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Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

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Abstract

Injection drug users (IDUs) are at risk for acquiring human immunodeficiency virus (HIV) through parenteral and sexual transmission. In this paper, we describe the prevalence and correlates of unsafe drug injecting and sexual behaviors among IDUs recruited across five cities in Georgia in 2009. IDUs were administered a questionnaire collecting information on demographics, drug use, sexual behaviors, and HIV testing behaviors. Correlates of risky injecting and sexual behaviors were determined using logistic regression. Of 1,127 IDUs, the majority (98.7%) were men, and the median duration of injecting drugs was 7 years. Unsafe injecting behavior at last injection was reported by 51.9% of IDUs, while 16.8% reported both unsafe injecting behavior and not using condoms with last occasional and/or commercial partner. In the multivariate analysis, independent correlates of unsafe injecting behavior at last injection were types of drugs injected [p = 0.0096; (for ephedrine, adjusted odds ratio (aOR) = 7.38; 95% CI, 1.50–36.26)] and not using condoms at last commercial sex (aOR = 2.29, 1.22–4.32). The following variables were significantly associated with unsafe injecting behavior at last injection and not using condoms at last sex with commercial and/or occasional partners in the multivariate analysis: marital status [p = 0.0002; (for divorced, widowed, and separated aOR = 2.62, 1.62–4.25; for single aOR = 1.61, 1.08–2.39)], being a member of a regular injecting group (aOR = 0.62, 0.44–0.88), types of drugs injected in the past month [p = 0.0024; (for buprenorphine aOR = 0.34, 0.18–0.63)], city of residence (p = 0.0083), and not receiving information on HIV (aOR = 1.82, 1.07–3.09). Though only ephedrine was injected by a smaller number of IDUs (9.1%), the vast majority of these (81.4%) reported unsafe injecting practices at last injection. High prevalence of unsafe injecting behaviors and diverse and at-risk sexual partnerships highlight the need to implement complex and targeted HIV interventions among IDUs in Georgia.

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Acknowledgments

We acknowledge with gratitude, the staff who worked on the study design, data collection, and processing: Tamara Sirbiladze, Lela Tavzarashvili, Lucija Zigrovic, Tamara Kasrashvili, staff members of the NGO “Bemoni.”

The fieldwork of the study was completed as part of the Global Fund to Fight AIDS, Tuberculosis and Malaria supported project “Establishment of the evidence base for the National HIV/AIDS Program by strengthening HIV/AIDS surveillance system.”

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Authors and Affiliations

  1. Curatio International Foundation, 37d I. Chavchavadze Avenue, Tbilisi, 0162, Georgia

    Ivdity Chikovani, Ketevan Goguadze, Natia Rukhadze & George Gotsadze

  2. WHO Collaborating Centre for Capacity Development in HIV Surveillance, School of Medicine, Zagreb, Croatia

    Ivana Bozicevic

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  1. Ivdity Chikovani
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  2. Ivana Bozicevic
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  3. Ketevan Goguadze
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Correspondence to Ivdity Chikovani.

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Chikovani, I., Bozicevic, I., Goguadze, K. et al. Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia. J Urban Health 88, 736–748 (2011). https://doi.org/10.1007/s11524-011-9571-8

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