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Sex work, drug use, HIV infection, and spread of sexually transmitted
infections in Moscow, Russian Federation.
Lancet 2005;366(9479):57–60.
Shakarishvili A, Dubovskaya LK, Zohrabyan LS, St Lawrence JS, Aral SO,
Dugasheva LG, Okan SA, Lewis JS, Parker KA, Ryan CA, and the LIBRA Project
Investigation Team.
Abstract
Rates of HIV-1 infection are growing rapidly, and the epidemic of sexually
transmitted infections is continuing at an alarming rate, in the Russian
Federation. We did a cross-sectional study of sexually transmitted infections,
HIV infection, and drug use in street youth at a juvenile detention facility,
adults at homeless detention centres, and women and men at a remand centre
in Moscow. 160 (79%) women at the remand centre were sex workers. 91 (51%)
homeless women had syphilis. At least one bacterial sexually transmitted
infection was present in 97 (58%) female juvenile detainees, 120 (64%) women
at the remand centre, and 133 (75%) homeless women. HIV seroprevalence was
high in women at the remand centre (n=7 [4%]), adolescent male detainees
(5 [3%]), and homeless women (4 [2%]). In view of the interaction between
sexually transmitted infections and HIV infection, these findings of high
prevalence of sexually transmitted infections show that these disenfranchised
populations have the potential to make a disproportionately high contribution
to the explosive growth of the HIV epidemic unless interventions targeting
these groups are implemented in the Russian Federation.