HIV Transmission among Injecting and Non-Injecting Drug Users in Tallinn, Estonia

Funding Source: U.S. Civilian Research and Development Foundation
Funding Period: 2009
Principal Investigator: Don C. Des Jarlais, Ph.D.

Estonia's HIV epidemic has largely been driven by injection drug use (IDU). Estonia currently has the highest HIV incidence rates in Europe; estimated IDU prevalence is 2.4% among 15-44 year olds in the country, with local studies showing HIV prevalence rates between 40%-90% among IDUs. The proportion of women among newly diagnosed cases has increased from 12% to 41% between 2000 and 2007. This increase suggests that heterosexual transmission is occurring on a larger scale in Estonia. Several studies conducted in the region including Estonia have shown that IDUs are sexually active with injection and non-injection partners, and use condoms infrequently. In addition, there are high rates of non-injection drug use among young adults. The conditions in Estonia have the potential for the spread of HIV from IDUs to non-injection drug users and a generalized heterosexual epidemic. The current study will determine how the spread of HIV may be occurring in Estonia. It will also develop new interventions to reduce HIV transmission to and among non-injection drug users.