HIV and hepatitis C prevalence, and related risk behaviours among people who inject drugs in three cities in Croatia: Findings from respondent-driven sampling surveys

Background

There are limited data on HIV and hepatitis C virus (HCV) epidemiology among people who inject drugs (PWID) in Croatia. This study aims to provide data on HIV and HCV prevalence and sexual and injecting risk behaviours among PWID in Zagreb, Split, and Rijeka.

Methods

Using respondent-driven sampling (RDS) we recruited from November 2014 to February 2015 a total of 176 PWID in Zagreb, 255 in Rijeka and 399 in Split. Participants provided biological specimens for HIV and HCV testing and completed a behavioural questionnaire.

Results

• The proportion of female PWID ranged from 19.5% in Zagreb to 26.0% in Split. 
• In the month before the survey, 2.5% of PWID in Split, 5.6% in Rijeka and 8.0% in Zagreb reported sharing non-sterile needles and syringes. 
• Many PWID injected opioid substitution therapy (OST) in the month before the survey (57.0% in Zagreb and 57.5% in Split and Rijeka, respectively). 
• Among PWID who had a casual sexual partner in the past 12 months (ranging from 39.2% in Split to 44.4% in Rijeka) condom use was low. 
• Although HIV prevalence was low (0.2% in Rijeka and Zagreb, 0.3% in Split), 
• HCV antibody prevalence was considerable (29.1% in Zagreb, 31.5% in Rijeka, 38.3% in Split). 
• HIV and HCV testing coverage in the past 12 months was insufficient (6.8% and 7.0% in Split; 13.2% and 13.5% in Zagreb; 20.2% and 21.5% in Rijeka, respectively).

Conclusion

We found a low-level HIV epidemic and a sizable HCV epidemic among PWID in Zagreb, Split and Rijeka. Presence of high-risk injecting and sexual behaviours together with inadequate HIV and HCV testing coverage call for development of a comprehensive approach to harm reduction and introduction of needle and syringe exchange programmes in prisons, as well as strengthening sexual health interventions.

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By:  Senad Handanagic, Ivana Bozicevic, Marta Civljak, Zoran Dominkovic, Sandra Sevic, Jelena Barbaric, Tatjana Nemeth Blazic, Oktavija Dakovic Rode, Josip Begovac

WHO Collaborating Centre for HIV Surveillance, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova 4, 10000, Zagreb, Croatia

Correspondence

Corresponding author. Tel.: +385 1 4590 147; fax: +385 1 4684 212. 

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Changing What It Means to 'Become a Man': Participants' Reflections on a School-Based Program to Redefine Masculinity in the Balkans

Calls to engage men and boys in efforts to promote health, prevent violence and advance gender equality have grown in recent years. However, there remains little evidence or reflection on how most effectively to change harmful norms related to masculinity. 

The study addresses this gap by exploring the perspectives of participants in the Young Men Initiative (YMI), an innovative programme that aimed to promote healthier masculinities among boys attending vocational high schools in several Balkan countries through educational workshops, residential retreats and a social marketing campaign. 

Qualitative data were collected through 37 in-depth interviews and 11 focus-group discussions with boys, youth facilitators and teachers. Findings from four schools (in Belgrade, Sarajevo, Prishtina and Zagreb) suggest that several elements of the programme resonated strongly with participants and supported their meaningful engagement in project activities. 

Five themes emerged as most salient in identifying how and why specific aspects of YMI positively influenced participants: personal reflection, experience-based learning, connections with youth facilitators, new peer groups and aspirational messaging. 

Building on these insights, the study highlights potentially useful strategies for other programmes seeking to reach boys and transform their understanding of masculinity.

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By:   Namy S1, Heilman B2, Stich S2, Crownover J3, Leka B4, Edmeades J5.

• 1 Raising Voices , Kampala , Uganda.
• 2 Independent Researcher.
• 3 CARE International Balkans , Banja Luka , Bosnia and Herzegovina.
• 4 CARE International Balkans , Prishtina , Kosovo.
• 5 International Center for Research on Women , Washington , DC , USA. 

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