Prevalence of HIV and risk behaviors among injecting drug users in Tallinn, Estonia in a series of cross-sectional studies

Transcription

1 Prevalence of HIV and risk behaviors among injecting drug users in Tallinn, Estonia in a series of cross-sectional studies Sigrid Vorobjov 1, Maris Salekešin 1, Katri Abel-Ollo 1, Anneli Uusküla 2, Don C. Des Jarlais 3 1 Estonian Drug Monitoring Centre, National Institute for Health Development, Tallinn, Estonia 2 Department of Public Health, University of Tartu, Tartu, Estonia 3 The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, USA

2 Methods: Studies for assessment of risk behaviour and infectious diseases among injecting drug users (IDUs) have been conducted in Estonia since 25 (studies in Tallinn 25 n=35, 27 n=35, 29 n=331) respondent driven sampling (RDS) was used to recruit IDUs data collection was conducted from June to August 213 participants had to be 18 years or older, speak Russian or Estonian, have injected drugs in the last 4 weeks, and be able to provide informed consent an interviwer-administered questionnaire in face-to-face interviews was used interviews were held in a room of the syringe exchange program venous blood was collected from participants and tested for HIV antibodies

3 In total 328 persons participated in 213 study 77% (n=252) were male 77% (n=253) were Russian speaking % Males Females

4 Mean age* *inclusion criteria was being 18 or older Mean age was 32 years (range 18 to 59 years) Females were slightly younger than males (3 years versus 33 years, p=.6) 7 6 Age in years Range Mean age

5 Age group distribution (years) %

6 Median duration of injecting drug use (years) Injecting career 2 years and less (%) % Median In 213 study: the mean age of starting injecting was 2 years (range 8 53 years)

7 Main drug injected in last 4 weeks The main drugs injected during last four weeks were fentanyl (78%, n=257) and amphetamine (2%, n=67) % heroin poppy liquid fentanyl amphetamine

8 Life-time prevalence of self-reported non fatal overdose % In 213 study: 68% (n=224) of respondents self-reported life-time non-fatal overdose experience 3% (n=89) had experienced non-fatal overdose during last year

9 Sharing of used syringes (last 4 weeks): Main sources for clean syringes (last 4 weeks) in 213: % Syringe exchange program n % 21 64, Pharmacy 76 23,2 Friends 2 6,1 Outreach worker 5 1,5 Other injecting drug users 4 1,2 1 Family 3, Drug dealer 1,3

10 Knowledge of HIV serostatus compared to HIV testing % tested HIV-positive HIV-positive self-reported In 213 study: 94% (n=38) of respondents self-reported HIV testing 73% (n=12) of HIV positive have been onart during lifetime

11 Newly diagnosed HIV cases in AIDS Counselling Centers by mode of transmission, (NIHD) Total IDU Other patients

12 Drug treatment (in 213 study) (1): 54% (n=178) of the study participants had received drug treatment during their life 27% (n=88) were on drug treatment during the study, receiving mainly methadone treatment 98% (n=253) of fentanyl users knew about the availability of methadone treatment, 51% of them said that they do not need this treatment

13 Drug treatment (2) Since 1998 methadone detoxification has been available MMT was officially introduced in 21 Available in Tallinn, from 23 extended to eastern part of Estonia, from 212 in Tartu methadone treatment financed by GF From 27 government funded, free of charge for the clients (HIV/AIDS strategy, Ministry of Social Affairs) Methadone treatment in prisons started in 28, by 29 methadone substitution treatment (Ministry of Justice) Offering methadone treatment in arrest houses started in 21 (Ministry of Interior)

14 Drug treatment (3) Methadone substitution treatment in 213, financed from the budget of HIV/AIDS strategy (Ministry of Social Affairs) 7 service providers, 9 different places (Tallinn, East Estonia, South Estonia) Substitution treatment was provided to 1166 drug users Client characteristics Mean age 3,9 years 76,3% were male 82,3% Russian speaking 29% new treatment clients (82,5% outpatient)

15 Thank you Study was funded by grant # R1AI8335 the National Institutes of Heath, USA