Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia.
OBJECTIVE
To establish the prevalence of antibodies to HIV (anti-HIV) and associated risk factors among injecting drug users (IDU) in Togliatti City, Samara Oblast, Russian Federation.


METHODS
An unlinked anonymous cross-sectional community recruited survey with oral fluid sample collection.


METHODS
Between September and October 2001, 426 IDU were recruited by trained fieldworkers. Participants completed an interviewer administered questionnaire, and oral fluid samples were tested for anti-HIV. Univariate and multivariate analyses compared potential risk factors for anti-HIV.


RESULTS
Anti-HIV prevalence was 56% (234/418). Three-quarters of anti-HIV-positive IDU (74%) were unaware of their positive status. In an adjusted model, the odds of HIV infection were higher among IDU who had ever injected home-produced drugs, who reported injecting with used needles and syringes in the past 4 weeks, and who were living in one particular district of the city (Komsomolksii).


CONCLUSIONS
The high prevalence of HIV, and a recent increase in HIV detected through routine screening tests since 2000, suggests that an explosive epidemic has occurred among IDU in Togliatti City. In the face of currently inadequate HIV prevention coverage among IDU, this has urgent implications for maximizing the distribution of sterile injecting equipment as well as for enhancing sexual risk reduction. Recognizing that it is likely that similar explosive epidemics are taking place in other Russian cities, we recommend community-wide HIV prevention coverage supported by city and state policies oriented to harm reduction.
Rhodes
Tim
T
Department of Social Science and Medicine, Imperial College Faculty of Medicine, University of London, London, UK. t.rhodes@ic.ac.uk
Lowndes
Catherine
C
Judd
Ali
A
Mikhailova
Larissa A
LA
Sarang
Anya
A
Rylkov
Andrey
A
Tichonov
Mikhail
M
Lewis
Kim
K
Ulyanova
Nina
N
Alpatova
Tatiana
T
Karavashkin
Victor
V
Khutorskoy
Mikhail
M
Hickman
Matthew
M
Parry
John V
JV
Renton
Adrian
A
D015492:AIDS Serodiagnosis; D000328:Adult; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D009055:Mouth / Q000276:immunology; D015995:Prevalence; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications*; D011795:Surveys and Questionnaires
D015483:HIV Antibodies