The impact of abused drugs spectrum among romanina IDU's on STI's, TB and blood born diseases in the last 10 years

Background: In the last 10 years despite the official data Romania had a stable population of problematic drug users (PWID) of ~ 18,500, but we have seen from 2010 a shift from 96% opiate users to 49% NPS users in 2011/2012 and since at least 45% of the users are on NPSS/ATS alone or combined with an opioid. In November 2011 Romania declared an HIV outbreak among IDU's.

Method: This is a secondary analysis of the National Commission of Fighting Against AIDS database in the last 10 years, looking at how the dynamics of preferred drug modifies the incidence of sexual and blood borne diseases.

Results: If till 2009 we had only 3 reported cases of HIV with IDU transmission, as the new “dream shops” selling “legal” and “herbal” highs opened in 2009 we begin to see 11 cases in 2009, 17 in 2010 and 161 in 2011, after that we had between 300 to 180 cases yearly. If till 2013 we found less than 12% pulmonary TB, after 2014 we had an increase to more than 30% of TB with around one fourth extra pulmonary TB and increasing MDR TB cases. HBV remained relatively steady at around 2% and decreasing to less than 1% in the last years due to extended vaccination access. HCV was also steady increasing from 78% to more than 83.7%.

Discussions: Even Romania is an EU country since January 2007, we still didn’t manage to ensure enough places for opioid dependence substitution treatment (OST), or enough Harm Reduction Measures like needle exchange programs (NEP) and hence we have increasing prevalence of HCV, STI’s and TB among our IDUs population.