title: Effects of sex work on the prevalence of syphilis among injection drug users in 3 Russian cities.
abstract: OBJECTIVE
  We examined risk factors for syphilis infection among injection drug users in 3 Russian Federation cities, focusing particular attention on the potential roles of gender and sex work.
  
  
  METHODS
  We conducted a cross-sectional survey of injection drug users in Moscow, Volgograd, and Barnaul, collecting behavioral data and testing for antibodies to Treponema pallidum. Associations between presence of antibodies to T pallidum and covariates were explored.
  
  
  RESULTS
  Overall, the prevalence of antibodies to T pallidum was 11% (95% confidence interval=9.7%, 13.1%). Syphilis was associated with involvement in sex work and with gender in Moscow and Barnaul but not in Volgograd. Female injection drug users not involved in sex work were more likely than men to be younger and to have recently begun to inject; female injection drug users involved in sex work were more likely than those not involved in sex work to inject daily.
  
  
  CONCLUSIONS
  Syphilis transmission dynamics varied by region. Sex work can increase syphilis risk among injection drug users, potentially feeding the momentum of sexually transmitted HIV and syphilis among noninjectors. Targeted interventions are needed to reduce both sexual and injection risk behaviors among injection drug users.
authors.affiliation: Centre for Research on Drugs and Health Behavior, Imperial College, London, England. lucy.platt@lshtm.ac.uk
authors.forename: Lucy
authors.initials: L
authors.lastname: Platt
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
authors.forename: Ali
authors.initials: A
authors.lastname: Judd
authors.forename: Evgeniya
authors.initials: E
authors.lastname: Koshkina
authors.forename: Svetlana
authors.initials: S
authors.lastname: Maksimova
authors.forename: Natalia
authors.initials: N
authors.lastname: Latishevskaya
authors.forename: Adrian
authors.initials: A
authors.lastname: Renton
authors.forename: Tamara
authors.initials: T
authors.lastname: McDonald
authors.forename: John V
authors.initials: JV
authors.lastname: Parry
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis*; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009031:Moscow / Q000453:epidemiology; D009061:Mouth Mucosa / Q000382:microbiology; D015999:Multivariate Analysis; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D017678:Sex Distribution; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000382:microbiology; D013587:Syphilis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D014210:Treponema pallidum / Q000276:immunology*; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data*
chemical_list: D000907:Antibodies, Bacterial