{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:20:39Z","timestamp":1791354039803,"version":"4.3.1"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T00:00:00Z","timestamp":1645401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007054","name":"Meso Scale Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The human immunodeficiency virus (HIV) outbreak among people who inject drugs (PWID) in Athens, Greece in 2011\u201313 was the largest recent epidemic in Europe and North America. We aimed to assess trends in HIV prevalence, drug use and access to prevention among PWID in Athens to estimate HIV incidence and identify risk factors and to explore HIV\u20101 dispersal using molecular methods during 2014\u201320.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two community\u2010based HIV\/hepatitis C programmes on PWID were implemented in 2012\u201313 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093320) and 2018\u201320 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091635) through consecutive respondent\u2010driven sampling (RDS) rounds. PWID were uniquely identified among rounds\/programmes. We obtained RDS\u2010weighted HIV prevalence estimates per round for 2018\u201320 and compared them to 2012\u201313. We assessed changes in HIV status, behaviours and access to prevention in PWID participating in both periods. We estimated HIV incidence in a cohort of seronegative PWID as the number of HIV seroconversions\/100 person\u2010years during 2014\u201320 and used Cox regression to identify associated risk factors. Molecular sequencing and phylogenetic analysis were performed in HIV seroconverters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HIV prevalence per round ranged between 12.0 and 16.2% in 2012\u201313 and 10.7 and 11.3% in 2018\u201320 with overlapping 95% confidence intervals (95% CI). Among PWID participating in both programmes, HIV prevalence (95% CI) increased from 14.2% (11.7\u201317.1%) in 2012\u201313 to 22.0% (19.0\u201325.3%) in 2018\u201320 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was a deterioration in socio\u2010economic characteristics such as homelessness [from 16.2% (95% CI\u2009=\u200913.5\u201319.2%) to 25.6% (22.3\u201329.0%)], a shift in cocaine use [16.6% (13.9\u201319.6%) versus 28.1% (24.7\u201331.7%], reduced access to free syringes [51.8% (48.0\u201355.7%) versus 44.5% (40.7\u201348.3%)] and a decrease in daily injecting [36.2% (32.6\u201339.9%) versus 28.5% (25.2\u201332.1%)]. HIV incidence (95% CI) in 2014\u201320 was 1.94 (1.50\u20132.52) new cases\/100 person\u2010years and younger age, lower educational level, larger injection network and daily injecting were risk factors. Almost 9% of HIV seroconversions occurred within a newly expanding phylogenetic cluster.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Athens, Greece, compared with the period 2012\u201313, in the period 2018\u201320 there was a deterioration in socio\u2010economic conditions among people who inject drugs, an increase in the use of cocaine, reduced access to needle and syringe programmes and stable low levels of human immunodeficiency virus testing. Ongoing human immunodeficiency virus transmission was documented during 2014\u201320 in existing as well as new transmission clusters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15812","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T05:34:41Z","timestamp":1643002481000},"page":"1670-1682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Ongoing HIV transmission following a large outbreak among people who inject drugs in Athens, Greece (2014\u201320)"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-0817","authenticated-orcid":false,"given":"Sotirios","family":"Roussos","sequence":"first","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens  Athens Greece"},{"name":"Hellenic Scientific Society for the Study of AIDS, STDs and 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