Hidden populations: discovering the differences between the known and the unknown drug using populations in the Republic of Georgia.

BACKGROUND: The HIV epidemic in Georgia is increasing. Data shows that compared to previous years, Georgia has increasingly more HIV-infected individuals than previous assessments. Select client groups remain hard to reach by harm reduction programs. The need for innovative strategies to involve these individuals is imperative. METHODS: The following study examines demographics and risk factors of participants, previously known and not known to harm reduction services, for HIV and other infectious disease in towns across Georgia in 2015 and compares risk among different groups, while also assessing the rationale for implementing Peer-Driven Interventions in Georgian Harm Reduction activities. Important differences in demographics and risk profile are thought to exist between those exposed, and those unexposed, to harm reduction activity. RESULTS: Important and striking differences between previously known and unknown participants, including demographic background and risk profile and behaviours exist in the drug using community. These differences can potentially explain some of the rise of HIV prevalence in Georgia. CONCLUSION: Significant differences exist between known and unknown drug users in Georgia, the differences between which are crucial for planning future and holistic harm reduction activities in Georgia, regionally and globally. The research advocates for smarter harm reduction activity, adds to the global evidence for the utility of Peer-Driven Intervention, and encourages sustained global effort for reduction of blood-borne disease burden globally.

Hiv prevalence among high risk behavior group persons with herpes zoster infection.

The aim of the two year (2003-2005) study was to study the HIV prevalence among high risk behavior groups of persons with Herpes Zoster infection. For this purpose we have investigated the high risk group patients: 1257 prisoners (1st group), 1543 IDUs (2nd group) and 1350 persons including: homosexuals, persons with history of frequent unprotected sex and persons with hepatitis B and C (3rd group). We revealed the persons with current or previous history of Herpes Zoster, and studied HIV prevalence among them. Besides, we have studied the immune status of revealed HIV positive persons, relationship between disease (Herpes Zoster) severity and CD4 count. Herpes Zoster infection was diagnosed based on clinical symptoms, anamnesis and by detection of VZV specific IgM and IgG by ELISA. HIV infection was diagnosed by ELISA method and was confirmed by Western Blot. CD4 count was detected by immunophenotyping technique and was analyzed using a FACSCalibur flow cytometer. The total prevalence of HIV infection among high risk behavior group persons with Herpes Zoster infection was 18,9% (31 HIV cases out of 164). The disease (Herpes Zoster) severity and duration was associated with decreased rate of cellular immunity, CD4 count. Herpes Zoster has a positive predictive value for HIV infection, predominantly recurrent Herpes Zoster. Herpes Zoster should be recognized as a marker condition indicating the necessity of screening for HIV, especially in Georgia, the region where the problem of IDU exists.