The prevalence of genital warts in the Baltic countries: findings from national cross-sectional surveys in Estonia, Latvia and Lithuania.

OBJECTIVES: To assess the prevalence and correlates of self-reported genital warts (GWs) among women and men aged 18-45 years in the Baltic countries. METHODS: In 2011-2013 we performed a cross-sectional survey using a self-administered questionnaire to collect information on the history of clinically diagnosed GWs, sociodemographic characteristics and sexual behaviour. Probability sampling methods were used to invite 16,959 individuals representing the general population, of whom 7760 (45.8%) participated (Estonia: 1967 women, 1221 men; Latvia: 1525 women, 1525 men; Lithuania: 1522 women). RESULTS: The estimated lifetime prevalence of clinically diagnosed GWs in women was 4.6% (95% CI 3.8 to 5.5) in Estonia, 2.9% (95% CI 2.0 to 3.6) in Latvia and 1.5% (95% CI 1.2 to 2.0) in Lithuania. Among men, the corresponding values were 2.8% (95% CI 1.9 to 4.0) in Estonia and 1.9% (95% CI 1.3 to 2.6) in Latvia. The mean age at first episode of clinically diagnosed GW was 24.6 years (95% CI 23.6 to 25.5) for women and 24.5 years (95% CI 22.9 to 26.0) for men. A lifetime history of clinically diagnosed GW was associated with a history of sexually transmitted infections other than GW (adjusted OR (AOR) 3.0, 95% CI 2.1 to 4.3 for women; AOR 5.3, 95% CI 3.0 to 9.2 for men), and a higher number (5+) of lifetime sexual partners (AOR 2.9, 95% CI 1.9 to 4.2 for women; AOR 2.1, 95% CI 1.2 to 3.9 for men). Men living comfortably within their household income had higher odds for GW (AOR 1.9, 95% CI 1.1 to 3.2). CONCLUSIONS: Our estimated prevalence of clinically diagnosed GWs was lower than estimates from the general population of other European countries.

Self-reported testing, HIV status and associated risk behaviours among people who inject drugs in Europe: important differences between East and West.

AIMS: To describe HIV-related risk behaviours, HIV testing and HIV status among people who inject drugs (PWIDs) in the 2000 in European countries with high-prevalence HIV epidemics among PWID. METHODS: Data from 12 cross-sectional studies among PWID from seven countries were used. Meta-analysis was used to synthesize the data and meta-regression to explain heterogeneity [in addition to deriving adjusted odds ratios (AORmeta)]. RESULTS: Data on 1791 PWID from western (the West) and 3537 from central and eastern (the East) European countries were available. The mean age of participating PWIDs was 30.6 years (SD 7.9), 75% were men, and 36% [95% confidence interval 34-37%) were HIV-infected (30% West, 38% East); 22% had not previously been tested for HIV. The prevalence of reported high-risk behaviour was significantly higher among PWID from the East. Comparison of HIV-infected and uninfected PWID within countries yielded similar results across all countries: HIV-infected PWID were less likely to be sexually active [AORmeta 0.69 (0.58-0.81)], reported less unprotected sex [AORmeta 0.59 (0.40-0.83)], but reported more syringe sharing [AORmeta 1.70 (1.30-2.00)] and more frequent injecting [AORmeta 1.40 (1.20-1.70)] than their HIV-uninfected counterparts. CONCLUSION: Despite the absolute differences in reported risk behaviours among PWID in western and eastern Europe, the associations of risk behaviours with HIV status were similar across the sites and regions. There is a substantial potential for further HIV transmission and acquisition based on the continuous risk behaviours reported. HIV prevention and harm reduction interventions targeting PWID should be evaluated.

Prevalence of IGRA-positivity and risk factors for tuberculosis among injecting drug users in Estonia and Latvia.

BACKGROUND: Illegal drug use and HIV are independent risk factors for tuberculosis (TB) among injecting drug users (IDU). Estonia and Latvia have experienced high rates of TB as well as IDU and HIV outbreaks. There is a lack of knowledge about TB among IDUs in these countries. The purpose of the current study was to estimate the prevalence and risk factors of Mycobacterium tuberculosis (MTB) infection among IDUs in Estonia and Latvia. METHODS: Participants for this cross-sectional study were recruited from syringe exchange programmes using respondent-driven sampling. For assessing infection with MTB interferon-gamma release assay (IGRA) was used. RESULTS: The study included 375 participants from Estonia and 313 from Latvia. The prevalence of IGRA-positivity among IDUs was 7.7% in Estonia and 25.6% in Latvia. HIV-prevalence was 62% in Estonia and 23% in Latvia. In both countries, IGRA-positivity rates did not differ between HIV-positive and HIV-negative participants. IGRA-positivity was independently associated with a prior diagnosis of TB in Estonia and with imprisonment (ever within a lifetime) and preceding contact with a TB patient in Latvia. CONCLUSION: Our findings indicate there is an urgent need for a more vigorous approach in providing IDUs with TB screening services.

Years of potential life lost due to HIV infection and associated factors based on national HIV surveillance data in Latvia, 1991-2010.

BACKGROUND: Latvia is still experiencing one of the highest human immunodeficiency virus (HIV) mortality rates in the European Union, and HIV is the 6(th) leading cause of death among young adults (15-39 y) in the country. The aim of the study was to determine the years of potential life lost (YPLL) as an indicator of premature mortality and the associated factors among people living with HIV (PLH) in Latvia. METHODS: Data from the National Registry of HIV/AIDS Cases was used for the time period 1991-2010. Data on 738 deaths were analysed. The cut-off age for YPLL calculations was 65 y. Univariable analysis was done using Mann-Whitney and Kruskal-Wallis tests. A linear regression model was constructed for determining the independent effects of the particular factors on the number of YPLL. RESULTS: The total number of YPLL due to HIV in Latvia was 21,097 (50.4/100,000 general population; 511.1/1000 PLH). Each PLH who died had lost 28.8 YPLL on average. The numbers of YPLL reflect the population groups most affected by the HIV epidemic (young men, non-ethnic Latvians, living in the capital city, and being infected via drug injection). Our regression model indicated that among deceased PLH, non-Latvian ethnicity and injecting drug use as the mode of HIV transmission were associated with an additional 2.4 (p = 0.003) and 5.7 (p < 0.001) average YPLL, respectively. CONCLUSIONS: A considerable number of years of potential life have been lost in Latvia due to HIV. YPLL is significantly associated with ethnicity and mode of HIV transmission.