@article{TEXTUAL,
      recid = {12951},
      author = {Zeziulin, Oleksandr and Kornilova, Maryna and Deac,  Alexandra and Morozova, Olga and Varetska, Olga and Pykalo,  Iryna and Dumchev, Kostyantyn},
      title = {Modes of HIV transmission among young women and their  sexual partners in Ukraine},
      journal = {PLOS ONE},
      address = {2024-06-26},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Background: Ukraine has the second-largest HIV epidemic  in Europe, with most new cases officially attributed to  heterosexual transmission. Indirect evidence suggested  substantial HIV transmission from people who inject drugs  (PWID) to their sexual partners. This study examined the  extent of heterosexual HIV transmission between PWID and  non-drug-using adolescent girls and young women (AGYW).&lt;/p&gt;  &lt;p&gt;Methods: A cross-sectional survey recruited AGYW  diagnosed with heterosexually-acquired HIV between 2016 and  2019 in nine regions of Ukraine. AGYW were asked to  identify and refer their sexual partners (‘Partners’), who  subsequently underwent HIV testing, and, if positive, HCV  testing. Both AGYW and Partners completed an interview  assessing HIV risk behaviors prior to AGYW’s HIV  diagnosis.&lt;/p&gt; &lt;p&gt;Results: In August-December 2020, we  enrolled 321 AGYW and 64 Partners. Among the Partners, 42%  either self-reported IDU or were HCV-positive, indicating  an IDU-related mode of HIV transmission. PWID Partners were  more likely to report sexually transmitted infections (STI)  and had lower educational levels. Of the 62 women who  recruited at least one Partner, 40% had a PWID Partner.  Within this subgroup, there was a higher prevalence of STIs  (52% vs. 24%) and intimate partner violence (36% vs. 3%).  Condom use was less common (52% vs. 38% reporting never  use), and frequent alcohol or substance use before sex was  higher (48% vs 30%) among AGYW with PWID Partner, although  this difference did not reach statistical significance.  Notably, 52% of women were aware of their Partners’  IDU.&lt;/p&gt; &lt;p&gt;Conclusion: At least 40% of heterosexual  transmission among AGYW in Ukraine can be linked to PWID  partners. Intensified, targeted HIV prevention efforts are  essential for key and bridge populations (PWID and their  sexual partners), addressing the biological and structural  determinants of transmission between key and bridge  populations, such as IDU- and HIV status disclosure, STIs,  IPV, and stigma.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/12951},
}