HIV epidemic in Moscow needs urgent measures

U.S. researchers say that HIV infection rates in vulnerable groups in Moscow could be between 30-120 times higher than those found in the general population.

The researchers report that they found high rates of HIV infection and sexually transmitted infections (STI’s) in homeless adults, juvenile detainees, and remand detainees, especially women.

Between January 2001 and April 2002, Anna Shakarishvilli of the U.S. Centres for Disease Control and Prevention, and colleagues, assessed the prevalence of STI’s and HIV infections in disenfranchised groups in Moscow.

They found that the rates of HIV-1 infections are growing rapidly, and the epidemic of sexually transmitted infections is continuing at an alarming rate.

The highest rates of infection appears to be in major cities such as Moscow, where infection is rapidly moving beyond high-risk groups, such as injecting drug users and sex workers, to the heterosexual population.

In their research the team surveyed 200 girls and 200 boys at a juvenile detention facility, 202 women and 200 men at homeless detention centres, and 200 women and 60 men at a remand centre in Moscow.

One hundred and fifty women at the remand centre were sex workers.

At least one bacterial sexually transmitted infection was found to be present in 97 female juvenile detainees, 120 women at the remand centre, and 133 homeless women.

HIV infection was high in women at the remand centre, adolescent male detainees, and homeless women, while twice as many females as males in juvenile and homeless centres reported injecting drug use within the past year.

According to Dr Shakarishvilli, the substantially raised infection rates and risk behaviour evident in females compared with males, and the increasing rates of HIV infection in women, illustrates that the potential for perinatal transmission and heterosexual spread of HIV in Moscow is very high.

Shakarishvilli says the findings highlight the urgent need for intervention, such as screening for sexually transmitted infections, counselling, and health education both within and beyond correctional settings.

The focus, she says, should be on women and young people at risk and the overlap between sex work and injecting drug use.

The work is published in the current edition of the Lancet.