Downloaded from https://journals.lww.com/aidsonline by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3tIQ5gQCIeyw1Zze6K7ld5LHoXfqyI3PpAcvjLs17LHfoYEZ2Zg7OwA== on 07/31/2018 Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Self-reported testing, HIV status and associated risk behaviours among people who inject drugs in Europe: important differences between East and West Anneli Uusku ¨la a , Mait Raag a , Cinta Folch c , Leoni Prasad d , Anda Karnite e , Maaike G. van Veen f , Ksenia Eritsyan g , Magdalena Rosinska h , Don C. Des Jarlais b and Lucas Wiessing i Aims: To describe HIV-related risk behaviours, HIV testing and HIV status among people who inject drugs (PWIDs) in the 2000 in European countries with high- prevalence HIV epidemics among PWID. Methods: Data from 12 cross-sectional studies among PWID from seven countries were used. Meta-analysis was used to synthesize the data and meta-regression to explain heterogeneity [in addition to deriving adjusted odds ratios (AORmeta)]. Results: Data on 1791 PWID from western (the West) and 3537 from central and eastern (the East) European countries were available. The mean age of participating PWIDs was 30.6 years (SD 7.9), 75% were men, and 36% [95% confidence interval 34 – 37%) were HIV-infected (30% West, 38% East); 22% had not previously been tested for HIV. The prevalence of reported high-risk behaviour was significantly higher among PWID from the East. Comparison of HIV-infected and uninfected PWID within countries yielded similar results across all countries: HIV-infected PWID were less likely to be sexually active [AORmeta 0.69 (0.58 – 0.81)], reported less unprotected sex [AORmeta 0.59 (0.40 – 0.83)], but reported more syringe sharing [AORmeta 1.70 (1.30 – 2.00)] and more frequent injecting [AORmeta 1.40 (1.20–1.70)] than their HIV- uninfected counterparts. Conclusion: Despite the absolute differences in reported risk behaviours among PWID in western and eastern Europe, the associations of risk behaviours with HIV status were similar across the sites and regions. There is a substantial potential for further HIV transmission and acquisition based on the continuous risk behaviours reported. HIV prevention and harm reduction interventions targeting PWID should be evaluated. ß 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2014, 28:1657–1664 Keywords: Europe, HIV, HIV testing, injection drug use, risk behaviour a Department of Public Health, University of Tartu, Tartu, Estonia, b The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center New York, USA, c Centre d’Estudis Epidemiolo ` gics sobre les Infeccions de Transmissio ´ Sexual i Sida de Catalunya (CEEISCAT), Institut catala ` d’Oncologia (ICO), Age `ncia Salut Pu ´ blica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain, d Institute of Public Health of the University of Porto, Porto, Portugal, e Riga Stradins University, Department of Public Health and Epidemiology, Riga, Latvia, f Public Health Service Amsterdam, Amsterdam, The Netherlands, g NGO Stellit, Saint-Petersburg State University, St Petersburg, Russian Federation, h National Institute of Public Health – National Institute of Hygiene, Warsaw, Poland, and i European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal. Correspondence to Anneli Uuskula, MD, MS, PhD, University of Tartu, Tartu, Estonia. E-mail: anneli.uuskula@ut.ee Received: 23 September 2013; revised: 3 April 2014; accepted: 3 April 2014. DOI:10.1097/QAD.0000000000000299 ISSN 0269-9370 Q 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins 1657