The Effect of Personal Network Exposure on Injecting Equipment Sharing among IDUs in Budapest, Hungary

Until the mid-1990s, the prevalence and incidence of HIV infection was uniformly low in countries across the Central and Eastern European region. In the past decade, however, this has changed dramatically, with a rapid increase in HIV infections in the region, especially in Eastern Europe where 41% of new HIV infection cases were among injecting drug users (IDUs) and as much as 66% of IDUs are infected with HIV in certain regions. While Russia, the largest country in Eastern Europe, has the fastest growing HIV rates in the world, the situation is different in Central Europe. For example, Hungary has low levels of HIV infection - estimated less than 1% of IDUs. Understanding the role of network factors in the spread and prevention of HIV could not only enable us to keep the HIV rates low among IDUs in countries like Hungary, but also provide a means for the effective prevention of other blood-borne and sexually transmitted infections (STIs) that share similar routes of transmission as HIV. Rogers' diffusion of innovations theory may help explain why HIV rates among IDUs are low in Hungary. Valente's related exposure or contagion model postulates that the more individuals within a social network adopt an innovation or a practice, the greater the probability of an individual is to adopt this innovation or practice. Personal network exposure (PNE), measured both within egocentric and sociocentric networks quantifies the extent to which a person is exposed to risk through their social network. The aim of this analysis was to assess the association of PNE and other correlates with injecting equipment sharing among IDUs in Budapest, Hungary.