Not All Injection Drug Users Are Created Equal: Heterogeneity of HIV, Hepatitis C Virus, and Hepatitis B Virus Infection in Georgia

Autor:	Malvina Aladashvili, Mark H. Kuniholm, Rohit A. Chitale, Kenrad E. Nelson, Nino Gabelia, Tengiz Tsertsvadze, Carlos del Rio, Ketavan Stvilia
Rok vydání:	2008
Předmět:	Adult Male HBsAg medicine.medical_specialty Health (social science) Adolescent Medicine (miscellaneous) HIV Infections HIV Antibodies medicine.disease_cause Georgia (Republic) Article Hepatitis Risk-Taking Orthohepadnavirus Acquired immunodeficiency syndrome (AIDS) Seroepidemiologic Studies Surveys and Questionnaires Internal medicine medicine Humans Hepatitis B Antibodies Substance Abuse Intravenous Needle sharing Hepatitis B virus biology business.industry Public Health Environmental and Occupational Health virus diseases Hepatitis C Hepatitis C Antibodies Hepatitis B biology.organism_classification medicine.disease Virology Psychiatry and Mental health Female business
Zdroj:	Substance Use & Misuse. 43:1424-1437
ISSN:	1532-2491 1082-6084
DOI:	10.1080/10826080802108293
Popis:	Injection drug users (IDU) are widely believed to have accelerated the looming HIV/AIDS epidemic now faced by the Russian Federation and countries of the former Soviet Union. However, IDUs may be heterogeneous with regard to risk behaviors and a sub-population may be responsible for the majority of blood-borne pathogen transmission. We studied 926 adult injection drug users (IDU) from the cities of Tbilisi, Batumi, and Poti in Georgia, a small country in the Caucuses region between the Black and Caspian Seas, between 1997 and 1998. Study participants were administered a confidential questionnaire and were tested for antibody to HIV, hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc). Five (0.5%) individuals were positive for HIV, 539 (58.2%) for HCV, 67 (7.2%) for HBsAg, and 475 for (51.3%) for anti-HBc. 88.7% of the surveyed individuals reported sharing needles with others, and needle sharing with more than ten other individuals versus no sharing was a highly significant predictor (OR: 278.12, 95% CI: 77.57, 997.20) of HCV seropositivity. In adjusted analysis, individuals who usually injected stolen medical/synthetic drugs had significantly lower odds of HCV (OR: 0.38, 95% CI: 0.22, 0.68) and HBV (OR: 0.58, 95% CI: 0.37, 0.90) than individuals most commonly injecting opium. Despite some limitations, these results suggest the presence of substantial heterogeneity between different injection drug-using groups in Georgia. Identification of high risk IDU sub-populations is vital to efficiently target risk reduction programs, and to prevent confounding by risk status in large HIV/AIDS behavioral intervention and vaccine trials.
Databáze:	OpenAIRE
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