Changes in HIV prevalence and risk among new injecting drug users in a Russian city of high HIV prevalence.
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.
Platt
Lucy
L
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
Rhodes
Tim
T
Hickman
Matthew
M
Mikhailova
Larissa
L
Lisetsky
Konstantin
K
Sarang
Anya
A
Lewis
Kim
K
Parry
John
J
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
D015483:HIV Antibodies