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Risk for Heterosexual HIV Transmission Among Non-Injecting Female Partners of Injection Drug Users in Estonia.
A Uusküla1, J M McMahon, M Kals
1Department of Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia. anneli.uuskula@ut.ee
AIDS and Behavior
|November 1, 2011
Summary
Injection drug users (IDUs) drive Estonia's HIV epidemic. Their non-injecting partners face significant HIV risk, potentially bridging the epidemic to the general population.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The HIV epidemic in Estonia and Eastern Europe is primarily concentrated among injection drug users (IDUs).
- Non-IDUs with IDU sexual partners represent a potential transmission bridge to the broader population.
Purpose of the Study:
- To estimate the risk of HIV transmission from IDUs to their non-injecting heterosexual partners in Estonia.
- To assess the role of non-IDUs with IDU partners in the potential expansion of the HIV epidemic.
Main Methods:
- Utilized HIV transmission modeling on data from heterosexual non-IDU/IDU couples in Kohtla-Järve, Estonia.
- Employed interviewer-administered surveys and HIV testing for IDUs and their main non-injecting partners.
- Applied Bernoulli modeling to estimate HIV incidence among HIV-negative non-injecting female partners of male IDUs.
Main Results:
- Estimated HIV incidence among non-injecting women with IDU partners ranged from 3.24 to 4.94 per 100 person-years.
- Risk varied based on the per-act transmission rate during acute-stage infection.
- Non-IDUs with IDU sexual partners were identified as being at high risk for HIV.
Conclusions:
- Non-IDUs with IDU sexual partners are at substantial risk of HIV infection.
- This population could act as a bridge for HIV transmission beyond core groups.
- Further study is warranted to determine if this could lead to a generalized HIV epidemic in Estonia and similar regions.
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