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. 2011 Oct;21(5):613-9.
doi: 10.1093/eurpub/ckq115. Epub 2010 Aug 26.

Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic

Linda M Niccolai  1 , Sergei V Verevochkin, Olga V Toussova, Edward White, Russell Barbour, Andrei P Kozlov, Robert Heimer
Affiliations

Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic

Linda M Niccolai et al. Eur J Public Health. 2011 Oct.

Abstract

Background: Russia has one of the world's fastest growing HIV epidemics and it has been largely concentrated among injection drug users (IDU). St Petersburg, Russia's second largest city, is one of the country's regions that has been most affected by the HIV epidemic. To monitor the current epidemic situation, we sought to estimate recent HIV incidence among IDU in St Petersburg.

Methods: In a cross-sectional study of 691 IDU recruited during 2005-08, HIV incidence was estimated by two methods: a retrospective cohort analysis and BED capture enzyme immunoassay (EIA) results. Socio-demographic and behavioural correlates of incident infections and spatial patterns were examined.

Results: In the retrospective cohort analysis, the incidence rate was estimated to be 14.1/100 person-years [95% confidence interval (CI) 10.7-17.6]. Using results of BED EIA and two correction formulas for known misclassification, incidence estimates were 23.9 (95% CI 17.8-30.1) and 25.5 (95% CI 18.9-32.0) per 100 person-years. Independent correlates of being recently infected included current unemployment (P = 0.004) and not having injected drugs in the past 30 days (P = 0.03). HIV incident cases were detected in all but one district in the city, with focal areas of transmission observed to be expanding.

Conclusions: High HIV incidence among IDU in St Petersburg attests to continued growth of the epidemic. The need for expansion of HIV prevention interventions targeted to vulnerable populations throughout the city is urgent. These results also suggest that the BED EIA may over-estimate incidence even after correction for low specificity.

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Figures

Figure 1
Figure 1
Map of HIV incident, HIV prevalent and HIV negative participants among 670 IDU recruited in St Petersburg Russia 2005–08, by city district (size of circle proportionate to number of participants recruited from each district)
See this image and copyright information in PMC

References

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