Key risk factors for populations especially vulnerable to HIV infection

Abstract

Since 2012, no data can be found on any scientific research accomplished in correction facilities of the Russian Federal Penitentiary Service with its aim being to identify HIV risk factors and adherence to antiretroviral therapy (ART) among prisoners. In correction facilities of the Sverdlovsk oblast, each fifth prisoner is HIV-positive and in future this means a grave HIV burden for the regional population. Between 2020 and 2022, an anonymous survey was accomplished within an observational analytical cross-sectional study. Overall, 302 men participated in it; they were all former prisoners who applied for aid to a socially-oriented nonprofit organization during their social adaptation. Injection drug use (IDU) was established to be the basic factor able to cause HIV in the analyzed group. Among HIV-positive respondents, 94.3 % had such experience prior to and during their service; among other prisoners, 55.6 % reported IDU (p < 0.001). Twenty-eight point nine percent of prisoners continued to use narcotics in prison. According to the survey results, 87.9 % of HIV-positive men only ‘sometimes’ used barrier protection during sexual intercourse or didn’t use it at all. Seventy-three point five percent of them had more than 10 sexual partners during their lifetime and 29.3 % had sexually transmitted diseases in their case history. It is noteworthy that 82.9 % of the HIV-positive respondents had sexual contacts already during the first six months after being released from prison. The study established a growing share of people who got antiretroviral therapy (ART) after release from the penitentiary system, from 63.1 % to 75.4 %; however, only 33.0 % of the patients who received ART were able to confirm they had never stopped doing it. Therefore, we have detected a high risk HIV spread among prisoners during their service with subsequent active HIV transmission into the general population.