Evaluation of HIV risk and outcomes in a nationally representative sample of incarcerated women in Azerbaijan, Kyrgyzstan, and Ukraine

ABSTRACT

Eastern European and Central Asian (EECA) is the only region globally where HIV incidence continues to rise. HIV is concentrated among high risk groups like prisoners. HIV prevalence is higher among women than men in both prisons and communities. Data are lacking on the HIV care continuum among female prisoners to inform effective HIV prevention and treatment interventions. This study examined HIV risk, prevalence of infectious diseases, access to care, and psychiatric comorbidities among a representative sample of 220 female prisoners in Azerbaijan, Kyrgyzstan, and Ukraine. Prevalence of comorbid substance use and psychiatric disorders was high with nearly one-third reporting pre-incarceration drug injection and alcohol use disorder (AUD). Half of the sample reported anxiety and depression. Among the subset of 26 (11.8%) women testing HIV+, 44% had CD4 counts <350 cells/μL but less than 2% were on antiretroviral therapy (ART). Most (88.5%) women with HIV were in Ukraine, where women also experienced higher rates of hepatitis C than in Azerbaijan or Kyrgyzstan. Women in Kyrgyzstan prisons experienced higher rates of syphilis compared to the other two countries. Findings suggest that, to achieve global HIV prevention and treatment targets, HIV testing and linkage to care must be scaled up among incarcerated women in the EECA.

KEYWORDS:

• Women
• prison
• Eastern Europe and Central Asia
• HIV care continuum
• epidemiological outcomes

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Yerina S. Ranjit http://orcid.org/0000-0002-4361-7508

Frederick L. Altice http://orcid.org/0000-0002-7860-693X

Additional information

Funding

This work was supported by National Institute on Drug Abuse: [grant number K23 DA033858,K24 DA017072,R01 DA033679,R01 DA29910,R21 DA042702]; Global Health Fellows and Scholars Research: [grant number R25 TW009338].