Figure 1 - uploaded by Mzia Tabatadze
Content may be subject to copyright.
Citations
The current study describes the most recent wave of BBS surveys among People Who Inject Drugs (PWIDs) in Georgia. Bio-BBS surveys among PWIDs has been conducted since 2002. The aim of this study is to measure HIV prevalence among PWIDs, monitor risk behaviors among these group and generate evidence for advocacy and policy-making.
The study used a cross-sectional study design. A sample of 2037 injecting drug users 18 years and older were recruited using respondent-driven sampling in seven major cities of Georgia: Tbilisi, Gori, Telavi, Zugdidi, Batumi, Kutaisi and Rustavi.
The study was financially supported by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM).
The knowledge of HIV incidence is essential to better understand patterns of HIV transmission. We estimated HIV incidence over 2010-2012 in eastern European country of Georgia. Mathematical modeling using Spectrum software and assay-based recent infection testing algorithm were applied. The study included 1155 HIV patients newly diagnosed in 2010-2012 (84% of total diagnoses). Of them, 231 were determined to be recently infected on recent infection testing algorithm. The proportion of recent cases did not differ between 2010, 2011 and 2012 (20.4% vs. 19.4% vs. 20.2%, p = 0.94). Both study methods derived comparable estimates ranging from 0.2 to 0.3%, which is up to twice as high as rates of new diagnosis reported in the same period. Despite the relatively stable HIV incidence over 2010-2012, the epidemic continues to grow because of the increasing gap between HIV-infected and diagnosed persons. Increased efforts are needed to reduce the number of people with undiagnosed HIV.
Objectives:
The aim of the study was to investigate HIV testing practice among female sex workers (FSWs) and men who have sex with men (MSM) in Tbilisi, Georgia and to identify determinants of never testing behaviour among MSM.
Methods:
Data obtained in two rounds of bio-behavioural surveys among FSWs (2006 and 2009) and MSM (2007 and 2010) were analysed. Determinants of never testing behaviour among MSM were investigated among 278 respondents recruited in 2010 through respondent-driven sampling.
Results:
Knowledge about the availability of HIV testing and never testing behaviour did not show changes among FSWs and MSM. Every third FSW and every second MSM had never been tested for HIV according to the latest surveys in 2010. In bivariate analysis among MSM, consistent condom use during anal intercourse with a male partner in the last year, awareness of HIV testing locations and preventive programme coverage were negatively associated with never testing behaviour, while those who considered themselves at no risk of HIV transmission were more likely to have never been tested. In multivariate analysis, lower odds of never testing for HIV remained for those who were aware of HIV testing locations [adjusted odds ratio (AOR) 0.12; 95% confidence interval (CI) 0.04-0.32] and who reported being covered by HIV prevention programmes (AOR 0.26; 95% CI 0.12-0.56).
Conclusions:
In view of the concentrated HIV epidemic among MSM in Georgia and the low rate of HIV testing uptake, interventions in this key population should take into consideration the factors associated with testing behaviour. The barriers to HIV testing and counselling uptake should be further investigated.
