Sex disparities and partners’ positive HIV status in HIV recent infection among people who inject drugs in Ukraine

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OBJECTIVE: The aim of this study is to analyze correlates of recent HIV infection among people who inject drugs (PWID) in Ukraine to inform public health interventions. DESIGN: Secondary data analysis of bio-behavioral surveillance (BBS) studies using respondent-driven sampling (RDS) conducted over multiple years. METHODS: We analyzed data from four rounds of RDS-based BBS conducted among PWID in Ukraine during 2013, 2015, 2017, and 2020. Analysis included 27 852 PWID who participated in 100 RDS studies in 33 cities. Only participants classified as having recent HIV infection and those who tested HIV negative were included. Recent HIV infection was identified using rapid or laboratory recency test, followed by viral load confirmation. We used univariate and multivariable mixed-effect logistic regression models to estimate crude and adjusted odds ratios (aORs) for correlates of recent HIV infection. RESULTS: The odds of testing recent were greater in 2017 that the other years. Reported use of sterile needles/syringes during the last injection was associated with lower odds [aOR 0.34, 95% confidence interval (95% CI) 0.16-0.73]. Having a sex partner living with HIV had the strongest association (aOR 5.58, 95% CI 2.02-15.38) with a recent-positive test result. Recent infections were positively associated with history of incarceration more than 1 year ago among men (aOR 1.83, 95% CI 1.10-3.06) and among women who were never incarcerated (aOR 2.81, 95% CI 1.65-4.77). CONCLUSION: This study underscores the importance of sex-specific interventions for PWID. The lower odds of recent HIV in connection to well tolerated injection practices highlights the importance of maintaining sustainable harm reduction programs.