PT - JOURNAL ARTICLE AU - Michele R Decker AU - Andrea L Wirtz AU - Stefan D Baral AU - Alena Peryshkina AU - Vladmir Mogilnyi AU - Rachel A Weber AU - Julie Stachowiak AU - Vivian Go AU - Chris Beyrer TI - Injection drug use, sexual risk, violence and STI/HIV among Moscow female sex workers AID - 10.1136/sextrans-2011-050171 DP - 2012 Jun 01 TA - Sexually Transmitted Infections PG - 278--283 VI - 88 IP - 4 4099 - http://sti.bmj.com/content/88/4/278.short 4100 - http://sti.bmj.com/content/88/4/278.full SO - Sex Transm Infect2012 Jun 01; 88 AB - Background/objectives The HIV prevalence in Eastern Europe and Central Asia continues to increase. While injection drug use (IDU) is leading factor, heterosexual transmission is on the rise. Little is known about female sex workers (FSWs) in the region despite the central role of commercial sex in heterosexual sexually transmitted infection (STI)/HIV transmission globally. The authors evaluated the prevalence of STI/HIV among Moscow-based FSWs and potential risk factors including IDU, sexual risks and violence victimisation.Methods Moscow-based FSWs (n=147) completed a clinic-based survey and STI/HIV testing over an 8-month period in 2005.Results HIV prevalence was 4.8%, and 31.3% were infected with at least one STI including HIV. Sexual behaviours significantly associated with STI/HIV included anal sex (adjusted odds ratio (AOR) 3.48), high client volume (three or more clients daily, AOR 2.71), recent subbotnik (sex demanded by police; AOR 2.50) and regularly being presented with more clients than initially agreed to (AOR 2.45). Past year experiences of physical violence from clients and threats of violence from pimps were associated with STI/HIV (AOR 3.14 and AOR 3.65, respectively). IDU was not significantly associated with STI/HIV. Anal sex and high client volume partially mediated the associations of abuse with STI/HIV.Conclusions Findings illustrate substantial potential for heterosexual STI/HIV transmission in a setting better known for IDU-related risk. Many of the STI/HIV risks observed are not modifiable by FSWs alone. STI/HIV prevention efforts for this vulnerable population will benefit from reducing coercion and abuse perpetrated by pimps and clients.