Abstract

BackgroundThe HIV epidemic in Georgia is increasing. Data shows that compared to previous years, Georgia has increasingly more HIV-infected individuals than previous assessments. Select client groups remain hard to reach by harm reduction programs. The need for innovative strategies to involve these individuals is imperative.MethodsThe following study examines demographics and risk factors of participants, previously known and not known to harm reduction services, for HIV and other infectious disease in towns across Georgia in 2015 and compares risk among different groups, while also assessing the rationale for implementing Peer-Driven Interventions in Georgian Harm Reduction activities. Important differences in demographics and risk profile are thought to exist between those exposed, and those unexposed, to harm reduction activity.ResultsImportant and striking differences between previously known and unknown participants, including demographic background and risk profile and behaviours exist in the drug using community. These differences can potentially explain some of the rise of HIV prevalence in Georgia.ConclusionSignificant differences exist between known and unknown drug users in Georgia, the differences between which are crucial for planning future and holistic harm reduction activities in Georgia, regionally and globally. The research advocates for smarter harm reduction activity, adds to the global evidence for the utility of Peer-Driven Intervention, and encourages sustained global effort for reduction of blood-borne disease burden globally.

Highlights

  • Despite low Human Immunodeficiency Virus (HIV) prevalence in the general population (0.07%), Georgia faces a considerable risk of an expanding HIV epidemic due to widespread high-risk practices among key affected populations; people who inject drugs (PWIDs) and men who have sex with men (MSM) [1], and needle-sharing practices have remained a significant factor for spreading HIV among people who inject drugs (43.8%) [1]

  • We present the findings of a pilot Peer-Driven Intervention (PDI) program in Georgia, with the aim to build on preliminary global research and to quantify and compare the differences in demographic information and risk profile of PWIDs previously known to Needle-Syringe Program (NSP) program and those who were previously unknown

  • According to analyses of Sexual Risk Index, female PDI participants had less risky behaviour than male PDI participants; we found the opposite among NSP male and female participants, with female NSP clients participating in more risky sexual behaviour, which could be related to participating in paid sex

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Summary

Introduction

Despite low HIV prevalence in the general population (0.07%), Georgia faces a considerable risk of an expanding HIV epidemic due to widespread high-risk practices among key affected populations; people who inject drugs (PWIDs) and men who have sex with men (MSM) [1], and needle-sharing practices have remained a significant factor for spreading HIV among people who inject drugs (43.8%) [1]. The estimated population size of injecting drug users (PWIDs) has increased during recent years in Georgia and in 2015 was estimated at 49,700, 1.41% of the 3.5 million Georgians [4]. The community-based harm reduction services are reaching between. Needle and syringe programs provide a basic package of services to PWID, including distribution of sterile injection equipment, voluntary counselling and testing (VCT) for HIV, HCV, HBV and syphilis, distribution of safe sex information and prophylactics, and overdose prevention materials, such as naloxone. Data shows that compared to previous years, Georgia has increasingly more HIV-infected individuals than previous assessments. Select client groups remain hard to reach by harm reduction programs. The need for innovative strategies to involve these individuals is imperative

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