HIV and hepatitis burden among women who inject drugs in Mozambique

Researchers analyzed data from 524 women who inject drugs recruited through respondent-driven sampling in Maputo, Beira, Tete, Quelimane and Nampula between July 2023 and March 2024. Participants completed questionnaires and rapid tests for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C antibodies; prevalence estimates were weighted, and regression analysis examined factors associated with HIV infection.

Weighted prevalence was 28.6% for HIV (95% CI, 15.5–41.6), 5.3% for HBsAg positivity (95% CI, 3.4–7.3) and 19.7% for anti-HCV positivity (95% CI, 3.1–36.2). HIV was independently associated with older age and residence in Maputo. Secondary or higher education and no recent sexually transmitted infection symptoms were associated with lower HIV prevalence. Among participants living with HIV, 85.0% knew their status; among those aware, 86.6% were receiving antiretroviral therapy, and 75.7% of those treated were virally suppressed.

The findings document a substantial burden of infection and gaps along the HIV care continuum in this population. The cross-sectional design cannot establish causality, and respondent-driven sampling and wide confidence intervals—particularly for anti-HCV—limit precision and generalizability. The authors call for expanded harm-reduction services and integrated testing and treatment; the study did not evaluate these interventions.