Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia.

INTRODUCTION In Georgia as in most Eastern European countries, injecting drug use remains one of the leading transmission modes of HIV infection. This paper aims to identify HIV prevalence and risk determinants among people who inject drugs (PWID). METHODOLOGY A cross -sectional, anonymous bio-behavioral survey of PWID was conducted in seven cities of Georgia in 2014-2015. Overall 2,022 PWID were investigated. Bivariate and multivariate regression analyses were performed to identify association of HIV positivity with other factors. RESULTS HIV prevalence among PWID was (2.2%, 95% CI 1.53-2.99). Significant associations were found between HIV positivity and history of drug injection (OR 1.03, p < 0.05), older age at first drug injection (OR 3.94, p <  0.01), safe sex behavior last year (OR 5.32, p < 0.01) and preventive program coverage (OR 2.0, p < 0.05). CONCLUSIONS HIV prevalence among PWID is stable and remains at low level. Our study shows that preventive interventions influence the sexual behavior of HIV positive PWID, however, the majority of injecting drug users are still not reached with these interventions. A changing environment may present additional challenges for harm reduction and current safe practices may change unless continuously supported by innovative HIV prevention programming.