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A total of drug injectors were recruited in Tallinn, and in Kohtla-Jarve. Intracluster correlation coefficients were calculated to measure the degree to which observations from individuals recruited by the same individual were correlated, and a random effects model was used to adjust for any correlation. Injecting drug use and risk behaviour characteristics varied by city. Interviews took place at fixed needle exchange sites administered by trained field workers nurses or employees from the needle exchange programmes. The social and economic changes associated with political transition influenced Estonians and Russians very differently. Although the interplay of such social structural factors in the creation of an environment of risk and vulnerability is difficult to gauge, evidence of city differences in injecting risk behaviours and environmental factors points to the importance of delineating how social and structural factors may mediate HIV transmission risk differently in different contexts [10,21]. Dried blood spot specimens were collected using single-use disposable lancets and neonatal Guthrie cards to detect antibodies to HIV anti-HIV [7,8].

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It is not since the explosive outbreaks of HIV among IDU in south east Asia in the mids that such high city estimates of prevalence have been reported [2,13]. The spread of HIV in Estonia is characterized by rapid transmission associated with drug injecting, but there is little reliable evidence estimating the prevalence of antibodies to HIV among injecting drug users IDU. Injecting drug use and risk behaviour characteristics varied by city. References After the collapse of the Soviet Union, Estonia has experienced major political, economic and social changes associated with declines in health and life expectancy as well as growth in informal economies, including drugs and the sex trade [1,2]. The social and economic changes associated with political transition influenced Estonians and Russians very differently. In the univariable analysis increased odds of anti-HIV positivity were associated with non-Estonian ethnicity [odds ratio OR 2. Our findings associate an increased risk of HIV in Tallinn with sharing injecting equipment with a sex partner.

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Interviews took place at fixed needle exchange sites administered by trained field workers nurses or employees from the needle exchange programmes. The spread of HIV in Estonia is characterized by rapid transmission associated with drug injecting, but there is little reliable evidence estimating the prevalence of antibodies to HIV among injecting drug users IDU. In the univariable analysis increased odds of anti-HIV positivity were associated with non-Estonian ethnicity [odds ratio OR 2. References After the collapse of the Soviet Union, Estonia has experienced major political, economic and social changes associated with declines in health and life expectancy as well as growth in informal economies, including drugs and the sex trade [1,2]. Multivariable analysis followed a conceptual framework approach described previously [10,11]. Table 1 After adjustment, only three variables remained significantly associated with increased odds of anti-HIV positivity. Although the interplay of such social structural factors in the creation of an environment of risk and vulnerability is difficult to gauge, evidence of city differences in injecting risk behaviours and environmental factors points to the importance of delineating how social and structural factors may mediate HIV transmission risk differently in different contexts [10,21].

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Risk behaviours and characteristics were compared between the two cities. In the context of a high background HIV prevalence, with over half the sample reporting two or more sex partners in the same time frame, this is an important finding for the targeting of HIV prevention. Injecting drug use and risk behaviour characteristics varied by city. The social and economic changes associated with political transition influenced Estonians and Russians very differently.

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