Determinants of Risky Sexual Behavior Among Injecting Drug Users (IDUs) in Georgia
First Online: 12 September 2012 DOI:
Cite this article as: Chikovani, I., Goguadze, K., Bozicevic, I. et al. AIDS Behav (2013) 17: 1906. doi:10.1007/s10461-012-0296-9 Abstract
Injection risk practices and risky sexual behaviors place injection drug users (IDUs) and their sexual partners particularly vulnerable to HIV. The purpose of the study was to describe and understand determinants of high-risk sexual behavior among IDUs in Georgia. A cross-sectional, anonymous survey assessed knowledge, behavior and HIV status in IDUs in five Georgian cities (Tbilisi, Gori, Telavi, Zugdidi, Batumi) in 2009. The study enrolled in total 1,127 (1,112 males, 15 females) IDUs. Results indicate that occasional sexual relationships are common among male IDUs, including married ones. A subsample of 661 male IDUs who reported having occasional and paid sex partners during the last 12 months was analyzed. Multivariate analysis shows that not having a regular partner in the last 12 month (adjusted odds ratio (aOR) 1.57, 95 % CI 1.04 2.37), and using previously used needles/syringes at last injecting (aOR 2.37, 95 % I 1.10–5.11) are independent correlates of inconsistent condom use with occasional and paid sexual partners among IDUs. Buprenorphine injectors have lower odds of inconsistent condom use with occasional and paid sexual partners compared to heroin injectors (aOR 0.47, 95 % CI 0.27–0.80), and IDUs who live in Telavi are twice more likely to engage in such risky sexual behavior than capital city residents (aOR 2.55, 95 % CI 1.46–4.48). More effective programs focused on sexual risk behavior reduction strategies should be designed and implemented.
Keywords Injection drug users Sexual behavior HIV Respondent driven sampling Georgia References
Burchell AN, Calzavara LM, Orekhovsky V. Response network. Characterization of an emerging heterosexual HIV epidemic in Russia. Sex Transm Dis. 2008;35(9):807–13.
Rüütel K, Uusküla A. HIV epidemic in Estonia in the third decade of the AIDS era. Scand J Infect Dis. 2006;38(3):181–6.
Bull SS, Piper P, Rietmeijer C. Men who have sex with men and also inject drugs—profiles of risk related to the synergy of sex and drug injection behaviors. J Homosex. 2002;42:31–51.
Somlai AM, Kelly JA, McAuliff TL, Ksobiech K, Hackl KL. Predictors of HIV sexual risk behaviors in a community sample of injection drug-using men and women. AIDS Behav. 2003;7:383–93.
Niccolai LM, Shcherbakova IS, Toussova OV, Kozlov AP, Heimer R. The potential for bridging of HIV transmission in the Russian Federation: sex risk behaviors and HIV prevalence among drug users (DUs) and their non-DU sex partners. J Urban Health. 2009;86(Suppl 1):131–43.
United Nations General Assembly Special Session on HIV/AIDS. Monitoring the declaration of commitment on HIV/AIDS. Georgia Country Progress Report. Reporting period 2008–2009.
. Accessed 16 Dec 2010.
Chikovani I, Bozicevic I, Goguadze K. Unsafe injection and sexual risk behavior among injecting drug users in Georgia. J Urban Health. 2011;88(4):736–48.
Heckathorn DD. Respondent driven sampling: a new approach to the study of hidden populations”. Soc Probl. 1997;44:174–99.
Heckathorn DD. Respondent driven sampling, II. Deriving population estimate from chain referral samples of hidden populations. Soc Probl. 2002;49:11–34.
Semaan S, Lauby J, Liebman J. Street and network sampling in evaluation studies of HIV risk reduction interventions. AIDS Rev. 2002;4:213–23.
Behavioral surveillance surveys: guidelines for repeated behavioral surveys in populations at risk of HIV. Family Health International, 2000. Available at:
. Accessed 21 May 2012.
Bogart LM, Kral AH, Scott A, et al. Sexual risk among injection drug users recruited from syringe exchange programs in California. Sex Transm Dis. 2005;32(1):27–34.
Baker SA, Morrison DM, Gillmore MR, et al. Sexual behaviors, substance use, and condom use in a sexually transmitted disease clinic sample. J Sex Res. 1995;32(1):37–44.
Kapadia F, Latka MH, Hudson SM, et al. Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities. Drug Alcohol Depend. 2007;11(91):56–63.
Kwiatkowski CF, Stober DN, Booth RE, et al. Predictors of increased condom use following HIV intervention with heterosexually active drug users. Drug Alcohol Depend. 1999;54(1):57–62.
Burt R, Thiede H, Barash E. Recent condom use by arrested injection drug users in King Country, Washington USA. Int J Drug Policy. 2006;17:222–9.
Evans JL, Hahn A, Page-Shafer K, et al. Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO study). J Urban Health. 2003;80:137–46.
Unger JB, Kipke MD, De Rosa CJ, et al. Needle-sharing among young IV drug users and their social network members: the influence of the injection partner’s characteristics on HIV risk behavior. Addict Behav. 2006;31:1607–18.
Gyarmathy VA, Li N, Tobin KE, et al. Unprotected sex in heterosexual partnership of injecting drug users in St. Petersbur, Russia. AIDS Behav. 2011;15(1):58–64.
Gyarmathy VA, Neagius A. The relationship of sexual dyad and personal network characteristics and individual attributes to unprotected sex among young injecting drug users. AIDS Behav. 2009;13(2):196–206.
Marshall BDL, Wood E, Zhang E, et al. Condom use among injection drug users accessing a supervised injecting facility. Sex transm Infect. 2009;85:121–6.
Shahmanesh M, Patel V, Mabey D, Cowan F. Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Trop Med Int Health. 2008;13:659–79.
Semaan S, Jarlais DC, Sogolow E, et al. A meta-analysis of the effect of HIV prevention interventions on the sex behaviors of drug users in the United States. J Acquir Immune Defic Syndr. 2002;30:S73–93.
Weller SC, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev 2002, Issue 1. Art. No.: CD003255. doi:
. Available at:
. Accessed 21 May 2012.
© Springer Science+Business Media, LLC 2012