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Strategies for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment as prevention and substance use treatment present unique challenges in <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> that may vary regionally. Understanding differences in the risk structure for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> transmission and disease progression among <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> is essential in developing and effectively targeting intervention strategies of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment as prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We present a baseline analysis of HIV Prevention Trials Network (<jats:styled-content style=\"fixed-case\">HPTN<\/jats:styled-content>) 074, a two\u2010arm, randomized controlled trial among <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> in Indonesia (n\u00a0=\u00a0258), Ukraine (n\u00a0=\u00a0457) and Vietnam (n\u00a0=\u00a0439). <jats:styled-content style=\"fixed-case\">HPTN<\/jats:styled-content> 074 was designed to determine the feasibility, barriers and uptake of an integrated intervention combining health systems navigation and psychosocial counselling for the early engagement of antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) and substance use treatment for <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> living with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>. Discordant <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> networks were enrolled, consisting of an <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive index and their <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative network injection partner(s). Among the enrolled cohort of 1154 participants (502 index participants and 652 network partners), we examine regional differences in the baseline risk structure, including sociodemographics, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and substance use treatment history, and injection and sexual risk behaviours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of participants were male (87%), with 82% of the enrolled females coming from Ukraine. The overall mean age was 34 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 30, 38). Most commonly injected substances included illegally manufactured methadone in Ukraine (84.2%), and heroin in Indonesia (81.8%) and Vietnam (99.5%). Injection network sizes varied by region: median number of people with whom participants self\u2010reported injecting drugs was 3 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 2, 5) in Indonesia, 5 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 3, 10) in Ukraine and 3 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>: 2, 4) in Vietnam. Hazardous alcohol use, assessed using the Alcohol Use Disorders Identification Test \u2013 Alcohol Consumption Questions (<jats:styled-content style=\"fixed-case\">AUDIT\u2010C<\/jats:styled-content>), was prominent in Ukraine (54.7%) and Vietnam (26.4%). Reported sexual risk behaviours in the past month, including having two or more sex partners and giving\/receiving money or drugs in exchange for sex, were uncommon among all participants and regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While regional differences in risk structure exist, <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> particularly in Ukraine need immediate attention for risk reduction strategies. Substantial regional differences in risk structure will require flexible, tailored treatment as prevention interventions for distinct <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25195","type":"journal-article","created":{"date-parts":[[2018,10,23]],"date-time":"2018-10-23T06:45:34Z","timestamp":1540277134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Regional differences between people who inject drugs in an <scp>HIV<\/scp> prevention trial integrating treatment and prevention (<scp>HPTN<\/scp> 074): a baseline analysis"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2389-6973","authenticated-orcid":false,"given":"Kathryn E","family":"Lancaster","sequence":"first","affiliation":[{"name":"Division of Epidemiology College of Public Health The Ohio State University Columbus OH 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