Estimating the Population Size of People Who Inject Drugs in Malaysia for 2014 and 2017 Using the Benchmark-Multiplier Method

Abstract

Background: As hepatitis C elimination efforts are launched, national strategies for screening and treatment scale-up in countries, such as Malaysia, must be designed and implemented. Strategic information, including estimates of the total number of patients chronically-infected with hepatitis C virus (HCV) and the size of key populations, such as people who inject drugs (PWID), is critical to informing these efforts. For Malaysia, the estimate of the PWID population size most frequently reported in global systematic reviews is for the year 2009. Objectives: To support ongoing national HCV planning efforts, we aimed to estimate the national population size of active PWID in Malaysia, for the years 2014 and 2017. Methods: To estimate the PWID population size, we applied standard benchmark-multiplier methodology, frequently used for PWID population size estimation, and extended it by adjusting for cessation of injecting drug use within the benchmark and calculating statistical uncertainty intervals. Results: The estimated active PWID population size was 153,000 (95% uncertainty interval (UI): 136,000–172,000) for 2014 and 156,000 (95% UI: 137,000–188,000) for 2017. Conclusions/importance: This updated estimate of the active PWID population size in Malaysia will help inform effective planning for the scale-up of HCV screening and treatment services. The proposed methodology is applicable to other countries that maintain national HIV registries and have conducted Integrated Biological and Behavioral Surveys among active PWID.

Keywords:

• Injecting drug use
• Malaysia
• HIV
• population estimation

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Acknowledgments

We thank the Ministry of Health Malaysia for making available the results of their 2018 key populations estimation and for their ongoing efforts in collecting and reporting national HIV/AIDS surveillance data. The analysis and conclusions expressed in this article are those of the authors and not necessarily of other groups or individuals. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of interest

LH and RH acknowledge operations grant support to Pharos Global Health from Gilead Sciences. All other authors declare that they have no competing interests