AIDS and Behavior

, Volume 17, Issue 3, pp 879–888 | Cite as

Risk for Heterosexual HIV Transmission Among Non-Injecting Female Partners of Injection Drug Users in Estonia

  • A. Uusküla
  • J. M. McMahon
  • M. Kals
  • A. Talu
  • K. Abel-Ollo
  • K. Rüütel
  • D. C. Des Jarlais
Original Paper


The HIV epidemic in Estonia, as with other eastern European countries, is currently concentrated among injection drug users (IDUs). Non-IDUs who have IDU sex partners could serve as a potential bridge in an expanding epidemic. We applied HIV transmission modelling to data collected from non-IDU/IDU heterosexual couples in Kohtla-Järve, Estonia to estimate HIV risk from IDUs to their sex partners based on self-reported sexual behaviors shared by the couple. IDUs and their current main non-injecting sex partners were recruited for an interviewer-administered survey and HIV testing. Bernoulli modelling techniques were applied to estimate the risk of HIV transmission (incidence) among HIV negative non-injecting female partners of male IDUs. The estimated HIV incidence in this population of non-injecting women with only main sexual partners in the last 6 months ranged from 3.24 to 4.94 HIV seroconversions per 100 person years depending on the value used in the models for the per act transmission rate during acute stage infection. Non-IDUs who have IDU sex partners are at high risk for HIV and could serve as a potential bridge to a more generalized epidemic. Whether this might lead to an expansion of the HIV epidemic beyond core groups in Estonia or other Eastern European countries warrants closer study.


HIV incidence Injecting drug users Main sexual partners Estonia 


La epidemia de VIH en Estonia, al igual que otros países de la Europa oriental, se concentra actualmente en usuarios de drogas inyectables (UDI). Las no-UDI que tienen parejas UDI podrían ser un puente potencial de expansión de la epidemia. Hemos aplicado modelos de transmisión del VIH a los datos recopilados de parejas heterosexuales no-UDI/UDI en Kohtla-Järve, Estonia, para estimar el riesgo de transmisión de VIH de UDI a sus parejas sexuales en base a las conductas sexuales reportadas voluntariamente por la pareja. Los UDI y sus parejas sexuales principales actuales no inyectadoras fueron reclutados para una encuesta por entrevistador y para prueba de VIH. Se aplicó la técnica del modelo de Bernoulli para estimar el riesgo de transmisión del VIH (incidencia) entre parejas femeninas VIH-negativas no inyectadoras de UDI masculinos. La incidencia del VIH estimada en esta población de mujeres no inyectadoras con sólo parejas sexuales principales en los últimos 6 meses osciló entre 3.24 y 4,94 seroconversiones de VIH por 100 años-persona (a-p), dependiendo del valor utilizado en los modelos de proporción de transmisión por acto durante la etapa de infección aguda. Las no-UDI con parejas sexuales UDI corren alto riesgo de infección de VIH y podrían servir como un puente potencial para una epidemia más generalizada. Se necesita un estudio más detallado para determinar si esto podría conducir a una expansión de la epidemia de VIH más allá de los grupos principales de Estonia u otros países de Europa del Este.

Palabras Clave

Incidencia del VIH Usuarios de drogas inyectables Parejas sexuales principales Estonia 


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • A. Uusküla
    • 1
  • J. M. McMahon
    • 2
  • M. Kals
    • 1
  • A. Talu
    • 3
  • K. Abel-Ollo
    • 3
  • K. Rüütel
    • 4
  • D. C. Des Jarlais
    • 5
  1. 1.Department of Public HealthUniversity of TartuTartuEstonia
  2. 2.School of NursingUniversity of RochesterRochesterUSA
  3. 3.Estonian Drug Monitoring CenterNational Institute for Health DevelopmentTallinnEstonia
  4. 4.Department of Infectious Diseases Surveillance and Drug Abuse PreventionNational Institute for Health DevelopmentTallinnEstonia
  5. 5.Baron Edmond de Rothschild Chemical Dependency InstituteBeth Israel Medical CenterNew YorkUSA

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