Correlates of HIV infection and being unaware of HIV status among soon‐to‐be‐released Ukrainian prisoners

Abstract

Introduction 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. Methods 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. Results 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. Conclusions 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.

Keywords

• prisoners
• substance use
• HIV/AIDS
• injection drug use
• risk behaviours
• Ukraine