@article {17374,
	title = {Design and baseline findings of a large-scale rapid response to an HIV outbreak in people who inject drugs in Athens, Greece: the ARISTOTLE programme},
	journal = {Addiction},
	volume = {110},
	number = {9},
	year = {2015},
	note = {Hatzakis, AngelosSypsa, VanaParaskevis, DimitriosNikolopoulos, GeorgiosTsiara, ChrissaMicha, KaterinaPanopoulos, AnastasiosMalliori, MeniPsichogiou, MinaPharris, AnastasiaWiessing, Lucasvan de Laar, MaritaDonoghoe, MartinHeckathorn, Douglas DFriedman, Samuel RDes Jarlais, Don Ceng001/World Health Organization/InternationalDP1 DA034989/DA/NIDA NIH HHS/P30 DA011041/DA/NIDA NIH HHS/Research Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov{\textquoteright}tEnglandAbingdon, England2015/06/03 06:00Addiction. 2015 Sep;110(9):1453-67. doi: 10.1111/add.12999. Epub 2015 Jul 14.},
	month = {Sep},
	pages = {1453-67},
	abstract = {AIMS: To (i) describe an intervention implemented in response to the HIV-1 outbreak among people who inject drugs (PWIDs) in Greece (ARISTOTLE programme), (ii) assess its success in identifying and testing this population and (iii) describe socio-demographic characteristics, risk behaviours and access to treatment/prevention, estimate HIV prevalence and identify risk factors, as assessed at the first participation of PWIDs. DESIGN: A {\textquoteright}seek, test, treat, retain{\textquoteright} intervention employing five rounds of respondent-driven sampling. SETTING: Athens, Greece (2012-13). PARTICIPANTS: A total of 3320 individuals who had injected drugs in the past 12 months. INTERVENTION: ARISTOTLE is an intervention that involves reaching out to high-risk, hard-to-reach PWIDs ({\textquoteright}seek{\textquoteright}), engaging them in HIV testing and providing information and materials to prevent HIV ({\textquoteright}test{\textquoteright}) and initiating and maintaining anti-retroviral and opioid substitution treatment for those testing positive ({\textquoteright}treat{\textquoteright} and {\textquoteright}retain{\textquoteright}). MEASUREMENTS: Blood samples were collected for HIV testing and personal interviews were conducted. FINDINGS: ARISTOTLE recruited 3320 PWIDs during the course of 13.5 months. More than half (54\%) participated in multiple rounds, resulting in 7113 visits. HIV prevalence was 15.1\%. At their first contact with the programme, 12.5\% were on opioid substitution treatment programmes and the median number of free syringes they had received in the preceding month was 0. In the multivariable analysis, apart from injection-related variables, homelessness was a risk factor for HIV infection in male PWIDs [odds ratio (OR) yes versus no = 1.89, 95\% confidence interval (CI) = 1.41, 2.52] while, in female PWIDS, the number of sexual partners (OR for \&gt; 5 versus one partner in the past year = 4.12, 95\% CI = 1.93, 8.77) and history of imprisonment (OR yes versus no = 2.76, 95\% CI = 1.43, 5.31) were associated with HIV. CONCLUSIONS: In Athens, Greece, the ARISTOTLE intervention for identifying HIV-positive people among people who inject drugs (PWID) facilitated rapid identification of a hidden population experiencing an outbreak and provided HIV testing, counselling and linkage to care. According to ARISTOTLE data, the 2011 HIV outbreak in Athens resulted in 15\% HIV infection among PWID. Risk factors for HIV among PWID included homelessness in men and history of imprisonment and number of sexual partners in women.},
	keywords = {Adolescent, Adult, Aged, Antiretroviral Therapy, Highly Active, Comorbidity, Disease Outbreaks/*statistics \& numerical data, Female, Greece, HIV Infections/diagnosis/*drug therapy/*epidemiology, Humans, Male, Middle Aged, Prevalence, Risk Factors, Risk-Taking, Socioenvironmental Therapy, Substance Abuse, Intravenous/*epidemiology, Young Adult},
	isbn = {1360-0443 (Electronic)0965-2140 (Linking)},
	author = {Hatzakis, A and Sypsa, V and Paraskevis, D and Nikolopoulos, G. and Tsiara, C and Micha, K. and Panopoulos, A. and Malliori, M. and Psichogiou, M and Pharris, A. and Wiessing, L. and Van De Laar, M. and Donoghoe, M. and Heckathorn, D. D. and Friedman, S. R. and Des Jarlais, D. C.}
}
