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Assoc. Prof . Saulius Čaplinskas , MD, PhD

Prevalence of Hepatitis C and other blood born viruses among Vilnius, Riga and Tallinn IDUs. P. S AULIUS C APLINSKAS , MD, PhD Director, Centre for Communicable Diseases and AIDS Assoc. Prof., Mykolas Romeris University Saulius @ulac.lt.

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Assoc. Prof . Saulius Čaplinskas , MD, PhD

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  1. Prevalence of Hepatitis C and other blood born viruses among Vilnius, Riga and Tallinn IDUs • P SAULIUS CAPLINSKAS, MD, PhD Director, Centre for Communicable Diseases and AIDS Assoc. Prof., Mykolas Romeris University Saulius@ulac.lt 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  2. Objective: • To evaluate prevalence of HIV, virus Hepatitis B /C and tuberculosis and related risk behaviour in injection drug users in Vilnius, Ryga and Tallin Kristi Rüütel1, Irma Čaplinskiene2,3, Anda Karnite4,5, Inga Brokere4, Ave Talu1, Katri Abel-Ollo1, Andris Ferdats4,Saulius Čaplinskas2,3, Anneli Uusküla6 1National Institute for Health Development, Estonia 2Lithuanian AIDS centre under Ministry of Health, Lithuania 3 Social policy faculty, M. Romeris University, Lithuania 4 Public Health Agency, Latvia 5Department of Public Health and Epidemiology, Riga Stradins University, Latvia 6Department of Public Health, University of Tartu, Estonia Assoc. Prof. Saulius Čaplinskas, MD, PhD

  3. Methods • A cross-sectional anonymous survey of current IDUs • Sampling (respondent driven sampling - RDS) • Recruiting strategy • First stage - selection of the seeds(n=6)to represent various demographic, variously structured social IDUs networks Assoc. Prof. Saulius Čaplinskas, MD, PhD

  4. METHODS • Data sampling duration • 16 weeks (October 2007 – January 2008) • IDUs were recruited from non-treatment settings • Participants received remuneration for their time in amount of 20 Litas (coupon of the supermarket) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 NUMBER OF RESEARCH PARTICIPANTS Assoc. Prof. Saulius Čaplinskas, MD, PhD

  5. Measurements 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 • Behavioural factors • Face-to-face interviews (structured WHO anonymous questionnaire) • Biological markers • serological testing on HIV, HBV, HCV, syphilis and tuberculosis markers Assoc. Prof. Saulius Čaplinskas, MD, PhD

  6. Sociodemographic data The majority of IDUs in the capital cities of Baltic states are young man. Significant proportion of them are not ethnic people, but representatives of other nationalities (Russians etc.).

  7. Injecting drug use Assoc. Prof. Saulius Čaplinskas, MD, PhD

  8. Injecting risk behaviour Assoc. Prof. Saulius Čaplinskas, MD, PhD

  9. Needle sharing in prison 70.8% 58.3% 45.2% 44.6% 44.0% 26.5% More attention should be paid to harm reduction and drug treatment in prison settings.

  10. Sexual risk behaviour (among sexually active)

  11. Number of sexual partners in last 12 months IDUs are sexually active. 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  12. Condom use (always) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  13. HIV positive sex partners Sexual risk behaviour is common. Sexual partners of IDUs are the bridging population to the general population. So sexual risk reduction should be improved. Assoc. Prof. Saulius Čaplinskas, MD, PhD

  14. Harm reduction and health care services * SEP – syringe exchange program Assoc. Prof. Saulius Čaplinskas, MD, PhD

  15. Syringe exchange programs and drug abuse treatment Assoc. Prof. Saulius Čaplinskas, MD, PhD

  16. HIV infection 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  17. Prevalence of infectious diseases Assoc. Prof. Saulius Čaplinskas, MD, PhD

  18. Availability of HCV test (%) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  19. Awareness of HCV status(comparison among Baltic states) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 During this research: Laboratory confirmation of HCV infection Aware about self HCV infection Assoc. Prof. Saulius Čaplinskas, MD, PhD

  20. Availability of HBV service (%) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  21. Availability of HIV test (%) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  22. Pre and post-test HIV counselling Voluntary counselling and testing services should be enhanced. Referral system from testing to care and treatment should be developed. Assoc. Prof. Saulius Čaplinskas, MD, PhD

  23. Accessibility of HIV prevention services 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Visits in LTC (syringe/needle exchange) at least once Drug treatment at least once in the life Assoc. Prof. Saulius Čaplinskas, MD, PhD

  24. Correct answers to HIV related questions Assoc. Prof. Saulius Čaplinskas, MD, PhD

  25. HCV infection relation with duration of injection among Vilnius IDUs 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  26. Co-infections (%) 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  27. Conclusions • The prevalence of HIV among IDUs in these study samples was high and injecting drug use and sexual risk behaviours were common. 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  28. Discussion • HIV prevalence among IDUs in all three cities is stabilizing, yet there exist associated risks for future spread of HIV and other blood borne infections by sexual transmission to the sexual partners of IDUs. • Scaling up and continuing prevention, care and treatment programs is essential (including focus on those already infected). • One of the keys in reducing the burden of HIV and other blood borne infections is prevention of illegal drug use and especially injecting drug use. 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

  29. Acknowledgements • Authors are grateful to the participants for their co-operation and to the study team. • Research team of Latvia would like to express their gratitude to: • Municipalities and HIV Prevention Services of Jekabpils, Jelgava, Kuldiga, Liepaja, Olaine, Welfare Department of Riga Municipality and NGO “DIA+LOGS” • State Agency of Tuberculosis and Lung Diseases • Public Health Agency • Infectology Center of Latvia • Riga Stradins University, Department of Public Health and Epidemiology • Research team of Estonia would like to express their gratitude to: • NGO Convictus Eesti • Estonian State Reference Laboratory of HIV Diagnostics • TB Laboratory at North-Estonian Regional Hospital • Virology Department of National Institute for Health Development • Department of Public Health, University of Tartu Assoc. Prof. Saulius Čaplinskas, MD, PhD

  30. Thank You! www.sauliuscaplinskas.lt • P 8thAnnual Meeting of the New VISBY University Network on Hepatitis C VILNIUS, LITHUANIA, February 14-17, 2009 Assoc. Prof. Saulius Čaplinskas, MD, PhD

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