Estimating the prevalence of syringe-borne and sexually transmitted diseases among injection drug users in St Petersburg, Russia.

Injection drug users (IDUs) are the vanguard of the human immunodeficiency virus (HIV) epidemic in Russia. We sought a non-invasive method to estimate a point prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and risk behaviours in IDUs attending the syringe exchange programme (SEP) in St Petersburg, Russia. One hundred and one IDUs returning syringes to the St Petersburg SEP were invited to complete a questionnaire requesting demographic, knowledge, and behavioural information, and to provide their syringes for antibody testing. The median age of IDUs was 23 years. Syringe prevalences were: 10.9% for HIV, 78.2% for HCV, 15.8% for HBV, and 6.9% for syphilis. All respondents recognized drug-related risk factors for getting AIDS. Only two-thirds of subjects recognized condoms to prevent sexually transmitted infections and half knew that oil-based lubricants are not appropriate for condoms. The IDU population studied was young and requires additional interventions to encourage safer sexual behaviours.

The influence of gender on factors associated with HIV transmission risk among young Russian injection drug users.

HIV infection rates are dramatically increasing in the Russian Federation. Epidemiological studies indicate that the greatest rise of HIV incidence has been among injection drug users (IDU). Young adults (N = 188) who reported injecting drug use completed surveys and interviews that assessed injection drug use behavior, sexual behavior, and HIV-related knowledge. The average age of participants was 21.3 years. Multiple linear regression analysis found male gender and younger age at sexual debut was positively and significantly associated with having multiple sexual partners. Gender moderated the effects of sexual debut and number of times injected drugs were used in the past month. Males who initiate sex at a younger age were more likely to report multiple sex partners and females who reported higher frequency of drug use were more likely to report multiple sex partners. Gender is an important factor, as well as moderator of risk behavior among Russian injection drug users. Delaying sexual debut, particularly for males, may be an effective strategy to reduce subsequent risk behavior. Prevention efforts among IDUs need to address sexual risk behavior in conjunction with injection risk behavior.