scholarly journals Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

2020 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek

Abstract Background: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased.Methods: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years.Results: Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions: The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

2020 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek

Abstract Background It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased. Methods We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years. Results Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.


2019 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek

Abstract Background: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission among newly registered patients is often biased. Methods: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2015-2017. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years. Results: Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions: The study confirmed the significant degree of misclassification of HIV mode of transmission among newly registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.


2020 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek

Abstract Background: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased.Methods: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years.Results: Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions: The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sam Hogan ◽  
Andrew Page ◽  
Felix Ogbo ◽  
Sameer Dixit ◽  
Rajesh Man Rajbhandari ◽  
...  

Abstract Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male people who inject drugs (male PWIDs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors need to be assessed. Methods The study used a series of 7 cross-sectional survey datasets from Pokhara (Nepal), collected between 2003 and 2017 (N = 2235) to investigate trends in HIV prevalence among male PWIDs by socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV. Results HIV prevalence decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence has increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (<=24 years compared to > 24 years, OR = 0.17, 95% CI = 0.10–0.31), being married (OR = 1.91, 95% CI = 1.25–3.02) and shorter duration of drug use (<=4 years compared to > 4 years, OR = 0.16, 95% CI = 0.09–0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75–4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64–4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20–4.11). Conclusion The prevalence of HIV in male PWIDs in Pokhara has been variable, but overall has reduced in recent years to 2.6% before increasing in 2017 to 4.9%. The main determinants which increase the risk of HIV among male PWIDs in Pokhara are low education level, a lack of treatment for drug addiction and the recent use of unsterilised equipment. Each of these indicate the need to improve addiction treatment and education programs for intra-venous drug use to aid this key population in avoiding risk-taking behaviours.


2015 ◽  
Vol 9 (04) ◽  
pp. 402-408 ◽  
Author(s):  
Sanaa M. Filemban ◽  
Yasser A. Yasein ◽  
Magdy H. H. Abdalla ◽  
Raafat Al-Hakeem ◽  
Jaffar A. Al-Tawfiq ◽  
...  

Introduction: Sexually transmitted infections (STI) are a major public health, social, and economic problem leading to morbidity, mortality, and stigma. This study was conducted to determine the prevalence of STIs, investigate behavioral risk factors and the relationship between the STIs/HIV and demographic factors. Methodology: A cross-sectional survey was conducted between 2013 and 2014 among attendees of the Ministry of Health hospitals. Results: The total number of participants was 3,994 (2,441 males and 1,553 females), with a mean age of 31.95 ± 9.45 years (range 12 to 77 years). The prevalence of STIs and HIV was 6.2% and 0.05% respectively. The mean age for infected people with STIs was 29.42 ± 7.51, vs. 32.12 ± 9.55 for non infected (p < 0.05). There was no diffference between infected and non infected people regarding gender, occupation and marital status. The prevalence of STIs was more commonly reported among non-Saudi (10.9%). Drug use (OR = 4.74; 95%; CI: 3.47–6.48), intravenous drug use (OR = 4.51; 95% CI: 1.45–13.12), illegal sex (OR = 10.7; 95% CI: 7.62–13.32), sex for money (OR = 6.36; 95% CI: 4.52–8.93), sex for pleasure (OR=9.76; 95% CI: 7.29–13.07) were significantly associated with STIs. Conclusion: The prevalence of STIs including HIV in Saudi Arabia is low compared to other countries in the region and globally.


2020 ◽  
Author(s):  
Sam Hogan ◽  
Andrew Page ◽  
Felix Ogbo ◽  
Sameer Dixit ◽  
Rajesh Man Rajbhandari ◽  
...  

Abstract Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male people who inject drugs (male PWIDs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors were assessed. Methods The study used a series of 7 cross-sectional survey datasets from Pokhara (Nepal), collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male PWIDs by socio-demographic, behavioural, and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV. Results HIV prevalence decreased from the levels seen in 2003 (22.0%) and 2005 (21.7%), with the lowest prevalence recorded in 2015 (2.6%), however prevalence increased in the most recent period (4.9%). A lower risk of HIV was associated with younger age (<=24 years compared to >24 years, OR = 0.17, 95% CI = 0.10-0.31), being married (OR = 1.91, 95% CI = 1.25-3.02) and shorter duration of drug use (<=4 years compared to >4 years, OR = 0.16, 95% CI = 0.09-0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75-4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64-4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20-4.11). Conclusion The prevalence of HIV in male PWIDs in Pokhara has been variable, but overall has reduced in recent years to 2.6% before increasing in 2017 to 4.9%. The main determinants which increase the risk of HIV among male PWIDs in Pokhara are low education level, a lack of treatment for drug addiction and the recent use of unsterilised equipment. Each of these indicate the need to improve addiction treatment and education programs for intra-venous drug use to aid this key population in avoiding risk-taking behaviours.


2016 ◽  
Vol 12 (1) ◽  
pp. 27-38 ◽  
Author(s):  
Anak Agung Sagung Sawitri ◽  
Anak Agung Gede Hartawan ◽  
Noel Craine ◽  
Ayu Kartika Sari ◽  
Ni Wayan Septarini ◽  
...  

Purpose – The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia. Design/methodology/approach – A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix. Findings – Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV. Research limitations/implications – The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics. Practical implications – The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting. Originality/value – This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
M Jakubauskiene ◽  
J Lindert

Abstract Background Addiction to illicit drugs is considered as medical condition requiring effective measures to prevent the disease and minimize harms of this addiction. Injecting drug use increases the risk for acquiring blood-borne infections among people who inject drugs (PWID). The aim of the study was to assess the risk behavior related to the use of intravenous narcotic and psychotropic substances among PWID in Lithuania. Methods A cross sectional survey using respondent driven sampling (RDS) of active intravenous drug users (n = 369) in Lithuania has been conducted in 2018-2019. RDS is a peer-referral sampling methodology applied to estimate characteristics of underserved populations that cannot be sampled randomly. 8 seeds were selected in 5 different sites across the country to recruit the study subjects. Descriptive statistics and logistic regression were conducted. Results Data collection was completed using 4 waves. Each seed yielded 3 to 24 eligible recruits. 80% of the sample were males, 20% - females. Age mean is 36.8 years, SD-7.69. The age of debut injecting drugs was 13 years, average age 20 years, SD 4.8. Average injecting duration was 12 years. 76% were incarcerated during their lifetime. 59% of PWID reported injecting heroin, 39% phentanyl, 13% amphetamines. 79% reported using sterile needles and syringes while injecting the last time and 21% were not. 17% were sharing non sterile injecting equipment during the last 30 days. Conclusions Younger age when started injecting drugs, duration of injecting drugs and imprisonment increased the risk of using unsterile needles and syringes and sharing injecting equipment. Main messages Behavioural risk factors are related to higher risks of drug use related infectious diseases. Targeted psychosocial interventions are needed to prevent the behavioural risks of injecting drug use.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 847-851
Author(s):  
Nithyanandham Masilamani ◽  
Dhanraj Ganapathy

Middle East Respiratory Syndrome (MERS) induced by new ß coronavirus MERS-(CoV) had first been described in Saudi Arabia in September 2012. MERS-CoV communication inside the population is often identified with clustered households and cramped communal spaces. The purpose of the study is to assess the knowledge and awareness of MERS-CoV among dental students in India. This was a questionnaire-based cross-sectional survey of 100 dental college students in Chennai. The self-designed questionnaires contained ten questions focused on the knowledge and awareness of MERS-CoV amongst dental college students. Questionnaires were circulated through an online website survey planet. After the responses were received from 100 participants, data were collected and analyzed, .87% are aware of MERS-CoV through media 13% from professional channels. 84%are aware of the clinical manifestation of MERS-CoV. 81%Are aware of the mode of transmission of MERS-CoV. 76%are aware of the preventive measures against MERS -CoV.68%. Are aware of the incubation period of MERS-CoV. 74%aware of PCR as a diagnostic test for MERS-CoV. This study concluded that dental students had strong awareness and knowledge of MERS. Also, there are a few differences in information and behaviours that require change. Large-scale health educational programs on MERS also should be facilitated by professional organizations to expand their reach and to strengthen knowledge to have a positive impact on their behaviour.


Sign in / Sign up

Export Citation Format

Share Document