Economic recession and emergence of an HIV-1 outbreak among drug injectors in Athens metropolitan area: A longitudinal study
Date
2013Author
Paraskeva, D.

Tsiara, Chrissa G.
Paraskeva, D.
Sypsa, V.
Lazanas, Marios


Skoutelis, A.
Wiessing, L.
Friedman, Samuel R.
Jarlais, Don C. Des
Terzidou, M.
Kremastinou, Jenny
Malliori-Minerva, Melpomeni
Hatzakis, A.
Source
PLoS ONEVolume
8Issue
11Google Scholar check
Keyword(s):
Metadata
Show full item recordAbstract
Background: During 2011, a dramatic increase (1600%) of reported HIV-1 infections among injecting drug users (IDUs) was noted in Athens, Greece. We herein assess the potential causal pathways associated with this outbreak. Methods: Our study employed high resolution HIV-1 phylogenetic and phylogeographic analyses. We examined also longitudinal data of ecological variables such as the annual growth of gross domestic product (GDP) of Greece in association with HIV-1 and HCV sentinel prevalence in IDUs, unemployment and homelessness rates and HIV transmission networks in Athens IDUs before and during economic recession (2008-2012). Results: IDU isolates sampled in 2011 and 2012 suggested transmission networks in 94.6% and 92.7% of the cases in striking contrast with the sporadic networking (5%) during 1998-2009. The geographic origin of most HIV-1 isolates was consistent with the recently documented migratory waves in Greece. The decline in GDP was inversely correlated with annual prevalence rates of HIV and HCV and with unemployment and homelessness rates in IDUs (all p<0.001). The slope of anti-HCV prevalence in the sentinel populations of IDUs and in "new" drug injectors was found 120 and 1.9-fold (p = 0.007, p = 0.08 respectively) higher in 2008-2012 (economic recession) compared with 2002-2006. The median (25th, 75th) size of transmission networks were 34 (12, 58) and 2 (2, 2) (p = 0.057) in 2008-2012 and 1998-2007, respectively. The coverage of harm reduction services was low throughout the study period. Conclusions: Scaling-up harm reduction services and addressing social and structural factors related to the current economic crisis should be urgently considered in environments where HIV-1 outbreaks may occur. © 2013 Paraskevis et al.
Collections
Cite as
Related items
Showing items related by title, author, creator and subject.
-
Article
A randomized phase II study with two schedules of the novel indoloquinone EO9 in non-small-cell lung cancer: A study of the EORTC early clinical studies group (ECSG)
Pavlidis, Nicholas; Hanauske, A. R.; Gamucci, T.; Smyth, J. F.; Lehnert, M.; Velde, A. Te; Lan, J.; Verweij, J. (1996)In a multicentre randomized trial of the EORTC-ECSG, we have treated 38 chemotherapy naive patients with advanced non-small-cell lung cancer (NSCLC) with EO9, a novel bioreductive alkylating indoloquinone. The drug was ...
-
Article
Carzelesin phase II study in advanced breast, ovarian, colorectal, gastric, head and neck cancer, non-Hodgkin's lymphoma and malignant melanoma: A study of the EORTC early clinical studies group (ECSG)
Pavlidis, Nicholas; Aamdal, S.; Awada, Ahmad; Calvert, H.; Fumoleau, P.; Sorio, R.; Punt, C.; Verweij, J.; Oosterom, A. T. Van; Morant, R.; Wanders, J.; Hanauske, A. R. (2000)Purpose: In a phase II trial, the activity of carzelesin, a cyclopropylpyrroloindole prodrug analog, was assessed. Patients and methods: Carzelesin was used as second- or third-line chemotherapy in patients with breast, ...
-
Article
Organization Studies: The Fourth Organization Studies Summer Workshop: “Embracing Complexity: Advancing Ecological Understanding in Organization Studies” 5—7 June 2008, Pissouri, Cyprus
Dooley, K. J.; Sandelands, L.; Tsoukas, Haridimos (2007)