The WHO Collaborating Centre is a part of the Andrija Stampar School of Public Health, School of Medicine in Zagreb. Hence, carrying out research in HIV epidemiology and prevention is one of our key activities. The research interest of the Centre’s staff is in HIV-surveillance related research and exploring which surveillance approaches and techniques work best in different settings, as well as in epidemiology and clinical outcomes of HIV and STIs.
We aim to put an increasing emphasis on validating different surveillance tools and approaches, and on synthesizing findings on how surveillance systems can achieve better effectiveness by exploring epidemiological, and wider contextual factors including:
- Methodological innovations in HIV surveillance
- Studies that develop and validate new surveillance tools and their feasibility in practice
- Operational research that explores the factors affecting effectiveness and sustainability of HIV surveillance systems
- Relevance and types of qualitative research that are useful for surveillance purposes, particularly during pre-surveillance assessment
- Translations of findings from HIV surveillance into HIV prevention, control and treatment programmes
- Role of STIs in enhancing the spread of HIV
Since 2002, we have co-organized the workshops on Designing Clinical Research with University of San Francisco, California. Almost each of our training courses includes the group exercises during which participants develop a protocol for implementation of various bio-behavioural surveys in different groups at-risk. A great emphasis is put on the methods and design of surveys during the protocol development exercise.
We have carried out the following research studies:
- Bio-bihevioural survey using RDS among PWID in three cities in Croatia, 2015
- Bio-bihevioural survey based on cluster sampling among female seasonal workers in Morocco, 2013
- Bio-bihevioural survey using RDS in MSM in Zagreb, Croatia, 2010-2011
- Cluster-based household survey on prevalence of chlamydial infection and sexual behaviours, knowledge and attitudes among young people in Croatia, 2010
- Review of HIV epidemics and policy responses among MSM in 27 countries of eastern Europe (commissioned by WHO EURO)
- Pre-surveillance assessment and bio-bihevioural survey based on RDS among FSW in Yemen, 2007-2008 (commissioned by WHO EMRO)
- Bio-bihevioural survey based on RDS among IDUs in three cities in Bosnia and Herzegovina, 2007 (commissioned by UNICEF)
- Bio-bihevioural survey based on RDS among MSM in Zagreb, Croatia, 2006
- Bihevioural survey based on convenience sampling among sailors in Croatia, 2005
- Time-location bihevioural survey among truck drivers in Croatia, 2005 and 2010
- Cluster-based household survey on sexual behaviours, knowledge and attitudes among young people in Croatia, 2005
Selected HIV-related publications of our staff
Štulhofer A, Jwehan I, AbuRabie R.
HIV and HCV prevalence and incarceration-related risks among injecting drug users in three West Bank governorates.
AIDS Care. 2016 Sep;28(9):1159-65.
Gökengin D, Oprea C, Uysal S, Begovac J.
The growing HIV epidemic in Central Europe: a neglected issue?
J Virus Erad. 2016 Jul 1;2(3):156-61.
Handanagic S, Bozicevic I, Civljak M, Dominkovic Z, Sevic S, Barbaric J, Nemeth Blazic T, Dakovic Rode O, Begovac J.
HIV and hepatitis C prevalence, and related risk behaviours among people who inject drugs in three cities in Croatia: Findings from respondent-driven sampling surveys.
Int J Drug Policy. 2016 Jun;32:57-63.
Štulhofer A, Sinković M, Božić J, Baćak V.
Victimization and HIV Risks Among Croatian Female Sex Workers: Exploring the Mediation Role of Depressiveness and the Moderation Role of Social Support.
Violence Against Women. 2016 Mar 28. pii: 1077801216636241. [Epub ahead of print]
Raben D, Mocroft A, Rayment M, Mitsura VM, Hadziosmanovic V, Sthoeger ZM, Palfreeman A, Morris S, Kutsyna G, Vassilenko A, Minton J, Necsoi C, Estrada VP, Grzeszczuk A, Johansson VS,Begovac J, Ong EL, Cabié A, Ajana F, Celesia BM, Maltez F, Kitchen M, Comi L, Dragsted UB, Clumeck N, Gatell J, Gazzard B, d'Arminio Monforte A, Rockstroh J, Yazdanpanah Y, Champenois K, Jakobsen ML, Sullivan A, Lundgren JD; HIDES Audit Study Group.
Auditing HIV Testing Rates across Europe: Results from the HIDES 2 Study.
PLoS One. 2015 Nov 11;10(11):e0140845.
Čakalo JI, Božičević I, Vitek C, Mandel JS, Salyuk T, Rutherford GW.
Misclassification of men with reported HIV infection in Ukraine.
AIDS Behav. 2015 Oct;19(10):1938-40.
Lausevic D, Begic S, Mugosa B, Terzic N, Vratnica Z, Labovic I, Bozicevic I.
Prevalence of HIV and other infections and correlates of needle and syringe sharing among people who inject drugs in Podgorica, Montenegro: a respondent-driven sampling survey.
Harm Reduct J. 2015 Feb 28;12:2.
Štulhofer A, Landripet I, Božić J, Božičević I.
HIV risks and HIV prevention among female sex workers in two largest urban settings in Croatia, 2008-2014.
AIDS Care. 2015;27(6):767-71.
Ðaković Rode O, Jemeršić L, Brnić D, Pandak N, Mikulić R, Begovac J, Vince A.
Hepatitis E in patients with hepatic disorders and HIV-infected patients in Croatia: is one diagnostic method enough for hepatitis E diagnosis?
Eur J Clin Microbiol Infect Dis. 2014 Dec;33(12):2231-6.
Gökengin D, Geretti AM, Begovac J, Palfreeman A, Stevanovic M, Tarasenko O, Radcliffe K.
2014 European Guideline on HIV testing.
Int J STD AIDS. 2014 Sep;25(10):695-704.
Vitek CR, Čakalo JI, Kruglov YV, Dumchev KV, Salyuk TO, Božičević I, Baughman AL, Spindler HH, Martsynovska VA, Kobyshcha YV, Abdul-Quader AS, Rutherford GW.
Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012.
PLoS One. 2014 Sep 24;9(9):e103657.
Houlihan CF, de Sanjosé S, Baisley K, Changalucha J, Ross DA, Kapiga S, Godinez JM, Bozicevic I, Hayes RJ, Watson-Jones D.
Prevalence of human papillomavirus in adolescent girls before reported sexual debut.
J Infect Dis. 2014 Sep 15;210(6):837-45.
Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, Kowalska JD, de Wit S, Law M, el Sadr W, Kirk O, Friis-Moller N, Monforte Ad, Phillips AN, Sabin CA, Lundgren JD; D:A:D Study Group.
Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration.
Lancet. 2014 Jul 19;384(9939):241-8.
Bozicevic I, Handanagic S, Lepej SZ, Begovac J.
The emerging and re-emerging human immunodeficiency virus epidemics in Europe.
Clin Microbiol Infect. 2013 Oct;19(10):917-29.
Elhadi M, Elbadawi A, Abdelrahman S, Mohammed I, Bozicevic I, Hassan EA, Elmukhtar M, Ahmed S, Abdelraheem MS, Mubarak N, Elsanousi S, Setayesh H.
Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011-2012.
Sex Transm Infect. 2013 Nov;89 Suppl 3:iii17-22.
Bozicevic I, Riedner G, Calleja JM.
HIV surveillance in MENA: recent developments and results.HIV surveillance in MENA: recent developments and results.
Sex Transm Infect. 2013 Nov;89 Suppl 3:iii11-16.
Višković K, Rutherford GW, Sudario G, Stemberger L, Brnić Z, Begovac J.
Ultrasound measurements of carotid intima-media thickness and plaque in HIV-infected patients on the Mediterranean diet.
Croat Med J. 2013 Aug;54(4):330-8.
Chikovani I, Goguadze K, Bozicevic I, Rukhadze N, Gotsadze G.
Determinants of risky sexual behavior among injecting drug users (IDUs) in Georgia.
AIDS Behav. 2013 Jun;17(5):1906-13. doi: 10.1007/s10461-012-0296-9.
Visković K, Stemberger L, Brnić Z, Begovac J.
Repeated presentation of Graves' disease as a manifestation of immune reconstitution syndrome in an HIV-infected patient taking HAART: case report.
Acta Clin Croat. 2013 Mar;52(1):125-7.
Perović Mihanović M, Haque NS, Rutherford GW, Zekan Š, Begovac J.
Toxicity-related antiretroviral drug treatment modifications in individuals starting therapy: a cohort analysis of time patterns, sex, and other risk factors.
Med Sci Monit. 2013 Jun 21;19:483-92. doi: 10.12659/MSM.889283.
Viskovic K, Begovac J.
Tuberculosis-Associated Immune Reconstruction Inflammatory Syndrome (TB-IRIS) in HIV-Infected Patients: Report of Two Cases and the Literature Overview.
Case Rep Infect Dis. 2013;2013:323208. doi: 10.1155/2013/323208. Epub 2013 Apr 18.
Sullivan AK, Raben D, Reekie J, Rayment M, Mocroft A, Esser S, Leon A, Begovac J, Brinkman K, Zangerle R, Grzeszczuk A, Vassilenko A, Hadziosmanovic V, Krasnov M, Sönnerborg A, Clumeck N, Gatell J, Gazzard B, Monforte Ad, Rockstroh J, Lundgren JD.
Feasibility and effectiveness of indicator condition-guided testing for HIV: results from HIDES I (HIV indicator diseases across Europe study).
PLoS One. 2013;8(1):e52845. doi: 10.1371/journal.pone.0052845. Epub 2013 Jan 15.
Bozicevic I, Lepej SZ, Rode OD, Grgic I, Jankovic P, Dominkovic Z, Lukas D, Johnston LG, Begovac J.
Prevalence of HIV and sexually transmitted infections and patterns of recent HIV testing among men who have sex with men in Zagreb, Croatia.
Sex Transm Infect. 2012 Nov;88(7):539-44. doi: 10.1136/sextrans-2011-050374. Epub 2012 May 24.
Grgic I, Lepej SZ, Lunar MM, Poljak M, Vince A, Vrakela IB, Planinic A, Seme K, Begovac J.
The prevalence of transmitted drug resistance in newly diagnosed HIV-infected individuals in Croatia: the role of transmission clusters of men who have sex with men carrying the T215S surveillance drug resistance mutation.
AIDS Res Hum Retroviruses. 2013 Feb;29(2):329-36. doi: 10.1089/AID.2012.0191. Epub 2012 Oct 4.
Dakovic Rode O, Markotic A, Kujundzic Tiljak M, Zidovec Lepej S, Begovac J.
Serum apoptosis markers in HIV-infected patients with human herpesvirus type 8 and herpes simplex virus type 2 co-infection.
Eur J Clin Microbiol Infect Dis. 2012 Dec;31(12):3303-8. doi: 10.1007/s10096-012-1696-5. Epub 2012 Jul 27.
Stulhofer A, Chetty A, Rabie RA, Jwehan I, Ramlawi A.
Erratum to: The prevalence of HIV, HBV, HCV, and HIV-related risk-taking behaviors among Palestinian injecting drug users in the East Jerusalem Governorate.
J Urban Health. 2012 Aug;89(4):677. doi: 10.1007/s11524-012-9746-y.
Stulhofer A, Chetty A, Rabie RA, Jwehan I, Ramlawi A.
The prevalence of HIV, HBV, HCV, and HIV-related risk-taking behaviors among Palestinian injecting drug users in the East Jerusalem Governorate.
J Urban Health. 2012 Aug;89(4):671-6. doi: 10.1007/s11524-012-9672-z. Erratum in: J Urban Health. 2012 Aug;89(4):677.
Puzek I, Stulhofer A, Božičević I.
Is Religiosity a Barrier to Sexual and Reproductive Health? Results from a Population-Based Study of Young Croatian Adults.
Arch Sex Behav. 2012
Chikovani I, Božičević I, Goguadze K, Rukhadze N, Gotsadze G.
Unsafe injection and sexual risk behavior among injecting drug users in Georgia.
J Urban Health. 2011 Aug;88(4):736-48. doi: 10.1007/s11524-011-9571-8.
Stulhofer A, Soh D, Jelaska N, Baćak V, Landripet I.
Religiosity and sexual risk behavior among Croatian college students, 1998-2008.
J Sex Res. 2011; 48:360-71.
Škerk V, Markotic A, Puljiz I, Kuzman I, Celjuska Tosev E, Habus J, Turk N, Begovac J.
Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period.
Med Sci Monit. 2011; 17:CR369-375
Mlinaric-Missoni E, Hagen F, Chew WH, Vazic-Babic V, Boekhout T, Begovac J.
In vitro antifungal susceptibilities and molecular typing of sequentially isolated clinical Cryptococcus neoformans strains from Croatia.
J Med Microbiol. 2011; 26.
Turcinov D, Begovac J.
Predicted coronary heart disease risk in croatian HIV infected patients treated with combination antiretroviral therapy.
Coll Antropol. 2011 Mar;35(1):115-21.
Kowalska JD, Mocroft A, Ledergerber B, Florence E, Ristola M, Begovac J, Sambatakou H, Pedersen C, Lundgren JD, Kirk O; Eurosida Study Group.
A standardized algorithm for determining the underlying cause of death in HIV infection as AIDS or non-AIDS related: results from the EuroSIDA study.
HIV Clin Trials. 2011 Mar-Apr;12(2):109-17. doi: 10.1310/hct1202-109.
Stulhofer A, Kuljanić K, Buzina DŠ.
Sexual health difficulties in a population-based sample of Croatian women aged 18-35 and the effects of the dual (career and motherhood) role.
J Sex Med. 2011; 8:1314-21.
Vuletić S, Sogorić S, Malatestinić D, Božicević I.
[Health status and health needs assessment--state of the art of the public health practice in Croatia].
Acta Med Croatica. 2010 Dec;64(5):317-25. Croatian.Baćak V, Stulhofer A.
Baćak, V, Štulhofer, A.
Condom Use Errors and Problems in a National Sample of Young Croatian Adults.
Arch Sex Behav. 2011; DOI: 10.1007/s10508-011-9838-x
Božičević I, Grgić I, Židovec-Lepej S, Čakalo JI, Belak-Kovačević S, Štulhofer A, Begovac J.
Urine-based testing for Chlamydia trachomatis among young adults in a population-based survey in Croatia: feasibility and prevalence.
BMC Public Health. 2011; DOI: 10.1186/1471-2458-11-230
Landripet I, Stulhofer A, Bacak V.
Changes in human immunodeficiency virus and sexually transmitted infections-related sexual risk taking among young Croatian adults: 2005 and 2010 population-based surveys.
Croat Med J. 2011; 52(4):458-68.
Stulhofer A, Lausević D, Bozicević I, Baćak V, Mugoba B, Terzić N, Drglin T.
HIV risks among female sex workers in Croatia and Montenegro.
Coll Antropol. 2010; 34(3):881-6.
Stulhofer A, Baćak V, Ajduković D, Graham C.
Understanding the association between condom use at first and most recent sexual intercourse: An assessment of normative, calculative, and habitual explanations
Soc Sci Med 2010; 70(12):2080-4.
Bozicevic I, Begovac J.
The emerging HIV epidemic among men who have sex with men in southeastern Europe.
Expert Rev Anti Infect Ther. 2010; 8:1351-8.
Grgic I, Zidovec Lepej S, Vince A, Begovac J.
Increased frequency of viral loads above 100,000 HIV-1 RNA copies/ml measured by Roche Cobas TaqMan assay in comparison with Cobas Amplicor assay
J Clin Virol 2010; 48(1):75-6.
Kriitmaa K, Testa A, Osman M, Bozicevic I, Riedner G, Malungu J, Irving G, Abdalla I.
HIV prevalence and characteristics of sex work among female sex workers in Hargeisa, Somaliland, Somalia.
AIDS. 2010; 2:S61-7.
Stulhofer A, Baćak V, Drglin T, Puljiz M, Miklin M.
Female sex work and HIV risks in Croatia.
AIDS Care 2009; 21(11): 1439-46.
Lepej SZ, Vrakela IB, Poljak M, Bozicevic I, Begovac J.
Phylogenetic analysis of HIV sequences obtained in a respondent-driven sampling study of men who have sex with men.
AIDS Res Hum Retroviruses 2009; 25(12):1335-8.
Turcinov D, Stanley C, Rutherford GW, Novotny TE, Begovac J.
Adherence to the Mediterranean diet is associated with a lower risk of body-shape changes in Croatian patients treated with combination antiretroviral therapy.
Eur J Epidemiol 2009; 24(5):267-74.
Ramirez-Piedad MK, Lepej SZ, Yerly S, Begovac J.
High prevalence of non-B HIV-1 subtypes in seamen and their sexual partners in Croatia.
J Med Virol. 2009; 81(4):573-7.
Viskovic K, Richman I, Klasnic K, Hernandez A, Krolo I, Rutherford GW, Romih V, Begovac J.
Assessment of ultrasound for use in detecting lipoatrophy in HIV-infected patients taking combination antiretroviral therapy.
AIDS Patient Care STDS 2009; 23(2):79-84.
Bozicevic I, Rode OD, Lepej SZ, Johnston LG, Stulhofer A, Dominkovic Z, Bacak V, Lukas D, Begovac J.
Prevalence of Sexually Transmitted Infections Among Men Who Have Sex with Men in Zagreb, Croatia.
AIDS Behav 2008; 32(3):693-5.
Rode OD, Lepej SZ, Begovac J.
Seroprevalence of herpes simplex virus type 2 in adult HIV-infected patients and blood donors in Croatia.
Coll Antropol 2008; 32(3):693-5.
Stulhofer A, Bacak V, Bozicevic I, Begovac J.
HIV-related sexual risk taking among HIV-negative men who have sex with men in Zagreb, Croatia.
AIDS Behav 2008; 12(3):505-12.
HIV related risks among Croatian migrant workers 2004-2006.
AIDS Care 2008; 20(3):361-9.
Stulhofer A, Graham C, Božičević I, Kufrin K, Ajduković D.
An Assessment of HIV/STI Vulnerability and Related Sexual Risk-Taking in a Nationally Representative Sample of Young Croatian Adults.
Arch Sex Behav 2007; 38(2):209-25.
Stulhofer A, Graham C, Bozicevic I, Kufrin K, Ajduković D.
HIV/AIDS-related knowledge, attitudes and sexual behaviors as predictors of condom use among young adults in Croatia.
Int Fam Plan Perspect 2007; 33(2):58-65.
Stulhofer A, Brouillard P, Nikolić N, Greiner N.
HIV/AIDS and Croatian migrant workers.
Coll Antropol. 2006; 30 Suppl 2:105-14.
Hirsl-Hećej V, Stulhofer A.
Condom use and its consistency among metropolitan high school students in Croatia, 1997-2001: has anything changed?
Coll Antropol 2006; 30 Suppl 2:71-8.
Bozicević I, Stulhofer A, Ajduković D, Kufrin K.
Patterns of sexual behaviour and reported symptoms of STI/RTIs among young people in Croatia--implications for interventions' planning.
Coll Antropol 2006; 30 Suppl 2:63-70.
Bozicevic I, Fenton KA, Martin IM, Rudd EA, Ison CA, Nanchahal K, Wellings K.
Epidemiological correlates of asymptomatic gonorrhea.
Sex Transm Dis 2006; 33(5):289-95.
Begovac J, Zekan A, Skoko-Poljak D.
Twenty years of human immunodeficiency virus infection in Croatia--an epidemic that is still in an early stage.
Coll Antropol 2006; 30 Suppl 2:17-23.
Baćak V, Soh D.
On the road: Croatian truck drivers, commercial sex and HIV/AIDS.
Coll Antropol. 2006; 30 Suppl 2:99-103.
Puljiz I, Begovac J.
Tuberculosis in HIV-infected patients in Croatia between 1986 and 2005.
Coll Antropol 2006; 30 Suppl 2:53-8.
Begovac J, Lisić M, Lukas D, Maretić T, Kniewald T, Novotny TE.
Marked improvement in survival among adult Croatian AIDS patients after the introduction of highly active antiretroviral treatment.
Coll Antropol. 2006; 30(1):175-9.