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  • Pisipilt
    listelement.badge.dso-type Kirje ,
    HIV-epidemic in Estonia: injecting drug use and quality of life of people living with HIV
    (2009-11-13T13:10:05Z) Rüütel, Kristi
    Among European countries, the highest rates in new HIV diagnoses are still reported in Estonia and the highest HIV-prevalence among injecting drug users has been described here. Besides knowledge, behaviour and health care system, many other environmental, socio-economical and legal factors drive HIV epidemic and influence the quality of life of people living with HIV. Understanding these factors is important in order to plan and implement interventions to slow the spread of HIV and improve the quality of life of people living with HIV. The thesis focuses on evaluation of the pre¬valence of HIV and related risk behaviours among injecting drug users and on assessment of the quality of life and the factors influencing quality of life of people living with HIV in Estonia. In our study HIV prevalence among injecting drug users was 54% in Tallinn and 90% in Kohtla-Järve. HIV-related risk behaviours (both injecting drug use and sexual behaviour-related) among the study participants were common. Scaling up HIV prevention programs targeting injecting drug users and their sexual partners is essential in order to prevent further spread of HIV. The self-reported quality of life of people living with HIV in care was satisfactory. The results revealed major disparities in quality of life based on gender, region, and route of infection. Most influential contributors to the different aspects of QoL were person’s employment status and HIV-disease stage. Besides clinical interventions, return-to-work programs and other measures to enhance the economic and employment opportunities are important for people living with HIV. The quality of life instrument used it this study (WHOQOL-HIV) was acceptable for people living with HIV in care and both the Russian and Estonian versions of the instrument are internally reliable and valid. The instruments can be used in future studies to evaluate the outcome of public health and clinical interventions targeting people living with HIV