Urgent measures needed to tackle HIV epidemic in Moscow

HIV infection rates in vulnerable groups in Moscow could be between 30-120 times higher than those found in the general Russian Federation population, concludes a research letter in this week's issue of THE LANCET. US researchers found high rates of HIV infection and sexually transmitted infections (STI's) in homeless adults, juvenile detainees, and remand detainees, especially women.

Rates of HIV-1 infections are growing rapidly, and the epidemic of sexually transmitted infections is continuing at an alarming rate, in the Russian Federation. The highest rates of infection are in major cities such as Moscow, where infection is rapidly moving beyond high-risk groups, such as injecting drug users and sex workers, to the heterosexual population.

Anna Shakarishvilli (US Centres for Disease Control and Prevention, USA) and colleagues assessed the prevalence of STI's and HIV infections in disenfranchised groups in Moscow. Between January 2001 and April 2002 the researchers surveyed 200 girls and 200 boys at a juvenile detention facility, 202 women and 200 men at homeless detention centres, and 200 women and 60 men at a remand centre in Moscow. 160 women at the remand centre were sex workers. They found that at least one bacterial sexually transmitted infection was present in 97 female juvenile detainees, 120 women at the remand centre, and 133 homeless women. HIV infection was high in women at the remand centre, adolescent male detainees, and homeless women. Twice as many females than males in juvenile and homeless centres reported injecting drug use within the past year.

Dr Shakarishvilli states: "In view of the substantially raised infection rates and behavioural risk in females compared with males in our study, and the increasing rates of HIV infection in women in the Russian Federation, the potential for perinatal transmission and heterosexual spread of HIV in Moscow is high. Our findings highlight the urgent need for intervention such as

Contact: Joe Santangelo

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