High HIV prevalence and risk factors among injection drug users in Tashkent, Uzbekistan, 2003–2004 1

Objectives: To determine HIV prevalence and potential associations with sociodemographic and behavioral factors among injection drug users (IDUs) in Tashkent, Uzbekistan.Methods: Subjects in this cross-sectional study provided sociodemographic and risk behavior data and were tested for HIV antibody with a saliva-based enzyme-linked immunosorbent assay (ELISA), followed by saliva-based Western blot confirmation.Results: Among the 701 IDU subjects enrolled, 209 (29.8%) were diagnosed with HIV infection, HIV infection was more likely among those unemployed (adjusted odds ratio [AOR]=1.47); whose first drug of abuse was heroin (AOR=2.21) or opium poppy extract (AOR=1.61); with a prior history of hepatitis (AOR=1.39); and those who reported never using condoms (AOR=1.65). Independent risk factors associated with HIV infection were heroin as the first illicit drug of abuse, prior hepatitis, lack of condom use, and unemployment.Conclusions: Heroin use, sexual transmission, and high unemployment seem to play important roles in HIV transmission. Implementation of effective harm reduction strategies is critical to control the expansion of the HIV epidemic in this country as well as in this region.