_96.8.608.16","doi-asserted-by":"publisher","DOI":"10.1071\/SH16141"},{"key":"2024092304051011000_96.8.608.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-017-2288-x","article-title":"Predictors and incidence of sexually transmitted hepatitis C virus infection in HIV positive men who have sex with men","volume":"17","author":"Medland","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2024092304051011000_96.8.608.18","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000834"},{"key":"2024092304051011000_96.8.608.19","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27406"},{"key":"2024092304051011000_96.8.608.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0155934","article-title":"Will sofosbuvir\/ledipasvir (Harvoni) be cost-effective and affordable for Chinese patients infected with hepatitis C virus? an economic analysis using real-world data","volume":"11","author":"Chen","year":"2016","journal-title":"PLoS One"},{"key":"2024092304051011000_96.8.608.21","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2014.00849","article-title":"Decision-making in stimulant and opiate addicts in protracted abstinence: evidence from computational modeling with pure users","volume":"5","author":"Ahn","year":"2014","journal-title":"Front Psychol"},{"key":"2024092304051011000_96.8.608.22","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.mbs.2010.03.002","article-title":"From heroin epidemics to methamphetamine epidemics: modelling substance abuse in a South African Province","volume":"225","author":"Nyabadza","year":"2010","journal-title":"Math Biosci"},{"key":"2024092304051011000_96.8.608.23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1521\/aeap.2019.31.1.1","article-title":"Causes and consequences of drug abuse: a comparison between synthetic drug and heroin users in urban China","volume":"31","author":"Yang","year":"2019","journal-title":"AIDS Educ Prev"},{"key":"2024092304051011000_96.8.608.24","doi-asserted-by":"publisher","DOI":"10.1080\/09595230801919486"},{"key":"2024092304051011000_96.8.608.25","unstructured":"Cardozo T et al . Cocaine and HIV Infection. In: Montoya ID , ed. Biologics to treat substance use disorders: vaccines, monoclonal antibodies, and enzymes. Springer International Publishing: Cham, 2016: 75\u2013103."},{"key":"2024092304051011000_96.8.608.26","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2015.00267","article-title":"New drugs and polydrug use: implications for clinical psychology","volume":"6","author":"Iudici","year":"2015","journal-title":"Front Psychol"},{"key":"2024092304051011000_96.8.608.27","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.drugpo.2017.05.027","article-title":"High hepatitis C incidence in relation to prescription opioid injection and poly-drug use: assessing barriers to hepatitis C prevention","volume":"47","author":"Puzhko","year":"2017","journal-title":"Int J Drug Policy"},{"key":"2024092304051011000_96.8.608.28","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1007\/s10461-017-1836-0","article-title":"Polydrug use and heterogeneity in HIV risk among people who inject drugs in Estonia and Russia: a latent class analysis","volume":"22","author":"Tavitian-Exley","year":"2018","journal-title":"AIDS Behav"},{"key":"2024092304051011000_96.8.608.29","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/hiv.12574","article-title":"Sexualized drug use ('chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men","volume":"19","author":"Pufall","year":"2018","journal-title":"HIV Med"},{"key":"2024092304051011000_96.8.608.30","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.drugpo.2014.06.008","article-title":"Risk control and rational recreation: a qualitative analysis of synthetic drug use among young urbanites in China","volume":"25","author":"Lin","year":"2014","journal-title":"Int J Drug Policy"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2019-054360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:05:56Z","timestamp":1727089556000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2019-054360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,18]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,11,18]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/sextrans-2019-054360"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2019-054360","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,18]]}}}