Uusküla, A., McMahon, J.M., Kals, M., et al. AIDS and Behavior (March 2013), Vol. 17 No. 3, pp. 879-888.
The authors assessed HIV prevalence among injection drug users (IDUs) and their heterosexual non-injecting main sexual partners. They applied HIV transmission modeling using data collected on self-reported behaviors to estimate HIV risk from IDUs to their sex partners in Kohtla-Järve, Estonia. The estimated risk of HIV transmission for non-IDU females with a male IDU partner was high– between 3.24 and 4.94 HIV seroconversions per 100 person-years. Condom use accounted for notable differences in estimated incidence: estimates were five times greater among women who did not use or inconsistently used condoms with partners compared to those who consistently used condoms. The estimated range of incidence highlights the impact of acute-stage HIV infection on transmission rates. The study used respondent-driven sampling to recruit IDUs. The majority of recruited IDUs were men (n=298); 69 male IDUs successfully recruited a non-injecting partner. Of 82 women screened, 69 enrolled. HIV prevalence among male IDUs and among non-IDU partners was estimated at approximately 70 percent and 35 percent, respectively. Slightly over half of the couples were concordant in HIV status. The authors concluded that non-IDUs who have sexual partners who inject drugs are at an increased risk for HIV, and future studies should assess whether this will contribute to advancing the HIV epidemic beyond key populations in Estonia.