title: Correlates of HIV infection and being unaware of HIV status among soon-to-be-released Ukrainian prisoners.
abstract: BACKGROUND
  Prisoners bear a disproportionate burden of Ukraine's volatile and transitional HIV epidemic, yet little is known in Eastern Europe about HIV testing, treatment and HIV-related risk among prisoners.
  
  
  METHODS
  A nationally representative biobehavioural health survey linked with serological testing was conducted among soon-to-be released prisoners in 13 Ukrainian prisons from June to November 2011.
  
  
  RESULTS
  Among 402 participants, 78 (19.4%) tested HIV seropositive of whom 38 (50.7%) were previously unaware of their HIV status. Independent correlates of HIV infection included drug injection (AOR=4.26; 95% CI: 2.23-8.15), female gender (AOR=2.00; 95% CI: 1.06-3.78), previous incarceration (AOR=1.99; 95% CI: 1.07-3.70) and being from Southern Ukraine (AOR=5.46; 95% CI: 2.21-13.46). Those aware of being HIV-positive reported significantly more pre-incarceration sex- and drug-related HIV risk behaviours than those who were unaware.
  
  
  CONCLUSIONS
  Routine rather than risk-based HIV testing and expansion of opioid substitution and antiretroviral therapy among prisoners is urgently needed to reduce HIV transmission in volatile transitional HIV epidemics.
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine; Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA; lyuba.azbel@yale.edu.
authors.forename: Lyuba
authors.initials: L
authors.lastname: Azbel
authors.affiliation: Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Wickersham
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
authors.forename: Yevgeny
authors.initials: Y
authors.lastname: Grishaev
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
authors.forename: Sergey
authors.initials: S
authors.lastname: Dvoryak
authors.affiliation: Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA; Division of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D012307:Risk Factors; D014455:Ukraine / Q000453:epidemiology; D055815:Young Adult
keywords: HIV/AIDS; Ukraine; injection drug use; prisoners; risk behaviours; substance use