title: Homelessness and Other Risk Factors for HIV Infection in the Current Outbreak Among Injection Drug Users in Athens, Greece.
abstract: Objectives. We examined HIV prevalence and risk factors among injection drug users (IDUs) in Athens, Greece, during an HIV outbreak. Methods. We used respondent-driven sampling (RDS) to recruit 1404 IDUs to the Aristotle intervention in August to October 2012. We interviewed participants and tested for HIV. We performed bivariate and multivariate analyses. Results. Estimated HIV prevalence was 19.8% (RDS-weighted prevalence = 14.8%). Odds of infection were 2.3 times as high in homeless as in housed IDUs and 2.1 times as high among IDUs who injected at least once per day as among less frequent injectors (both, P < .001). Six percent of men and 23.5% of women reported transactional sex in the past 12 months, and condom use was low. Intercourse with non-IDUs was common (53.2% of men, 25.6% of women). Among IDUs who had been injecting for 2 years or less the estimated incidence rate was 23.4 new HIV cases per 100 person-years at risk. Conclusions. Efforts to reduce HIV transmission should address homelessness as well as scaling up prevention services, such as needle and syringe distribution and other risk reduction interventions.
authors: At the time of the study, Vana Sypsa, Dimitrios Paraskevis, Maria Kantzanou, Antigoni Katsoulidou, Mina Psichogiou, and Angelos Hatzakis were with the National Retrovirus Reference Center, Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Greece. Meni Malliori and Anastasios Panopoulos were with the Organisation Against Drugs (OKANA), Athens. Georgios K. Nikolopoulos was with the Hellenic Center for Disease Control and Prevention, Athens. Anastasios Fotiou was with the Greek Reitox Focal Point of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), University Mental Health Research Institute, Athens. Anastasia Pharris and Marita Van De Laar were with the European Centre for Disease Prevention and Control, Stockholm, Sweden. Lucas Wiessing was with the EMCDDA, Lisbon, Portugal. Don Des Jarlais was with the Beth Israel Medical Center, New York, NY. Samuel R. Friedman was with the National Development and Research Institutes, New York, NY.
authors: Vana
authors: V
authors: Sypsa
authors: Dimitrios
authors: D
authors: Paraskevis
authors: Meni
authors: M
authors: Malliori
authors: Georgios K
authors: GK
authors: Nikolopoulos
authors: Anastasios
authors: A
authors: Panopoulos
authors: Maria
authors: M
authors: Kantzanou
authors: Antigoni
authors: A
authors: Katsoulidou
authors: Mina
authors: M
authors: Psichogiou
authors: Anastasios
authors: A
authors: Fotiou
authors: Anastasia
authors: A
authors: Pharris
authors: Marita
authors: M
authors: Van De Laar
authors: Lucas
authors: L
authors: Wiessing
authors: Don Des
authors: DD
authors: Jarlais
authors: Samuel R
authors: SR
authors: Friedman
authors: Angelos
authors: A
authors: Hatzakis