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Improving survey methods in sero-epidemiological studies of injecting drug users: a case example of two cross sectional surveys in Serbia and Montenegro.

Background: Little is known about the prevalence of HIV or HCV in injecting drug users (IDUs) in Serbia and Montenegro. We measured prevalence of antibodies to HIV (anti-HIV) and hepatitis C virus (anti-HCV), and risk factors for anti-HCV, in community-recruited IDUs in Belgrade and Podgorica, and d...

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Published in:BMC Infectious Diseases Vol. 9; no. 1; pp. 14 - 15
Main Authors: Judd A, Rhodes T, Johnston LG, Platt L, Andjelkovic V, Simic D, Mugosa B, Simic M, Zerjav S, Parry RP, Parry JV, Judd, Ali, Rhodes, Tim, Johnston, Lisa G, Platt, Lucy, Andjelkovic, Violeta, Simić, Danijela, Mugosa, Boban, Simić, Milena, Zerjav, Sonja
Format: research Journal Article
Published: BioMed Central 2009
Online Access:View this record in EBSCOhost
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      dt: 2009
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      pub: BioMed Central
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        10.1186/1471-2334-9-14
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        PMC2647543
        105480277
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        atl: Improving survey methods in sero-epidemiological studies of injecting drug users: a case example of two cross sectional surveys in Serbia and Montenegro.
      aug:
        au:
          Judd A
          Rhodes T
          Johnston LG
          Platt L
          Andjelkovic V
          Simic D
          Mugosa B
          Simic M
          Zerjav S
          Parry RP
          Parry JV
          Judd, Ali
          Rhodes, Tim
          Johnston, Lisa G
          Platt, Lucy
          Andjelkovic, Violeta
          Simić, Danijela
          Mugosa, Boban
          Simić, Milena
          Zerjav, Sonja
        affil: MRC Clinical Trials Unit, London, UK
      sug:
        subj:
          HIV Seropositivity Epidemiology
          Substance Abuse, Intravenous Epidemiology
          Persons with Substance Use Disorders
          Surveys
          Adult
          AIDS Serodiagnosis
          Antibodies, Viral Blood
          Cross Sectional Studies
          Europe, Eastern
          Female
          Health Screening
          Hepatitis C Epidemiology
          HIV Infections Epidemiology
          Male
          Prevalence
          Risk Factors
          Human
          Adult: 19-44 years
          Female
          Male
      ab: Background: Little is known about the prevalence of HIV or HCV in injecting drug users (IDUs) in Serbia and Montenegro. We measured prevalence of antibodies to HIV (anti-HIV) and hepatitis C virus (anti-HCV), and risk factors for anti-HCV, in community-recruited IDUs in Belgrade and Podgorica, and determined the performance of a parallel rapid HIV testing algorithm.Methods: Respondent driven sampling and audio-computer assisted survey interviewing (ACASI) methods were employed. Dried blood spots were collected for unlinked anonymous antibody testing. Belgrade IDUs were offered voluntary confidential rapid HIV testing using a parallel testing algorithm, the performance of which was compared with standard laboratory tests. Predictors of anti-HCV positivity and the diagnostic accuracy of the rapid HIV test algorithm were calculated.Results: Overall population prevalence of anti-HIV and anti-HCV in IDUs were 3% and 63% respectively in Belgrade (n = 433) and 0% and 22% in Podgorica (n = 328). Around a quarter of IDUs in each city had injected with used needles and syringes in the last four weeks. In both cities anti-HCV positivity was associated with increasing number of years injecting (eg Belgrade adjusted odds ratio (AOR) 5.6 (95% CI 3.2-9.7) and Podgorica AOR 2.5 (1.3-5.1) for >or= 10 years v 0-4 years), daily injecting (Belgrade AOR 1.6 (1.0-2.7), Podgorica AOR 2.1 (1.3-5.1)), and having ever shared used needles/syringes (Belgrade AOR 2.3 (1.0-5.4), Podgorica AOR 1.9 (1.4-2.6)). Half (47%) of Belgrade participants accepted rapid HIV testing, and there was complete concordance between rapid test results and subsequent confirmatory laboratory tests (sensitivity 100% (95%CI 59%-100%), specificity 100% (95%CI 98%-100%)).Conclusion: The combination of community recruitment, ACASI, rapid testing and a linked diagnostic accuracy study provide enhanced methods for conducting blood borne virus sero-prevalence studies in IDUs. The relatively high uptake of rapid testing suggests that introducing this method in community settings could increase the number of people tested in high risk populations. The high prevalence of HCV and relatively high prevalence of injecting risk behaviour indicate that further HIV transmission is likely in IDUs in both cities. Urgent scale up of HIV prevention interventions is needed.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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