title: Needle exchange use, sexual risk behaviour, and the prevalence of HIV, hepatitis B virus, and hepatitis C virus infections among Bulgarian injection drug users.
abstract: At a time when the rates of HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) infections have risen among injection drug users (IDUs) in other countries in the region, little is known about the prevalence of these infections among Bulgarian injectors and about their sexual risk behaviours. IDUs (n = 773) in a community-based needle exchange programme (NEP) and two major drug treatment facilities in Sofia completed a structured interview and were tested for HIV, HBV, and HCV antibodies. While HCV prevalence in the sample was 73.9%, HBV and HIV prevalence was low -6% and 0.5%, respectively. Having more than 10 sexual partners, having sex with someone with hepatitis C or another IDU, and never using a condom with another IDU were common among those who were recruited through NEP. As 40% of the IDUs reported using NEP, it appears that needle exchange provides an opportunity to reach high-risk populations and prevent sexual transmission of blood-borne pathogens.
authors.affiliation: Department of Preventive Medicine and Community Health, New Jersey Medical School, Newark, NJ, USA. zvassilev@njpies.org
authors.forename: Z P
authors.initials: ZP
authors.lastname: Vassilev
authors.forename: H
authors.initials: H
authors.lastname: Hagan
authors.forename: A
authors.initials: A
authors.lastname: Lyubenova
authors.forename: N
authors.initials: N
authors.lastname: Tomov
authors.forename: G
authors.initials: G
authors.lastname: Vasilev
authors.forename: D
authors.initials: D
authors.lastname: Krasteva
authors.forename: D C
authors.initials: DC
authors.lastname: Des Jarlais
mesh_terms: D000328:Adult; D002031:Bulgaria / Q000453:epidemiology; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016485:Needle Sharing; D018671:Needle-Exchange Programs; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous