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Trends in Injection Risk Behaviors among People Who Inject Drugs and the Impact of Harm Reduction Programs in Ukraine, 2007–2013

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Abstract

The study examined trends in injection risk behaviors among people who inject drugs (PWIDs) and assessed the impact of harm reduction programs in Ukraine during 2007–2013. We performed a secondary analysis of the data collected in serial cross-sectional bio-behavioral surveillance surveys administered with PWIDs in Ukraine in 2007, 2008, 2011, and 2013. Using data from 14 Ukrainian cities, we assessed short-term trends in injection risk behaviors with the Cochran-Armitage test for trend and multivariable logistic regression models, adjusted for age, sex, region, marital status, education level, occupation, age at injection drug use initiation, experience of overdose, and self-reported HIV status. The overall test for trend indicated a statistically significant decrease over time for sharing needle/syringe during the last injection (p < 0.0001), sharing needle/syringe at least once in the last 30 days (p < 0.0001), and using a common container for drug preparation (p < 0.0001). The prevalence of injecting drugs from pre-loaded syringes was high (61.0%) and did not change over the study period. After adjusting for all significant confounders and comparing to 2007, the prevalence of sharing needle/syringe during the last injection was unchanged in 2008 (OR = 1.06, 95% CI = 0.92, 1.21), and declined in 2011 (OR = 0.18, 95% CI = 0.15, 0.22) and 2013 (OR = 0.17, 95% CI = 0.14, 0.21). Sharing needles/syringes in the last 30 days significantly decreased when compared to that in 2007 (2008: OR = 0.81, 95% CI = 0.74, 0.89; 2011: OR = 0.43, 95% CI = 0.38, 0.47; and 2013: OR = 0.31, 95% CI = 0.27, 0.35). The prevalence of using common instruments for drug preparation also decreased compared to that in 2007 (2008: OR = 0.88, 95% CI = 0.85, 0.91; 2011: OR = 0.85, 95% CI = 0.85, 0.90; and 2013: OR = 0.74, 95% CI = 0.71, 0.76). The observed reduction in the prevalence of injection risk behavior over time is encouraging. Our findings suggest that prevention programs in Ukraine have positive impact and provide support for governmental expansion of these programs.

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Acknowledgements

Data collection was funded by the International Charitable Foundation “Alliance for Public Health” through a grant from The Global Fund. Iuliia Makarenko was supported by a grant from the Fogarty International Center, National Institutes of Health, USA (D43 TW000233). Danielle Ompad was supported by the National Institute of Drug Abuse-funded Center for Drug Use and HIV Research (CDUHR - P30 DA011041).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY, USA

    Iuliia Makarenko, J. DeHovitz & L. Gensburg

  2. New York State International Training and Research Program, State University of New York – Downstate, Brooklyn, NY, USA

    Iuliia Makarenko & J. DeHovitz

  3. College of Global Public Health, New York University, New York, NY, USA

    D. C. Ompad

  4. Center for Drug Use and HIV Research, Rory Meyer College of Nursing, New York University, New York, NY, USA

    D. C. Ompad

  5. Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA

    D. C. Ompad

  6. ICF “Alliance for Public Health”, Kyiv, Ukraine

    Y. Sazonova & T. Saliuk

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  1. Iuliia Makarenko
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  2. D. C. Ompad
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  3. Y. Sazonova
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  4. T. Saliuk
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Correspondence to Iuliia Makarenko.

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Makarenko, I., Ompad, D.C., Sazonova, Y. et al. Trends in Injection Risk Behaviors among People Who Inject Drugs and the Impact of Harm Reduction Programs in Ukraine, 2007–2013. J Urban Health 94, 104–114 (2017). https://doi.org/10.1007/s11524-016-0119-9

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