Not all injection drug users are created equal

Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia

Mark H. Kuniholm, Malvina Aladashvili, Carlos Del Rio, Ketavan Stvilia, Nino Gabelia, Rohit A. Chitale, Tengiz Tsertsvadze, Kenrad E. Nelson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Injection drug users (IDU) are widely believed to have accelerated the looming HIV/AIDS epidemic now faced by the Russian Federation and countries of the former Soviet Union. However, IDUs may be heterogeneous with regard to risk behaviors, and a subpopulation may be responsible for the majority of blood-borne pathogen transmission. We studied 926 adult injection drug users (IDU) from the cities of Tbilisi, Batumi, and Poti in Georgia, a small country in the Caucuses region between the Black and Caspian Seas, between 1997 and 1998. Study participants were administered a confidential questionnaire and were tested for antibody to HIV, hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc). Five (0.5%) individuals were positive for HIV; 539 (58.2%), for HCV; 67 (7.2%), for HBsAg; and 475, for (51.3%) anti-HBc. Surveyed individuals, 88.7%, reported sharing needles with others, and needle sharing with more than 10 other individuals versus no sharing was a highly significant predictor (OR: 278.12, 95% CI: 77.57, 997.20) of HCV seropositivity. In adjusted analysis, individuals who usually injected stolen medical/synthetic drugs had significantly lower odds of HCV (OR: 0.38, 95% CI: 0.22, 0.68) and HBV (OR: 0.58, 95% CI: 0.37, 0.90) than individuals most commonly injecting opium. Despite some limitations, these results suggest the presence of substantial heterogeneity between different injection drug-using groups in Georgia. Identification of high-risk IDU subpopulations is vital to efficiently target risk reduction programs and to prevent confounding by risk status in large HIV/AIDS behavioral intervention and vaccine trials.

Original languageEnglish (US)
Pages (from-to)1424-1437
Number of pages14
JournalSubstance Use and Misuse
Volume43
Issue number10
DOIs
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Virus Diseases
Drug Users
Hepatitis B virus
Hepacivirus
contagious disease
HIV
Needle Sharing
drug
Injections
Hepatitis B Surface Antigens
Acquired Immunodeficiency Syndrome
Blood-Borne Pathogens
Black Sea
Opium
Hepatitis B Antibodies
HIV Antibodies
Infectious Disease Transmission
USSR
Risk Reduction Behavior
Risk-Taking

Keywords

  • Caucasus region
  • Epidemiology
  • Former Soviet Union
  • Georgia
  • Hepatitis B virus
  • Hepatitis C virus
  • Heroin
  • HIV
  • Injection drug users
  • Synthetic drugs

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine (miscellaneous)
  • Psychology(all)

Cite this

Kuniholm, M. H., Aladashvili, M., Rio, C. D., Stvilia, K., Gabelia, N., Chitale, R. A., ... Nelson, K. E. (2008). Not all injection drug users are created equal: Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia. Substance Use and Misuse, 43(10), 1424-1437. https://doi.org/10.1080/10826080802108293

Not all injection drug users are created equal : Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia. / Kuniholm, Mark H.; Aladashvili, Malvina; Rio, Carlos Del; Stvilia, Ketavan; Gabelia, Nino; Chitale, Rohit A.; Tsertsvadze, Tengiz; Nelson, Kenrad E.

In: Substance Use and Misuse, Vol. 43, No. 10, 08.2008, p. 1424-1437.

Research output: Contribution to journalArticle

Kuniholm, MH, Aladashvili, M, Rio, CD, Stvilia, K, Gabelia, N, Chitale, RA, Tsertsvadze, T & Nelson, KE 2008, 'Not all injection drug users are created equal: Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia', Substance Use and Misuse, vol. 43, no. 10, pp. 1424-1437. https://doi.org/10.1080/10826080802108293
Kuniholm, Mark H. ; Aladashvili, Malvina ; Rio, Carlos Del ; Stvilia, Ketavan ; Gabelia, Nino ; Chitale, Rohit A. ; Tsertsvadze, Tengiz ; Nelson, Kenrad E. / Not all injection drug users are created equal : Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia. In: Substance Use and Misuse. 2008 ; Vol. 43, No. 10. pp. 1424-1437.
@article{c47663b50ddc4fd29b0e3263cad8b321,
title = "Not all injection drug users are created equal: Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia",
abstract = "Injection drug users (IDU) are widely believed to have accelerated the looming HIV/AIDS epidemic now faced by the Russian Federation and countries of the former Soviet Union. However, IDUs may be heterogeneous with regard to risk behaviors, and a subpopulation may be responsible for the majority of blood-borne pathogen transmission. We studied 926 adult injection drug users (IDU) from the cities of Tbilisi, Batumi, and Poti in Georgia, a small country in the Caucuses region between the Black and Caspian Seas, between 1997 and 1998. Study participants were administered a confidential questionnaire and were tested for antibody to HIV, hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc). Five (0.5{\%}) individuals were positive for HIV; 539 (58.2{\%}), for HCV; 67 (7.2{\%}), for HBsAg; and 475, for (51.3{\%}) anti-HBc. Surveyed individuals, 88.7{\%}, reported sharing needles with others, and needle sharing with more than 10 other individuals versus no sharing was a highly significant predictor (OR: 278.12, 95{\%} CI: 77.57, 997.20) of HCV seropositivity. In adjusted analysis, individuals who usually injected stolen medical/synthetic drugs had significantly lower odds of HCV (OR: 0.38, 95{\%} CI: 0.22, 0.68) and HBV (OR: 0.58, 95{\%} CI: 0.37, 0.90) than individuals most commonly injecting opium. Despite some limitations, these results suggest the presence of substantial heterogeneity between different injection drug-using groups in Georgia. Identification of high-risk IDU subpopulations is vital to efficiently target risk reduction programs and to prevent confounding by risk status in large HIV/AIDS behavioral intervention and vaccine trials.",
keywords = "Caucasus region, Epidemiology, Former Soviet Union, Georgia, Hepatitis B virus, Hepatitis C virus, Heroin, HIV, Injection drug users, Synthetic drugs",
author = "Kuniholm, {Mark H.} and Malvina Aladashvili and Rio, {Carlos Del} and Ketavan Stvilia and Nino Gabelia and Chitale, {Rohit A.} and Tengiz Tsertsvadze and Nelson, {Kenrad E.}",
year = "2008",
month = "8",
doi = "10.1080/10826080802108293",
language = "English (US)",
volume = "43",
pages = "1424--1437",
journal = "Substance Use and Misuse",
issn = "1082-6084",
publisher = "Informa Healthcare",
number = "10",

}

TY - JOUR

T1 - Not all injection drug users are created equal

T2 - Heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia

AU - Kuniholm, Mark H.

AU - Aladashvili, Malvina

AU - Rio, Carlos Del

AU - Stvilia, Ketavan

AU - Gabelia, Nino

AU - Chitale, Rohit A.

AU - Tsertsvadze, Tengiz

AU - Nelson, Kenrad E.

PY - 2008/8

Y1 - 2008/8

N2 - Injection drug users (IDU) are widely believed to have accelerated the looming HIV/AIDS epidemic now faced by the Russian Federation and countries of the former Soviet Union. However, IDUs may be heterogeneous with regard to risk behaviors, and a subpopulation may be responsible for the majority of blood-borne pathogen transmission. We studied 926 adult injection drug users (IDU) from the cities of Tbilisi, Batumi, and Poti in Georgia, a small country in the Caucuses region between the Black and Caspian Seas, between 1997 and 1998. Study participants were administered a confidential questionnaire and were tested for antibody to HIV, hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc). Five (0.5%) individuals were positive for HIV; 539 (58.2%), for HCV; 67 (7.2%), for HBsAg; and 475, for (51.3%) anti-HBc. Surveyed individuals, 88.7%, reported sharing needles with others, and needle sharing with more than 10 other individuals versus no sharing was a highly significant predictor (OR: 278.12, 95% CI: 77.57, 997.20) of HCV seropositivity. In adjusted analysis, individuals who usually injected stolen medical/synthetic drugs had significantly lower odds of HCV (OR: 0.38, 95% CI: 0.22, 0.68) and HBV (OR: 0.58, 95% CI: 0.37, 0.90) than individuals most commonly injecting opium. Despite some limitations, these results suggest the presence of substantial heterogeneity between different injection drug-using groups in Georgia. Identification of high-risk IDU subpopulations is vital to efficiently target risk reduction programs and to prevent confounding by risk status in large HIV/AIDS behavioral intervention and vaccine trials.

AB - Injection drug users (IDU) are widely believed to have accelerated the looming HIV/AIDS epidemic now faced by the Russian Federation and countries of the former Soviet Union. However, IDUs may be heterogeneous with regard to risk behaviors, and a subpopulation may be responsible for the majority of blood-borne pathogen transmission. We studied 926 adult injection drug users (IDU) from the cities of Tbilisi, Batumi, and Poti in Georgia, a small country in the Caucuses region between the Black and Caspian Seas, between 1997 and 1998. Study participants were administered a confidential questionnaire and were tested for antibody to HIV, hepatitis C virus (HCV), hepatitis B virus surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc). Five (0.5%) individuals were positive for HIV; 539 (58.2%), for HCV; 67 (7.2%), for HBsAg; and 475, for (51.3%) anti-HBc. Surveyed individuals, 88.7%, reported sharing needles with others, and needle sharing with more than 10 other individuals versus no sharing was a highly significant predictor (OR: 278.12, 95% CI: 77.57, 997.20) of HCV seropositivity. In adjusted analysis, individuals who usually injected stolen medical/synthetic drugs had significantly lower odds of HCV (OR: 0.38, 95% CI: 0.22, 0.68) and HBV (OR: 0.58, 95% CI: 0.37, 0.90) than individuals most commonly injecting opium. Despite some limitations, these results suggest the presence of substantial heterogeneity between different injection drug-using groups in Georgia. Identification of high-risk IDU subpopulations is vital to efficiently target risk reduction programs and to prevent confounding by risk status in large HIV/AIDS behavioral intervention and vaccine trials.

KW - Caucasus region

KW - Epidemiology

KW - Former Soviet Union

KW - Georgia

KW - Hepatitis B virus

KW - Hepatitis C virus

KW - Heroin

KW - HIV

KW - Injection drug users

KW - Synthetic drugs

UR - http://www.scopus.com/inward/record.url?scp=49449099772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49449099772&partnerID=8YFLogxK

U2 - 10.1080/10826080802108293

DO - 10.1080/10826080802108293

M3 - Article

VL - 43

SP - 1424

EP - 1437

JO - Substance Use and Misuse

JF - Substance Use and Misuse

SN - 1082-6084

IS - 10

ER -