Knowledge of HIV serostatus and risk behaviour among injecting drug users in Estonia

Abstract

We used the findings from two, cross-sectional studies of HIV serostatus and risk behaviours to assess the effects of knowledge of HIV serostatus and risk behaviours (relating to sex and injection drug use) among injecting drug users (IDUs). Respondent-driven sampling was used simultaneously at two sites in Estonia (the capital Tallinn, and the second-largest city of Ida-Virumaa County, Kohtla-Järve). The research tool was an interviewer-administered survey. Biological samples were collected for HIV testing. Participants were categorised into three groups based on HIV testing results and self-report on HIV serostatus: HIV-negative (n=133); HIV-positive unaware of their serostatus (n=75); and HIV-positive aware of their serostatus (n=168). In total, 65% of the participants tested positive for HIV. Of those 69% were aware of their positive serostatus. HIV-positive IDUs aware of their serostatus exhibited more risk behaviours than their HIV-positive counterparts unaware of their serostatus or HIV-negative IDUs. Effective prevention of HIV among IDUs should therefore, include programmes to reduce high-risk sexual and drug use behaviours at the public health scale and enhanced prevention efforts focusing on HIV-infected individuals.

Keywords:

• injecting drug use
• HIV
• knowledge of HIV serostatus
• risk behaviour
• voluntary counselling and testing

Acknowledgements

This study was supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. One goal of the Global Fund programme, titled National Partnership to Increase the Scale of Estonia's Response to a Concentrated and Rapidly Developing HIV/AIDS Epidemic, was an estimation of HIV-prevalence and risk behaviour among IDUs (Grant nr EST-202-G01-H-00). The research of Anneli Uusküla was financed by target funding 0182648s04 from the Estonian Ministry of Education and Research, by a grant No. R01 TW006990 from the Fogarty International Center, NIH, USA, and by Norwegian Financial Mechanism/EEA (grant EE0016). The research of Mati Rahu was financed by the Estonian Ministry of Education and Research (target funding 01921112s02 and SF 0940026s07). Lucy Platt, Natalia Bobrova and Tim Rhodes receive funding from the UK Department for International Development and the Centre for Research on Drugs and Health Behaviour receives core funding from the Department of Health for England and Wales.