Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic.

"Conflicts of interest : None declared."

"Funding National Institutes of Health grants U01DA017387 (National Institute of Drug Abuse, PI R.H.); P30NIMH62294 (National Institute Mental Health, PI P. Cleary); D43TW001028 (Fogarty International Center, PI R. Dubrow) to Yale University. Conflicts of interest: None declared. Key pointsRussia has experienced one of the fastest growing HIV epidemics anywhere in the world, and it is concentrated among injection drug users (IDU).Our findings reveal a very high HIV incidence rate among IDU in St Petersburg Russia, estimated to be between 14 and 25 new cases per 100 person-years.Currently there is an urgent need for expanded prevention efforts, both primary and secondary, to reduce the high HIV transmission in this setting. Given that we identified focal areas of transmission to be expanding and limited behavioural risk factors, these efforts need to be widespread."