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The European Journal of Public Health Advance Access originally published online on February 17, 2009
The European Journal of Public Health 2009 19(3):260-265; doi:10.1093/eurpub/ckp009
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Infectious Diseases

Vulnerability to drug-related infections and co-infections among injecting drug users in Budapest, Hungary

V. Anna Gyarmathy1, Alan Neaigus2,3 and Eszter Ujhelyi4

1 European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
2 New York City Department of Health and Mental Hygiene, New York, NY, USA
3 Mailman School of Public Health, Columbia University, New York, NY, USA
4 Szent László Hospital, Budapest, Hungary

Correspondence: V. Anna Gyarmathy, European Monitoring Centre for Drugs and Drug Addiction, Rua da Cruz de Santa Apolónia 23-25, 1149-045 Lisbon, Portugal, tel: +351 21 811 3000, fax: +351 21 813 1711, e-mail: anna.gyarmathy{at}emcdda.europa.eu

Received October 3, 2008 , accepted January 15, 2009

Background: Drug-related infectious diseases are among the major health consequences of drug use, and any existing drug-related infection may predispose injecting drug users (IDUs) to other infections. Methods: We assessed among IDUs in Budapest, Hungary the prevalence of and vulnerability to selected drug-related infections and co-infections. The sample consisted of 186 participants recruited between October 2005 and December 2006. Results: We found 0% HIV, 37% HCV, 24% HAV, and 14% past HBV infection. Infections with Herpes 1 or 2, tuberculosis, Chlamydia, syphilis, and gonorrhoea were 79%, 12%, 7%, 4%, and 0%, respectively. Co-infection with HAV/HCV was 12%, HBV/HCV 9%, HAV/HBV 7%, and HAV/HBV/HCV 4%. Those over age 30, the ethnic Roma, and the homeless were more likely to have any hepatitis and a higher number of drug-related infections. Amphetamine injectors were more likely to have a higher number of drug-related infections and those who travelled within Hungary were more likely to have any STI. However, those who worked at least part time and those who were in treatment were less likely to have drug-related infections. Conclusions: These results highlight the need of interventions in Hungary to reach and focus on marginalized (Roma or homeless) IDUs and address not only injecting and sex risk, but also hygienic living and injecting conditions. Furthermore, structural interventions to increase social integration (working or being in treatment) may improve welfare and decrease drug use and infection risk tied to drug use/injection among disadvantaged, marginalized, mostly minority populations.

Keywords: central Europe, hepatitis infections, HIV/AIDS, injecting drug use, marginalized populations


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