Azbel Lyuba, Wickersham Jeffrey A, Grishaev Yevgeny, Dvoryak Sergey, Altice Frederick L
Ukrainian Institute on Public Health Policy, Kyiv, Ukraine; Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA;
Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA.
J Int AIDS Soc. 2014 Sep 10;17(1):19005. doi: 10.7448/IAS.17.1.19005. eCollection 2014.
Prisoners bear a disproportionate burden of Ukraine's volatile and transitional HIV epidemic, yet little is known in Eastern Europe about HIV testing, treatment and HIV-related risk among prisoners.
A nationally representative biobehavioural health survey linked with serological testing was conducted among soon-to-be released prisoners in 13 Ukrainian prisons from June to November 2011.
Among 402 participants, 78 (19.4%) tested HIV seropositive of whom 38 (50.7%) were previously unaware of their HIV status. Independent correlates of HIV infection included drug injection (AOR=4.26; 95% CI: 2.23-8.15), female gender (AOR=2.00; 95% CI: 1.06-3.78), previous incarceration (AOR=1.99; 95% CI: 1.07-3.70) and being from Southern Ukraine (AOR=5.46; 95% CI: 2.21-13.46). Those aware of being HIV-positive reported significantly more pre-incarceration sex- and drug-related HIV risk behaviours than those who were unaware.
Routine rather than risk-based HIV testing and expansion of opioid substitution and antiretroviral therapy among prisoners is urgently needed to reduce HIV transmission in volatile transitional HIV epidemics.
在乌克兰动荡且处于过渡阶段的艾滋病流行情况中，囚犯承受着格外沉重的负担，但在东欧，人们对囚犯中的艾滋病检测、治疗及与艾滋病相关的风险了解甚少。
2011年6月至11月，在乌克兰13所监狱中对即将获释的囚犯开展了一项与血清学检测相关的具有全国代表性的生物行为健康调查。
在402名参与者中，78人（19.4%）艾滋病病毒血清学检测呈阳性，其中38人（50.7%）此前并不知道自己感染了艾滋病病毒。艾滋病病毒感染的独立相关因素包括注射毒品（调整后比值比[AOR]=4.26；95%置信区间[CI]：2.23 - 8.15）、女性（AOR=2.00；95% CI：1.06 - 3.78）、曾被监禁（AOR=1.99；95% CI：1.07 - 3.70）以及来自乌克兰南部（AOR=5.46；95% CI：2.21 - 13.46）。知晓自己感染艾滋病病毒的人报告的入狱前与性和毒品相关的艾滋病风险行为明显多于不知情者。
迫切需要在囚犯中开展常规而非基于风险的艾滋病检测，并扩大阿片类药物替代疗法和抗逆转录病毒疗法，以减少动荡的过渡性艾滋病流行中的病毒传播。
