HIV Risk Behaviors and Prevalence Among Female IDUs in Ukraine

Introduction: The HIV epidemic in Ukraine is one of the largest and most prolific in all of Europe. This has remained the case since the late 1990’s when researchers first recognized the high numbers of HIV-infected drug users in Ukraine. While much of the epidemic has proliferated through injection risk behavior, sexual transmission is becoming more widespread. This study compared sex and injection risk behaviors among male and female IDUs and found high risk and prevalence among Ukraine’s female IDU population. Methods: From July 2010 through September 2012, 3142 injection drug users (IDUs) were recruited from three cities (Odessa, Nikolaev and Donetsk). Participants were recruited through street outreach and current drug use was verified by signs of recent venipuncture. After eligibility was verified, participants completed a questionnaire regarding HIV risk behaviors and were then tested for HIV. Results: Twenty-eight percent of the sample was female and were more likely to be married (45% vs. 27%). There were no significant differences between the ages of females vs. males, with the average age being about 33 years old. While males reported injecting more times on average than females (34 vs. 31 times) in the 30 days prior to the baseline interview and also were more likely to report having had an STD (45% vs. 40%), females had higher HIV-positive serology results than males (40% vs. 45%). On HIV risk, females reported significantly more high risk injection and sex behaviors. For example, females reported using a common container (47% vs. 38%) more frequently.  Additionally, females reported front or backloading more frequently than males (80% vs. 73%), and they reported sharing of works (42% vs. 28%) more than males. Not only did females report significantly greater high risk injection behavior than their male counterparts, but the rate at which they reported these behaviors is very high. Although male participants reported more sex with multiple partners (19% vs. 10%), females reported significantly more sex without a condom (43% vs. 37%), more sex with an IDU partner (70% vs. 31%) and more sex with someone who is HIV-positive (8% vs. 4%). Regression analyses will be performed to assess predictor variables. Conclusions: The results point to a trend of high risk behavior and HIV prevalence among female IDUs in Ukraine. Gender-specific interventions must be introduced to address this problem in a country with a large and growing HIV epidemic. Support was provided by the National Institute on Drug Abuse, DA-026739.