HIV risk behaviour among participants of syringe exchange programmes in central/eastern Europe and Russia

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Abstract

Objective: To assess HIV risk behaviour among participants in syringe exchanges in five Central/Eastern European cities: Prague (Czech Republic), Budapest (Hungary), Skopje (Former Yugoslavian Republic of Macedonia), Krakow (Poland) and Poltava (Ukraine), and five Russian cities: Nizhniy Novgorod, Pskov, Rostov-Na-Donu, St. Petersburg, and Volgograd. Design: Cross-sectional survey with questions on injection risk behaviours for the 30 days prior to first use of the syringe exchange programme and for the 30 days prior to interview (while using the syringe exchange programme). Methods: Respondents were recruited from participants of the syringe exchanges. Structured questionnaires covering drug use and HIV risk behaviour were administered by trained interviewers. Results: 1671 respondents were interviewed across the ten programmes. Participants in the programmes tended to be young and relatively recent initiates into drug injection. Relatively low percentages of participants reported receptive syringe sharing (‘injecting with needles and syringes used by others’) in the past 30 days, from 1 to 29% across the ten programmes. These represented statistically significant reductions from the percentages of respondents reporting receptive syringe sharing in the 30 days prior to first use of the syringe exchange—from 7 to 47%. Conclusions: IDUs participating in the exchanges appear to be responding very positively in reducing sharing of needles and syringes. Syringe exchange and other HIV prevention programmes for injecting drug users (IDUs) in this geographic region should be expanded rapidly.

Section snippets

Methods

The data were collected during the second half of 1999. All of these programmes provided basic syringe exchange in terms of information about HIV/AIDS and exchanging new sterile needles and syringes for used-potentially HIV contaminated-needles and syringes. The programmes operated primarily on a one-for-one exchange of needles and syringes, though at times some gave out less than one syringe for each syringe taken in. The programmes were selected in consultation between the researchers and the

Results

Table 1a, Table 1b present selected socio-demographic characteristics and drug use information of the respondents who completed the risk behaviour interview from the ten sites. Table 2a, Table 2b present additional demographic and drug use data from the supplementary interviews from respondents whose supplementary interview could be matched to a risk behaviour interview. A majority of participants were male at all ten programmes, though the size of the majority ranged from 64% in Poltava to 92%

Variation across the ten programmes

Table 1a, Table 1b, Table 2a, Table 2b show considerable variations in the demographic characteristics and drug use histories of participants in the ten programmes. The distinction between participants who are very young, powder heroin injectors (sometimes called ‘New Russian’ injectors in Russia) versus somewhat older, homemade opiate preparation injectors was useful for classifying seven of the ten programmes. The variations in demographic characteristics and drug use histories are a strong

Acknowledgements

We would like to acknowledge the participants in the research and the helpful cooperation of the staff of the programmes. The study was funded through a contract from the Open Society Institute to Beth Israel Medical Center. NIDA grants R01DA12342 to Beth Israel Medical Center and P30 DA11041 to National Development and Research Institutes supported additional data analyses.

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