Partnership to implement street youth HIV prevalence survey

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APHA Scientific Session and Event Listing

2048.0: Sunday, November 04, 2007 - Board 7

Abstract #158103

Partnership to implement street youth HIV prevalence survey

Allison Lynch¹, Dmitry Kissin², Lauren Zapata², Roman Yorick¹, Elena Vinogradova³, Galina Volkova³, Elena Cherkassova¹, Jennifer Leigh¹, Denise Jamieson, MD, MPH², Polly Marchbanks², and Susan Hillis². (1) Doctors of the World-USA, 80 Maiden Lane, 6th Floor, New York, NY 10038, 212-584-4831, allison.lynch@dowusa.org, (2) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS K34, Atlanta, GA 30341, (3) St. Petersburg City AIDS Center, Naborezhnaya Obvodnovo Kanala #179, St. Petersburg, 190103, Russia

PURPOSE/BACKGROUND: This study assessed HIV seroprevalence among 313 street youth in St. Petersburg and described social, sexual and behavioral characteristics associated with HIV infection. Survey was conducted during March-May 2006 in St. Petersburg, Russia.

PARTNERSHIP MODEL: Doctors of the World (DOW) sought assistance confirming HIV test results of its 2005 HIV convenience sample of 55 street youth (31% positivity). DOW received assistance from US Centers for Disease Control and Prevention (CDC) to conduct a systematic, unbiased survey of HIV seroprevalence among St. Petersburg street youth; incorporated Russian NGO service provider partners in site selection, survey staffing. St. Petersburg City AIDS Center facilitated compliance with requirements, interagency cooperation, and clinical, virologic, and immunologic assessments for youth with positive rapid HIV tests. DOW co-designed, co-implemented, and co-staffed survey, provided follow-up services.

DESIGN/METHODS: A cross-sectional assessment was conducted which included city-wide mapping of 41 street youth locations, random selection of 22 study sites, rapid HIV testing for all consenting 15-19 year old street youth at these sites, and interviewer-administered survey.

RESULS/OUTCOME: Of 313 participants, 117 (37.4%) were HIV-infected. Subgroups with seroprevalences >60% included: double orphans (64.3%), those with no place to live (68.1%), those previously diagnosed with a sexually transmitted infection (70.5%), those currently sharing needles (86.4%), and those currently using injection drugs (78.6%), stadol (82.3%), heroin (78.1%), inhalants (60.5%). Characteristics independently associated with HIV infection included: injection drug use, sharing needles, being a double or single orphan, having no place to live, and being diagnosed with a sexually transmitted infection. Most HIV-infected street youth were sexually active (96.6%), had multiple partners (65.0%), used condoms inconsistently (80.3%).

Results justify programmatic response (prevention, treatment, support). DOW, with survey partners, is beginning to implement this response, developing a replicable model.

RECOMMENDATIONS: Partners' strengths improved results and impact in all areas with no significant challenges: 1. Improved study design, project implementation, accuracy of results. 2. Strengthened documentation of need for improved prevention, treatment, and support programs and policies among high-risk youth via knowledge of HIV prevalence and related behavioral risk characteristics. 3. Created constituency among survey partners for service and policy initiatives.

Learning Objectives:

Presentation participants will be able to describe how Russian government and nongovernmental service providers, a US public health agency, and an international NGO collaborated to implement an HIV prevalence survey of street youth in St. Petersburg, Russia.

Keywords: HIV/AIDS, Adolescents, International

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

HIV/AIDS: Focus on Asia and Eastern Europe

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA