Prevalence of HIV and Hepatitis C and access to opioid substitution treatment among people who inject drugs in three cities in Croatia: findings from the second wave of respondent-driven sampling surveys.
Sandra Šević, Goran Koletić, Tatjana Nemeth Blažić, Mirjana Lana Kosanović Ličina, Josipa-Lovorka Andreić, Senad Handanagić, Magda Pletikosa Pavić, Ivana Božičević
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Abstract
Background: The second wave of integrated bio-behavioural surveys was conducted among people who inject drugs (PWID) in the cities of Zagreb, Split, and Rijeka in Croatia to estimate the prevalence of HIV and hepatitis C virus (HCV) antibodies and sexual and injecting risk behaviours.
Methods: Respondent-driven sampling (RDS) was used to recruit a total of 301 PWID in Split, 130 in Rijeka, and 86 in Zagreb from March to July 2022. Participants provided biological specimens for HIV and HCV testing and completed a behavioural questionnaire. RDS-Analyst software was used to calculate weighted population estimates with 95% confidence intervals (95% CI).
Results: Approximately one in four PWID were women (range from 24.3% in Zagreb to 29.9% in Rijeka). Overall, HIV prevalence was low, with no cases identified in Zagreb, and 0.6% and 0.8% in Split and Rijeka, respectively. HCV antibody prevalence was 37.2% among PWID in Zagreb and Rijeka, and as high as 59.5% in Split. Testing for HIV and HCV in the 12 months before the survey was reported by 11.3-19.8% and 17.3-21.6% of PWID across the cities, respectively. Use of needles and syringes in the past 30 days that had already been used by someone else was reported by 8.9-26.5% across the cities. A large proportion of PWID-54.0% in Zagreb, 31.0% in Rijeka and 29.9% in Split-never used needle and syringe exchange programmes. Being in drug addiction treatment at the time of the survey was reported by 50.8% in Split, 57.3% in Rijeka and 73.3% in Zagreb. Injecting cocaine in 30 days before the survey was common, ranging from 12.7 to 32.1% across the cities.
Conclusion: HIV prevalence continues to be low among PWID in Croatia, whereas HCV prevalence is substantial. Due to low coverage of HIV and HCV testing and insufficient use of harm reduction services, there is a potential for further spread of drug-related infectious diseases in this population.
期刊介绍:
Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.