Authors affiliation:
Department of Social Science and Medicine, Imperial College
Faculty of Medicine, University of London, London, UK; City Narcological
Services and NGO Parents Against Drugs, Togliatti City, Samara Oblast,
Russian Federation; AIDS Foundation East-West, Moscow, Russian Federation;
Sexually Transmitted and Bloodborne Virus Laboratory, Central Public Health
Laboratory, Colindale, London, UK; Fifth City Hospital, Laboratory-Diagnostic
Centre, Togliatti, Samara Oblast, Russian Federation; City AIDS Centre,
Togliatti City, Samara Oblast, Russian Federation; and Togliatti City Administration
and Department of Health, Togliatti, Samara Oblast, Russian Federation.
OBJECTIVE
To establish the prevalence of antibodies to HIV (anti-HIV) and associated
risk factors among injecting drug users (IDU) in Togliatti City, Samara
Oblast, Russian Federation.
DESIGN
An unlinked anonymous cross-sectional community recruited survey with oral
fluid sample collection.
METHODS
Between September and October 2001, 426 IDU were recruited by trained field
workers. Participants completed an interviewer administered questionnaire,
and oral fluid samples were tested for anti-HIV. Univariate and multivariate
analyses compared potential risk factors for anti-HIV.
RESULTS
Anti-HIV prevalence was 56% (234/418). Three-quarters of anti-HIV-positive
IDU (74%) were unaware of their positive status. In an adjusted model,
the odds of HIV infection were higher among IDU who had ever injected home-produced
drugs, who reported injecting with used needles and syringes in the past
4 weeks, and who were living in one particular district of the city (Komsomolksii).
CONCLUSION
The high prevalence of HIV, and a recent increase in HIV detected through
routine screening tests since 2000, suggests that an explosive epidemic
has occurred among IDU in Togliatti City. In the face of currently inadequate
HIV prevention coverage among IDU, this has urgent implications for maximizing
the distribution of sterile injecting equipment as well as for enhancing
sexual risk reduction. Recognizing that it is likely that similar explosive
epidemics are taking place in other Russian cities, we recommend community-wide
HIV prevention coverage supported by city and state policies oriented to
harm reduction.
PMID: 12218407
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