Marseille 2007
| Abstract #501 - A qualitative study of HIV risks among injecting drug users in Tbilisi, Republic of Georgia | ||||
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Session: 6.17: Posters A (Poster) on Monday in Chaired by Authors: Presenting Author: Dr William Zule - RTI International, United States |
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| Additional Authors: Dr Elizabeth Costenbader, Mr Curtis Coomes, | ||||
| Aim: Injecting drug use in the former Soviet states has increased dramatically in recent years. Parts of Russia and several of the former Soviet states have witnessed dramatic increases in HIV among injecting drug users (IDUs). In contrast, prevalence of HIV among IDUs in the Republic of Georgia has remained at approximately 1% during this time. However, relatively high rates of hepatitis C virus infection and risky injection practices among IDUs in Georgia have been reported. This presentation reports findings from a qualitative pilot study examining injection practices and sexual behaviors among IDUs in Tbilisi that may influence the future course of the epidemic. | ||||
| Method / Issue: Focus groups and semi-structured interviews were conducted with injecting drug users in Tbilisi, Georgia between October 2006 and January 2007. A total of twenty three participants (2 focus groups with 6 and 7 participants each and 10 semi-structured interviews with individual IDUs) were enrolled in the study. Participants were recruited by an outreach worker from a local syringe exchange program. Interview guides were developed in English and translated into Georgian. Focus groups and semi-structured interviews were conducted in Georgian and audio-taped. Taped interviews were transcribed in Georgian and translated into English for analysis. | ||||
| Results / Comments: All participants were male and ranged in age from 21 to 50. Although most participants reported some type of post-secondary education, the majority were unemployed, primarily due to lack of employment opportunities in Tbilisi. The injection drug reported most commonly among these participants was Subutex (i.e. buprenorphine), which is purchased in tablets for approximately $120 a tablet, that are dissolved and split as a liquefied drug solution between 3 or 4 IDUs. Subutex is often mixed with antihistamines such as Pipophen or Dimedrol to enhance the effects. Other opioids that respondents reported using included heroin, methadone, and an opiate derived from poppy straw. In addition to opioids, many respondents talked about making homemade stimulantsVint and Jeff. Although most IDUs seemed to be aware of the risks of direct sharing of syringes and tried to avoid the practice, indirect sharing practices associated with the preparation and division of opioids and stimulants were quite common. Subutex, heroin, and other opiates, appear to be used primarily by male drug users and seem to be associated with minimal sexual risk among IDUs in Tbilisi. In contrast, respondents talked about using Vint and Jeff in social settings that often included women and high risk sexual activities. | ||||
| Discussion: Although HIV prevalence among IDUs in Tbilisi is low, injection-related and sexual HIV risk behaviors reported by participants in this qualitative study were relatively high. Under these conditions the potential may exist for rapid increases in HIV among IDUs similar to those that have been observed in other former Soviet states. Additional research is needed to determine the potential role other factors such as network structure, syringe availability or syringe type that may in reducing transmission. Funded by a grant from UNC-Center for AIDS Research. | ||||
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