Correlates of HIV infection and being unaware of HIV status among soon-to-be-released Ukrainian prisoners

INTRODUCTION Prisoners bear a disproportionate burden of Ukraine's volatile and transitional HIV epidemic, yet little is known in Eastern Europe about HIV testing, treatment and HIV-related risk among prisoners. METHODS A nationally representative biobehavioural health survey linked with serological testing was conducted among soon-to-be released prisoners in 13 Ukrainian prisons from June to November 2011. RESULTS Among 402 participants, 78 (19.4%) tested HIV seropositive of whom 38 (50.7%) were previously unaware of their HIV status. Independent correlates of HIV infection included drug injection (AOR=4.26; 95% CI: 2.23-8.15), female gender (AOR=2.00; 95% CI: 1.06-3.78), previous incarceration (AOR=1.99; 95% CI: 1.07-3.70) and being from Southern Ukraine (AOR=5.46; 95% CI: 2.21-13.46). Those aware of being HIV-positive reported significantly more pre-incarceration sex- and drug-related HIV risk behaviours than those who were unaware. CONCLUSIONS Routine rather than risk-based HIV testing and expansion of opioid substitution and antiretroviral therapy among prisoners is urgently needed to reduce HIV transmission in volatile transitional HIV epidemics.