HIV risk behaviour among participants of syringe exchange programmes in central/eastern Europe and Russia

Objective: To assess HIV risk behaviour among participants in syringe exchanges in five Central/Eastern European cities: Prague (Czech Republic), Budapest (Hungary), Skopje (Former Yugoslavian Republic of Macedonia), Krakow (Poland) and Poltava (Ukraine), and five Russian cities: Nizhniy Novgorod, Pskov, Rostov-Na-Donu, St. Petersburg, and Volgograd. Design: Cross-sectional survey with questions on injection risk behaviours for the 30 days prior to first use of the syringe exchange programme and for the 30 days prior to interview (while using the syringe exchange programme). Methods: Respondents were recruited from participants of the syringe exchanges. Structured questionnaires covering drug use and HIV risk behaviour were administered by trained interviewers. Results: 1671 respondents were interviewed across the ten programmes. Participants in the programmes tended to be young and relatively recent initiates into drug injection. Relatively low percentages of participants reported receptive syringe sharing ('injecting with needles and syringes used by others') in the past 30 days, from 1 to 29% across the ten programmes. These represented statistically significant reductions from the percentages of respondents reporting receptive syringe sharing in the 30 days prior to first use of the syringe exchange - from 7 to 47%. Conclusions: IDUs participating in the exchanges appear to be responding very positively in reducing sharing of needles and syringes. Syringe exchange and other HIV prevention programmes for injecting drug users (IDUs) in this geographic region should be expanded rapidly.