Журнал «Медицина неотложных состояний» Том 18, №6, 2022
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Knowledge of and prevalence of chronic viral infections in internally displaced people in the region of Gori, Georgia
Авторы: Tetyana Vasylyeva (1), Marine Gogia (2)
(1) — Division of Infectious Diseases and Global Public Health, University of California San Diego, CA, USA
(2) — Georgian Harm Reduction Network, Tbilisi, Georgia
Рубрики: Медицина неотложных состояний
Разделы: Медицинские форумы
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Introduction. Internally displaced persons (IDPs) account for more than 50 % of forced migrants worldwide and their access to treatment and prevention of chronic viral infections remains poor. Georgia has experienced 2 waves of internal displacement as a result of military conflicts: in 1991–1993 and in 2008. As of 2019, 282,000 IDPs are registered in Georgia. Since 2015, Georgia has made tremendous progress towards eliminating HCV, with an estimated 35 % of HCV-positive people being diagnosed and > 80 % of those diagnosed, cured. In 2019, anti-HCV prevalence was estimated to be 8.9 %, RNA/cAg+ HCV prevalence — 3.9 %, and HIV prevalence — 0.4 %. A study conducted in 2004 showed that prevalence and incidence of infectious diseases was 3.6 and 2.9 times higher, respectively, in IDPs than in the general population in Georgia, but no recent studies published HIV and HCV prevalence in the Georgian IDPs population.
Materials and methods. In June 2022, we interviewed 100 IDPs residing in Poplars, Karaleti, Khurvaleti, Scra, and Blacks villages in the Gori region. Participants were asked about their migration experience, their sexual and drug injecting practices, and medical history with relation to HIV/HCV. Participants were tested for HIV and HCV with rapid tests; in case of a positive HCV test result viral RNA test was perform using Xpert® HCV Viral Load tests.
Results. The average age of participants in the study was 37.5 years (range 18–63); 31 % were women, 65 % were self-employed or unemployed. 83 % of participants relocated to the IDPs shelters immediately after the Russian invasion in 2008 and 17 % after the invasion in 1991–1993. 48 % of participants reported ever injecting drugs (98 % men); 52 % of those (N = 25) injected drugs in the last 30 days and 52 % (N = 25) have < 5 years of injecting experience. 100 % of participants reported to be heterosexual, and 1 person reported sex work. 32 % of women and 12 % of men did not know where to get tested for HIV. 42 % of women and 82 % of men reported to ever having had an HIV test; 94 % of people who inject drugs (PWID) reported having been tested before. 65 % of all participants, and 77 % of PWID participants were tested for HCV in the last 2 years. 6 % of all participants and 9 % of those who reported having been tested before, had a positive HCV test before; all of them received treatment 2–5 years ago and were cured of the infection. 95 % of participants reported not knowing where to get tested for HCV at the moment. 3 % of women, 74 % of men, and 92 % of PWID reported behaviors becoming riskier after displacement. 100 % of participants tested negative for HIV; 11 % of participants tested anti-HCV positive, this figure was 23 % among PWID.
Conclusions. In this study, we did not find evidence for higher HIV or HCV prevalence in Georgian IDPs compared to the previously reported estimates in the general population. While the IDPs population is reached by prevention services as evidenced by the high number of people who have been tested for HIV and HCV before, many people lack knowledge about where they can receive a test on demand. Participants reported having riskier behaviors after displacements and high proportion of participants started injection drug use recently (in the last 5 years) which means that at-risk individuals need to be continuedly screened and diagnosed, to achieve further progress in HIV and HCV control in the country.