AEGiS-15IAC: Predictors of risky needle use among street-recruited IDUs in Ukraine following intervention efforts.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Predictors of risky needle use among street-recruited IDUs in Ukraine following intervention efforts.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1110)

Booth RE, Mikulich-Gilbertson S, Brewster JT, Salomonson-Sautel S, Semerik S
University of Colorado Health Sciences Center, Denver, United States

BACKGROUND: The explosive rise of the HIV epidemic in Ukraine was likely attributable to both the economic and social turmoil brought on by the collapse of the Soviet Union, as well as the injection practices of IDUs in Ukraine. The present study was designed to assess factors associated with continued needle-related risk behaviors following intervention efforts.

METHODS: One hundred IDUs were recruited through street outreach in each of three sites, Kiev, Odessa and Makeevka/Donetsk. Participants received a baseline interview and subsequent outreach interventions based on the Indigenous Leader Outreach Model (ILOM). The ILOM utilizes former or current drug users to recruit IDUs and subsequently function as prevention advocates to: 1) increase AIDS awareness; 2) encourage a realistic assessment of individual risk and offer a viable range of alternatives; 3) reinforce risk reduction; and 4) encourage target group members to advocate safer drug and sex behaviors with their network members. Participants were re-interviewed at six months.

RESULTS: Of the 300 study participants, 90% were successfully interviewed at follow-up. More than 75% purchased their drugs in preloaded syringes from gypsies. At baseline, 60% reported risky needle use in the past 30 days, defined as sharing a needle/syringe, injecting with drugs from a common container used by other injectors or front/backloading. At follow-up, this percentage declined to 35%. Factors associated with continued high risk needle use included fewer years of injecting, having an IDU sex partner and being HIV infected. Conclusion Despite a significant reduction in risky needle use, more than one-third of the IDUs in this study continued these risk behaviors following intervention efforts. It is especially troubling that HIV infection predicted risky needle use. Clearly, additional interventions are required, particularly for those who are already infected.

Keywords: AEGIS, Risk-Taking, Sexual Behavior, HIV Infections, Needles, HIV Seropositivity, Syringes, Acquired Immunodeficiency Syndrome, Ukraine, Interviews, USSR, utilization

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