Refining HIV risk: the modifying effects of youth, gender and education among people who inject drugs in Poland.
OBJECTIVE
The goal of this study was to examine specific factors placing young (aged <30) women who inject drugs at higher risk for HIV, and to establish the need for targeted interventions within this population.


METHODS
A national cross-sectional sero-survey was conducted in 2004-2005 in six regions in Poland. A snowball sample of ever-injectors was recruited from drug treatment facilities and the surrounding community. Log-binomial regression was used to estimate adjusted prevalence ratios (PRs).


RESULTS
A total of 491 injection drug users younger than 30 were recruited, of whom 159 were women and 332 were men. The prevalence of HIV was 16.4% and 9.6% among women and men, respectively. In multivariate analysis, young female injectors whose education terminated at the primary level were more likely to be HIV-positive compared to males with a similar level of education (PR = 3.34, 95% CI = 1.86-6.00) and more highly educated women (PR = 4.16, 95% CI = 2.21-7.82).


CONCLUSIONS
This study confirms an elevated risk of HIV among under-educated young women. Suggestions for specific interventions to reduce HIV transmission are presented. Additional research is needed to quantify the differential distribution of risk behaviors which amplify their likelihood of transmission.
Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland. mczerwinski@pzh.gov.pl
Michal
M
Czerwinski
Louise-Anne
LA
McNutt
Jack A
JA
DeHovitz
Andrzej
A
Zielinski
Magdalena
M
Rosinska
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016001:Confidence Intervals; D003710:Demography; D004493:Education; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007267:Injections; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012727:Sex Characteristics; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D055815:Young Adult