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Many studies over the last decade provide strong evidence of elevated rates of suicidality among lesbian, gay, bisexual, and transgender populations compared to heterosexual populations. The aim of the current study was to investigate suicidal ideation and attempts and related factors among men who have sex with men (MSM) in Estonia. We conducted a nationwide Internet-based study among MSM with 265 eligible participants. Our results reveal high rates of self-reported suicidal ideation (lifetime prevalence 45%) and attempts (lifetime prevalence 11%) as well as a high rate of problem drinking (33%) and depressive symptoms (32%) among MSM. Recent suicidal ideation (14% had thought about suicide in the last 12 months) was related to depressive symptoms and lower socioeconomic situation. There is a need to develop specific interventions to address these issues among MSM and to provide gay-friendly mental health services. [ABSTRACT FROM PUBLISHER]

HIV testing constitutes an important strategy to control the HIV epidemic, which therefore merits an observation of HIV testing practices to help improve testing effectiveness. In 2008, a cross-sectional survey among recently diagnosed (≤ 3 years) HIV-infected patients was conducted in Belgium, Estonia, Finland and Portugal. Participants were questioned about reasons for HIV testing, testing place and testing conditions. Univariate and multivariate analyses were performed. Out of 1460 eligible participants, 629 (43%) were included. Forty-one per cent were diagnosed late and 55% had never undergone a previous HIV test with perceived low risk being the primary reason for not having been tested earlier. Heterogeneity in HIV testing practices was observed across countries. Overall, tests were most frequently conducted in primary care (38%) and specialised clinics (21%), primarily on the initiative of the health care provider (65%). Sixty-one per cent were tested with informed consent, 31% received pretest counselling, 78% received post-test counselling, 71% were involved in partner notification and 92% were in care three months after diagnosis. The results showed that HIV testing is done in a variety of settings suggesting that multiple pathways to HIV testing are provided. HIV testing practice is being normalised, with less focus on pretest counselling, yet with emphasis on post-test follow-up. Major barriers to testing are centred on the denial of risk. Efforts are needed to concurrently promote public awareness about HIV risk and benefits of HIV testing and train clinicians to be more proactive in offering HIV testing. [ABSTRACT FROM AUTHOR]

The special norms in testing for HIV infection are not typical of testing or screening for other diseases. In four European countries, we studied health professionals’ views on HIV testing This study is based on cross-sectional surveys of two groups of health professionals: presidents of selected health professional societies and head physicians and nurses of selected hospital clinics in Belgium, Estonia, Finland, and Portugal in 2008. A common structured semi-anonymous questionnaire was used in the four countries. The number of societies responding varied from five to 10 and for hospital clinics from six to 18; the response rates were from 32% to 100% and 41% to 100%, respectively. Opinions on whether HIV testing is like any other test and on the value of specific approaches in HIV testing varied both within and between countries. Some professionals thought that HIV testing is different from the testing of other infectious diseases; others thought that such an exceptional approach may be a disservice to people and to the health system. Many professionals thought that HIV testing should not be thought of only from the point of view of the individual to be tested, but also from that of other people (potential patients). Obligatory testing was considered appropriate in certain circumstances. Generally, more HIV testing in health care was called for. Normalization of HIV testing, i.e., considering it like any other diagnostic test, is unlikely to meet much opposition from health professionals. Larger surveys are needed to confirm the results. [ABSTRACT FROM PUBLISHER]

Estonia has rapidly expanding injection drug use (IDU) driven HIV/AIDS epidemic with the highest reported incidence rate and prevalence (1.3%) of HIV in the European region. To evaluate the feasibility of IDU prevalence estimations based on routine nationwide data sources using capture-recapture methodology, and provide estimates of IDU prevalence. IDUs were identified from the Police, Health insurance fund, State HIV reference laboratory data sources. Poisson regression models were fitted to the observed data, with interactions between data sources fitted to replicate 'dependencies' between the data sources. There were 13,886 (95% CI 8132-34,443) IDUs in Estonia in 2004, which translates into a prevalence of 2.4% (95% CI 1.4-5.9%) among people aged 15-44 years. The estimate is in line with the estimate provided by the panel of experts and estimates from the neighbouring countries experiencing similar societal and economic challenges. [ABSTRACT FROM AUTHOR]

This article describes current trends of HIV/AIDS and related conditions in Estonia, with the aim of highlighting key determinants in transmission dynamics and risk groups, problems and barriers of combating HIV/AIDS, and possible implications for prevention and control. Throughout the transition period Estonia has experienced major changes in political, economic, and social structure which all have contributed to increased violence, high-risk sexual behaviour, and substance abuse. Incidences of hepatitis B, C and sexually transmitted infections (STIs) increased in the early 1990s. HIV outbreaks were first detected among injecting drug users (IDUs) in 2000 and are still concentrated among this population group. High rates of sexual risk behaviour and inadequate knowledge regarding prevention of disease transmission in Estonia emphasizes the threat of a sex-related and STI facilitated driven HIV epidemic. To prevent further spread of HIV it is necessary to implement harm reduction interventions among IDUs. However, without effective management of socioeconomic and administrative barriers to health care and other services, an explicit policy on drugs will not reach marginalized groups and will not be able to prevent a further spread of these interrelated epidemics. [ABSTRACT FROM AUTHOR]