AIDS and Behavior

, Volume 17, Issue 5, pp 1906–1913 | Cite as

Determinants of Risky Sexual Behavior Among Injecting Drug Users (IDUs) in Georgia

  • Ivdity Chikovani
  • Ketevan Goguadze
  • Ivana Bozicevic
  • Natia Rukhadze
  • George Gotsadze
Original Paper


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.


Injection drug users Sexual behavior HIV Respondent driven sampling Georgia 


  1. 1.
    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.PubMedCrossRefGoogle Scholar
  2. 2.
    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.PubMedCrossRefGoogle Scholar
  3. 3.
    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.PubMedCrossRefGoogle Scholar
  4. 4.
    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.PubMedCrossRefGoogle Scholar
  5. 5.
    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.PubMedCrossRefGoogle Scholar
  6. 6.
    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.
  7. 7.
    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.PubMedCrossRefGoogle Scholar
  8. 8.
    Heckathorn DD. Respondent driven sampling: a new approach to the study of hidden populations”. Soc Probl. 1997;44:174–99.CrossRefGoogle Scholar
  9. 9.
    Heckathorn DD. Respondent driven sampling, II. Deriving population estimate from chain referral samples of hidden populations. Soc Probl. 2002;49:11–34.CrossRefGoogle Scholar
  10. 10.
    Semaan S, Lauby J, Liebman J. Street and network sampling in evaluation studies of HIV risk reduction interventions. AIDS Rev. 2002;4:213–23.PubMedGoogle Scholar
  11. 11.
    Behavioral surveillance surveys: guidelines for repeated behavioral surveys in populations at risk of HIV. Family Health International, 2000. Available at: Accessed 21 May 2012.
  12. 12.
    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.PubMedCrossRefGoogle Scholar
  13. 13.
    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.CrossRefGoogle Scholar
  14. 14.
    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.CrossRefGoogle Scholar
  15. 15.
    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.PubMedCrossRefGoogle Scholar
  16. 16.
    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.CrossRefGoogle Scholar
  17. 17.
    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.PubMedCrossRefGoogle Scholar
  18. 18.
    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.PubMedCrossRefGoogle Scholar
  19. 19.
    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.PubMedCrossRefGoogle Scholar
  20. 20.
    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.PubMedCrossRefGoogle Scholar
  21. 21.
    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.PubMedCrossRefGoogle Scholar
  22. 22.
    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.PubMedCrossRefGoogle Scholar
  23. 23.
    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.PubMedGoogle Scholar
  24. 24.
    Weller SC, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev 2002, Issue 1. Art. No.: CD003255. doi: 10.1002/14651858.CD003255. Available at: Accessed 21 May 2012.

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ivdity Chikovani
    • 1
  • Ketevan Goguadze
    • 1
  • Ivana Bozicevic
    • 2
  • Natia Rukhadze
    • 1
  • George Gotsadze
    • 1
  1. 1.Curatio International FoundationTbilisiGeorgia
  2. 2.WHO Collaborating Centre for Capacity Development in HIV SurveillanceSchool of MedicineZagrebCroatia

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