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Background . Although injection drug use emerged as the initial propellant of HIV in Central Asia, the epidemic may be verging on widespread diffusion through bridge populations to the general population. While HIV incidence appears to be increasing sharply, the absolute number of infections is modest. The epidemic is potentially controllable if prevention measures are implemented soon. To assist development of venue-based prevention, this study describes a key bridge population, injection drug users (IDUs) with high sexual partnership rates and examines their venue visiting frequency and new sexual partnership formation at public venues and develops a method to estimate the size of venue-based risk populations. Methods . Data were collected via a PLACE (Priorities for Local AIDS Control Efforts) study conducted in 2003 in Almaty and Karaganda, Kazakhstan, and Osh, Kyrgyzstan. Three cross-sectional surveys were performed in each city to identify and characterize public venues where HIV transmission is likely and to describe characteristics of socializing patrons. To assess whether high sexual partnership IDUs have more frequent attendance at public venues and/or are more likely to meet a new sexual partner at them than other patrons, generalized estimating equations were used in multivariate analyses. The Laska, Meisner, Siegel method to estimate population size from a single sample was used to develop a venue-based strategy to estimate population size. Results . IDUs with high sexual partnership rates are marginally more likely to socialize at public venues at least weekly (OR (95% CI): 1.7 (1.0, 2.8) for men and 1.8 (1.0, 3.6) for women) and significantly more likely to have met a new sexual partner at the venue (OR (95% CI): 8.7 (4.7, 16.0) for men and OR (95% CI): 75.9 (32.4, 177.9) for women) compared to IDUs without high partnership rates. In Osh, 56,171 individuals (95% CI: 43,634, 68,708) and 262,557 individuals (80,815, 444,319) in Almaty visited targeted public venues over a four week period. Conclusion . As the potential exists for the HIV epidemic in Central Asia to shift through bridge populations from one mainly driven by needle sharing to one that is sexually transmitted, public venues offer attractive locations to introduce prevention programs.
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