RESEARCH – May 2009

Risk behaviour and HIV prevalence among injecting drug users


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AIM AND METHODS. To provide information about the prevalence of risk behaviour and  HIV among the priority target group in HIV prevention in Estonia, two studies were  conducted in 2007. A respondent driven sampling method was used to collect data among injecting drug users (IDU) in Tallinn and Kohtla-Järve and the take-all approach (new clients), or the quota sample (multiple clients), was used for questioning the visitors of syringe exchange services (SE). RESULTS. More than three-fourths of IDUs are men. The majority of them have injected for many years and inject every day. Of the IDUs 65% in Tallinn and 79% in Kohtla-Järve did not share any injecting equipment with others.
Of the IDUs 40% in the capital and 59% in Kohtla-Järve used a condom during every sexual intercourse in the past four weeks. About half of the IDU population is HIV-infected – 48% in the capital and 59% in Kohtla-Järve. The level of HCV and HBV prevalence is even higher and 39% of the IDUs in Tallinn and 47% in Kohtla-Järve have all three infections.  About 2/3 of the interviewed IDUs visited SE during the past month. Seventy-six per cent of the new visitors of SE and 89% of the multiple clients did not share syringes with other IDUs. Forty-four per cent of the new visitors and 62% of the multiple visitors used a condom during every sexual intercourse in the past four weeks.
CONCLUSIONS. Today the coverage of SE services is good, multiple clients of SE have less risk behaviour than new clients and the level of the risk behaviour, related to injecting of drugs, is not high among the IDU population in Tallinn and Kohtla-Järve. At the same time, the prevalence of HIV is very high in this target group, many IDUs do not visit the infectionist and the epidemic has been recognised as a big challenge facing the health system of Estonia.