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P3.225 HSV-2 Seroprevalence Among Current Injection Drug Users in Estonia
  1. A Uusküla1,
  2. M Raag1,
  3. K Abel-Ollo2,
  4. A Talu2,
  5. K Rüütel2,
  6. M Salekesin2,
  7. L Niccolai3,
  8. T White3,
  9. R Heimer3
  1. 1University of Tartu, Tartu, Estonia
  2. 2National Institute for Health Development, Tallinn, Estonia
  3. 3Yale University School of Public Health, New Haven, CT, United States


Background STI prevalence or incidence data among HIV infected can help to distinguish populations with different levels of sexual HIV transmission risk. Herpes simplex virus type 2 (HSV-2) is considered useful because it is almost exclusively sexually transmitted, cannot be cured and leads to the production of lifelong antibodies. Unfortunately, few IDU studies include HSV-2 prevalence data.

Aim of the current work is to examine prevalence of and associations between HSV-2 infection, and HIV infection among injecting drug users (IDUs) in Kohtla-Järve, Estonia.

Methods Current IDU were recruited using chain referral methodology (RDS). Informed consent was obtained, a structured questionnaire including demographics, drug use history, and sexual risk behaviour was administered, and a blood sample was collected for HIV and HSV-2 antibody testing.

Results A total of 600 subjects were recruited in 2012. Subjects were primarily male (73%), with a mean age of 30 (SD 4.9) years. The prevalences of HIV and HSV-2 were 62%, and 32%, accordingly. Odds for being HSV-2 positive was higher among HIV infected IDUs (OR 1.9.95% CI 1.3–2.9). One third (27%) of the sexually active IDUs reported always using condoms (with in the last 4 weeks) prior the study.

Being HSV-2 positive was not associated with reported injection risk behaviour. HSV-2 seropositivity was associated with gender (higher among women; OR 2.7, 95% CI 1.8–4.0), and sexual behaviour: higher among those reporting IDU-sexual partners (OR 1.7, 95% CI 1.1–2.7), and those not always using condom (OR 2.0, 95% CI 1.2–3.4).

Conclusion HSV-2 seroprevalence can be used as a marker of (long-term) sexual risk. However, it might not capture more recent behaviour change in response to the HIV/AIDS among population groups studied.

High prevalence of HSV2 infection coupled with low reported condom use highlight the need of targeted sexual risk reduction interventions for IDU and their partners.

  • HIV
  • HSV-2
  • injection drug use

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