HIV outbreak among injecting drug users in the Helsinki region: social and geographical pockets

Kivelä, Pia; Krol, Anneke; Simola, Susan; Vaattovaara, Mari; Tuomola, Pekka; Brummer‐Korvenkontio, Henrikki; Ristola, Matti

doi:10.1093/eurpub/ckl252

Cited by 23 publications

(16 citation statements)

References 19 publications

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“…There is thus contextual and interpersonal factors affecting drug use associated with socioeconomics. This parallels the finding from Helsinki that HIV infections in IDU were associated with personal poverty and living in a deprived area (39).…”

Section: Injection Drug Usesupporting

confidence: 87%

The Social Determinants of HIV: A Review

Reidpath

Moyer

2008

SSRN Journal

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Section: Injection Drug Usesupporting

confidence: 87%

The Social Determinants of HIV: A Review

Reidpath

Moyer

2008

SSRN Journal

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“…However, our data indicate that there has been communication between IDUs using heroin and amphetamine, since they did not show distinct phylogenetic clustering. Since the turn of the century, amphetamine abuse has increased in Stockholm, and it is the major drug in Helsinki (13). Thus, the introduction of CRF01_AE in Stockholm seems likely to have involved amphetamine users.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Two Separate but Linked HIV-1 CRF01_AE Outbreaks among Injection Drug Users in Stockholm, Sweden, and Helsinki, Finland

Skar

Axelsson

Berggren

et al. 2011

J Virol

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The number of new CRF01_AE cases over a rooted phylogenetic tree accurately reflected the transmission dynamics and showed a temporary increase, by a factor of 12, in HIV incidence during the outbreak. Virus levels were similar in CRF01_AE and subtype B infections, arguing against differences in contagiousness. Similarly, there were no major differences in other baseline characteristics. Instead, the outbreak in Stockholm (and Helsinki) was best explained by an introduction of HIV into a standing network of previously uninfected IDUs. The combination of phylogenetics and epidemiological data creates a powerful tool for investigating outbreaks of HIV and other infectious diseases that could improve surveillance and prevention.

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“…[121][122][123] Based on that information, the mean turnover for IDU was estimated to be 8.9 years. ▸ Thirty-two datasets [124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139][140][141][142] described the mean duration of injecting career up to the moment of the interview. It varied from 1.3 to 14.3 years, leading to a mean and a median of 8.6 years.…”

Section: Injecting Drugs Usersmentioning

confidence: 99%

Analysis of duration of risk behaviour for key populations: a literature review

et al. 2012

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BackgroundThe objective of this paper is to review literature in order to calculate regional estimates of the average duration of time individuals maintain a specific high-risk behaviour.MethodsThe review targeted the key populations of female sex workers (FSW), male clients of female sex workers (MCFSW), people who inject drugs (injecting drug users (IDU)) and high-risk men who have sex with men (MSM). To be included in the review the study had to provide information on (1) the time a person spent at risk until death or cessation of the risk behaviour, (2) the percentage of the sample who initiated the risk behaviour in less than a year or (3) the mean or median duration of the behaviour from a representative sample.Results49 papers were found for the FSW population describing the period of time FSW stay in sex work to be between 2.9 years (Asia) and 12 years (Latin America). Eight papers were found for MCFSW showing the duration of the risk behaviour in this category varying from 4.6 years in Africa to 32 years in Asia. 86 papers were reviewed for the population of IDU showing that the average time a person injects illegal drugs varies from 5.6 years (Africa) to 21 years (South America). No information was found for duration of high-risk behaviour among MSM; instead, the definitions found in the literature for high- and low-risk behaviour among MSM were described.ConclusionsThere is high variability of estimates of duration of high-risk behaviours at regional level. More research is needed to inform models and prevention programmes on the average duration of time individuals maintain a specific high-risk behaviour.

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HIV outbreak among injecting drug users in the Helsinki region: social and geographical pockets

Abstract: The Finnish HIV outbreak is restricted socially to a very marginalized IDU population, and spatially to local pockets of poverty. In low prevalence countries, prevention programs should be targeted early at high-risk areas and populations.

Cited by 23 publications

References 19 publications

The Social Determinants of HIV: A Review

The Social Determinants of HIV: A Review

Dynamics of Two Separate but Linked HIV-1 CRF01_AE Outbreaks among Injection Drug Users in Stockholm, Sweden, and Helsinki, Finland

Analysis of duration of risk behaviour for key populations: a literature review

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