Predictors of self-reported HIV infection among drug injectors in Ukraine.

Abstract

To identify characteristics, including current high-risk drug and sex behaviors, associated with self-reported HIV infection among injection drug users (IDUs) in Ukraine. Targeted sampling of IDUs from Kiev, Odessa, and Makeevka/Donetsk, Ukraine. From June through August 2002, 100 IDUs from each site were recruited through street outreach, including 212 who had previously been tested for HIV and knew their serostatus. Subjects were administered a standardized computer-assisted interview assessing HIV-related drug and sex risk behaviors and history of HIV testing. Twenty six percent of the 212 participants reported they were HIV-positive. Univariate followed by multiple logistic regression analyses were used to identify factors associated with HIV infection. In the 30-day period before their interview, HIV-infected IDUs were significantly more likely to have injected with a needle previously used by another injector without disinfecting, frontloaded and/or backloaded, and shared the drug solution from a common container. In addition, they had higher prevalence rates for hepatitis B virus and hepatitis C virus than those not infected with HIV. On the other hand, they were more likely to have reported no sex partners and, if sexually active, more likely to have used a condom. The high HIV seroprevalence among IDUs in Ukraine, combined with their continued engagement in needle-related risk behaviors, assures the continuance of the epidemic in this region, a region that is the epicenter of HIV in Europe.