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Changing drug use and HIV prevalence among injecting drug users in Ukraine: evidence from biobehavioral surveys

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2012, Vol.2, Supplement 1| Tobacco control and public health in Eastern Europe 2nd conference ‘Economics, sociology, theory and practice of public health’ conference proceedings | s33

Changing drug use and HIV prevalence among injecting drug users in

Ukraine: evidence from biobehavioral surveys

Dumchev, Kostyantyn; Saliuk, Tetyana; Shvab, Inna; Smyrnov, Pavlo; Vitek, Charles

BACKGROUND: Integrated biobehavioral surveys (IBBS) have been used to evaluate the impact of HIV prevention efforts among most-at-risk groups in Ukraine since 2007. Harm reduction program coverage among injecting-drug users (IDUs) in-creased substantially from 96,000 in 2008 to 170,000 in 2010 with support from the Global Fund, and IBBS have shown declining HIV preva-lence. Aim of the study was to examine the changes in HIV prevalence, drug use patterns and risky behaviors in IDUs on national and city level.

METHODS: For this analysis, three IDU-IBBS datasets were combined – 2008 (N=3711), 2009 (N=3962), and 2011 (N=9069). The analysis in-cluded 25 cities that participated in either 2008 or 2009, and 2011. Changes in HIV prevalence, drug use, and risk behaviors were compared between 2008/9 and 2011.

RESULTS: The surveyed IDU population in 2011 was older than in 2008/9 (31.0 vs. 32.8 years; p<.0001), and included more females (23.5% vs. 25.5%; p=.0038), with substantial variation across cities.

Overall HIV prevalence in the sample declined slightly (22.9% to 21.6%; p=.05). In eight cities, HIV prevalence decreased significantly (-5% to -18%), while significant increases were seen in five cities (8% to 15%). Prevalence among IDUs younger than 25 years declined (9.9% to 7.2%; p=.0078).

The combined dataset showed no difference in opi-oid or stimulant past-30-day use, with variation at

city level. Clean needle/syringe use during last in-jection increased significantly (88.8% to 97.0%; p<.0001), with no opposing trend in any city. Three cities had an increase in past-30-day nee-dle/syringe sharing; nine – in container sharing; twelve – in use of preloaded syringes. Changes in condom use were not significant (54.1% to 54.9%, p=.32).

CONCLUSIONS: IDUs in Ukraine are ageing and HIV seroprevalence among IDUs continues to de-cline, especially among young IDUs. However, prevention programming needs to respond to sig-nificant regional variations in risk behaviors and HIV transmission.

KEY WORDS: HIV, prevalence, IDU, biobehavioral surveys

ABOUT THE AUTHORS: Dumchev, Kostyantyn, U.S. Centers for Disease Control and Prevention, k.dumchev@gmail.com

Saliuk, Tetiana, International HIV/AIDS Alliance in Ukraine

Shvab, Inna, International HIV/AIDS Alliance in Ukraine

Smyrnov, Pavlo, International HIV/AIDS Alliance in Ukraine

Vitek, Charles, U.S. Centers for Disease Control and Prevention

This paper was received 02.04.2012, accepted 15.04.2012, published 10.07.2012.

Изменения в потреблении наркотиков и распространенности ВИЧ среди

потребителей инъекционных наркотиков в Украине: данные

биоповеденческих исследований

Думчев Константин Викторович, Салюк Татьяна Александровна, Шваб Инна Анатольевна,

Смирнов Павел Левкович, Витек Чарльз

УДК 616.98:578.828ВІЛ-056.83]:303.4+616-074]477)

КЛЮЧЕВЫЕ СЛОВА: ВИЧ, распространенность, ПИН, биоповеденческие исследования

ОБ АВТОРАХ: Думчев Константин Викторович, Центр Контроля и профилактики Заболеваний США

Салюк Татьяна Александровна, Международный Альянс по ВИЧ/СПИД в Украине

Шваб Инна Анатольевна, Международный Аль-янс по ВИЧ/СПИД в Украине

Смирнов Павел Левкович, Международный Аль-янс по ВИЧ/СПИД в Украине

Витек Чарльз, Центр Контроля и профилактики Заболеваний США

(2)

conference proceedings

s34 |2 конф-ція «Економіка, соціологія, теорія і практика охорони здоров’я» Контроль над тютюном й охорона громадського здоровья у Східній Європі | 2012, том 2, додаток 1

infectious diseases

Зміни у вживанні наркотиків та поширеності ВІЛ серед споживачів

ін’єкційних наркотиків в Україні: дані біоповедінкових досліджень

Думчев Костянтин Вікторович, Салюк Тетяна Олександрівна, Шваб Інна Анатоліївна, Смирнов

Павло Левкович, Вітек Чарльз

КЛЮЧОВІ СЛОВА: ВІЛ, поширеність, СІН, біопове-дінкові дослідження

ВІДОМОСТІ ПРО АВТОРІВ: Думчев Костянтин Вікто-рович, Центр Контролю та Профілактики Захворю-вань США

Салюк Тетяна Олександрівна, Міжнародний Альянс з ВІЛ/СНІД в Україні

Шваб Інна Анатоліївна, Міжнародний Альянс з ВІЛ/СНІД в Україні

Смирнов Павло Левкович, Міжнародний Альянс з ВІЛ/СНІД в Україні

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