title: Changes in HIV prevalence and risk among new injecting drug users in a Russian city of high HIV prevalence.
abstract: OBJECTIVE
  To measure HIV prevalence and associated risk factors among recent initiates into drug injecting in 2001 and 2004 in Togliatti City, Russian Federation.
  
  
  METHODS
  Two unlinked, anonymous, cross-sectional, community-recruited surveys of injecting drug users (IDUs) with oral fluid samples for anti-HIV testing.
  
  
  METHODS
  IDUs completed an interviewer-administered questionnaire, and oral fluid samples were tested for antibodies to HIV. Demographic characteristics and injecting risk behaviors were compared between subsamples of IDUs who reported injecting for 3 years or less in each of the survey years, 2001 (n = 138) and 2004 (n = 96). Univariable and multivariable analyses explored risk factors with anti-HIV among these new injectors.
  
  
  RESULTS
  Among IDUs overall, although HIV prevalence was high, a lower prevalence was found in 2004 (38.5%, 95% confidence interval [CI]: 34.1 to 42.9) than in 2001 (56%, 95% CI: 51.2 to 60.8). A significantly lower prevalence of HIV was found among new injectors in 2004 (11.5%, 95% CI: 5.0 to 17.9) than in 2001 (55.2%, 95% CI: 46.7 to 63.8). Proportionally, fewer new injectors reported injecting daily, injecting with used needles/syringes, and frontloading in 2004 compared with 2001. Decreased odds of anti-HIV were associated with being recruited in 2004 and with a history of drug treatment. Increased odds of HIV were associated with exchanging sex, duration of injection, and frontloading.
  
  
  CONCLUSIONS
  Findings indicate a decrease in HIV prevalence among new injectors between 2001 and 2004 and emphasize the role of provision of needle/syringes through pharmacies and providing access to voluntary HIV testing. These findings have implications for other cities in which explosive HIV outbreaks have occurred.
authors.affiliation: Centre for Research on Drugs and Health Behaviour, Public and Environmental Health Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. 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: Matthew
authors.initials: M
authors.lastname: Hickman
authors.forename: Larissa
authors.initials: L
authors.lastname: Mikhailova
authors.forename: Konstantin
authors.initials: K
authors.lastname: Lisetsky
authors.forename: Anya
authors.initials: A
authors.lastname: Sarang
authors.forename: Kim
authors.initials: K
authors.lastname: Lewis
authors.forename: John
authors.initials: J
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015483:HIV Antibodies / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: D015483:HIV Antibodies