Substance Use Patterns of HIV-Infected Russian Women With and Without Hepatitis C Virus Co-infection

Individuals with HIV and hepatitis C virus (HCV) co-infection may experience substance use related health complications. This study characterized substance use patterns between HIV/HCV co-infected and HIV mono-infected Russian women. HIV-infected women (N = 247; M age = 30.0) in St. Petersburg, Russia, completed a survey assessing substance use, problematic substance use, and the co-occurrence of substance use and sexual behaviors. 

Covariate adjusted logistic and linear regression analyses indicated that HIV/HCV co-infected participants (57.1 %) reported more lifetime drug use (e.g., heroin), problem drinking, substance use problems, and increased likelihood of past injection drug use relative to HIV mono-infected individuals. HIV/HCV co-infection was prevalent and associated with increased substance use and problematic drug use. 

Findings highlight the need for ongoing substance use and HIV/HCV risk behavior assessment and treatment among HIV/HCV co-infected Russian women.

Purchase full article at:  http://goo.gl/SntQHM

By:  Brown JL1, DiClemente RJ2,3,4, Sales JM2,3, Rose ES2, Safonova P5, Levina OS6, Belyakov N7, Rassokhin VV5.

• 1Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Suite 104, Cincinnati, OH, 45229, USA. jennifer.brown2@uc.edu.
• 2Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
• 3Centers for AIDS Research, Emory University, Atlanta, GA, USA.
• 4Department of Pediatrics, Division of Infectious Diseases, Epidemiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
• 5St. Petersburg AIDS Center, St. Petersburg, Russia.
• 6Stellit, St. Petersburg, Russia.
• 7North-West Regional Center for Control and Prevention of AIDS, St. Petersburg, Russia. 
• AIDS Behav. 2016 Mar 19.

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Russia's PornHub 2015 Use Review

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Motivators & Barriers to HIV Testing among Street-Based Female Sex Workers in St. Petersburg, Russia

Female sex workers are particularly susceptible to HIV-infection in Russia. However, a dearth of information exists on their utilisation of HIV services. 

A mixed-methods, cross-sectional study was conducted to examine motivators and barriers to HIV testing among street-based sex workers in St. Petersburg, Russia. The health belief model was the theoretical framework for the study. Twenty-nine sex workers participated in in-depth interviews, and 139 sex workers completed interviewer-administered surveys between February and September 2009. 

Barriers to getting an HIV test were fear of learning the results, worrying that other people would think they were sick, and the distance needed to travel to obtain services. Motivators for getting tested were protecting others from infection, wanting to know one's status and getting treatment if diagnosed. Logistic regression analysis demonstrated that knowing people living with HIV and length of time since start of injection drug use were significantly associated with recently getting tested. 

These results are important to consider when developing public health interventions to help female sex workers in Russia learn their HIV status and get linked to care and treatment services if needed.

Purchase full article at:   http://goo.gl/20JLsI

By:   King EJ1, Maman S1, Dudina VI2, Moracco KE1, Bowling JM1.

• 1 Department of Health Behavior , Gillings School of Global Public Health, University of North Carolina-Chapel Hill , Chapel Hill , NC , USA.
• 2 Department of Sociology , St. Petersburg State University , St. Petersburg , Russia. 

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Clients of Street-Based Female Sex Workers & Potential Bridging of HIV/STI in Russia

In Russia, sexual transmission of HIV is increasing and street-based female sex workers (FSW) have a high HIV prevalence, but the role of male clients of FSW in HIV transmission and bridging to the general population has not been studied. 

Sixty-two male clients completed structured interviews during February-March of 2010 in St. Petersburg Russia. Descriptive analyses focused on condom use with different types of sex partners, substance use, and STI/HIV testing histories. 

• The median lifetime and past 12 month numbers of FSW partners were 10 and 3, respectively. 
• A majority of clients (74%) reported having non-FSW partners during the past 12 months, 
• and nearly half (47%) reported having regular sex partners. 
• Consistent condom use was reported in 61% of relationships with FSW partners 
• and in 43% of relationships with non-FSW partners. 
• A majority of clients (58%) was classified as active or potential bridgers based on having both FSW and non-FSW partners and reporting inconsistent condom use with their non-FSW partners. 
• A majority (61%) also reported concurrent partnerships with FSW and non-FSW partners. 
• Nearly half (48%) of last contacts with FSW partners involved consumption of alcohol by the client. 
• Non-injection and injection drug use in the past 30 days were reported by 15% and 7% of clients, respectively. 
• 29% reported history of an STI and 
• 74% reported a previous HIV test; 
• active/potential bridgers were significantly less likely than unlikely bridgers to have ever been tested for HIV. 

These data signal the potential for HIV/STI transmission among male clients of street-based FSW in St. Petersburg Russia due to their variety of partner types, sub-optimal condom use, and concurrent partnerships. Larger studies are needed to confirm these findings, further explore the roles of alcohol and drug use, and identify effective strategies and interventions for HIV prevention.

Below:  Distributions of bridging status^a, concurrency^b, and partner mix^c in the past 12 months (n=62)

^aDefinitions for bridging status variable are as follows: active bridging - reporting inconsistent condom use during vaginal sex with both FSW and non-FSW partners; potential bridging – reporting consistent condom use during vaginal sex with FSW partners and inconsistent condom use during vaginal sex with non-FSW partners; unlikely bridging – reporting consistent condom use during vaginal sex with FSW and non-FSW partners, or consistent condom use during vaginal sex with FSW and not having a non-FSW sex partner. One participant who reported consistent condom use during vaginal sex with non-FSW partner and inconsistent condom use during vaginal sex with FSW was classified as potential bridging. These categories were mutually exclusive. Participants with missing and “don’t know” responses to condom use questions were classified as inconsistent condom users because consistent condom use could not be verified.

^bNot mutually exclusive categories.

^cMutually exclusive categories

  

Full article at:   http://goo.gl/zjOQ5L

By:   Linda M. Niccolai,a,* Veronika A. Odinokova,b Liliya Z. Safiullina,b Zinaida D. Bodanovskaya,b Robert Heimer,a Olga S. Levina,b and Maia M. Rusakovab

^aYale School of Public Health and Center for Interdisciplinary Research on AIDS, 60 College Street, New Haven CT 06520 USA

^bNGO Stellit, 3 Mira Street #207, St. Petersburg 197101 RUSSIA

^*Corresponding author: Linda M. Niccolai, Email: ude.elay@ialoccin.adnil

  

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Non-Fatal Overdoses & Related Risk Factors among People Who Inject Drugs in St. Petersburg, Russia & Kohtla-Järve, Estonia

Background

This study seeks to identify the prevalence of, and risk factors associated with, non-fatal overdose among people currently injecting drugs (PWID) in St. Petersburg (Russia) and in Kohtla-Järve (Estonia).

Methods

Five hundred eighty-eight study participants in Kohtla-Järve (in 2012) and 811 in St. Petersburg (in 2012–2013) were recruited using respondent driven sampling for interviewing and HIV testing.

Results

Three-quarters (76 %) of the current PWID were male. Participants from St. Petersburg were older (mean age 32.1 vs. 29.6 years, p < 0.0001) and reported a longer average duration of injecting drugs (mean duration: 13.3 vs. 10.9 years, p < 0.0001). Main drugs injected were opioids (fentanyl in Kohtla-Järve, heroin in St Petersburg). HIV prevalence was 63 % (95 % CI 59–67 %) in Kohtla-Järve and 56 % (95 % CI 52–59 %) in St. Petersburg. Two thirds of the PWID in Kohtla-Järve and St. Petersburg reported ever having experienced a drug overdose involving loss of consciousness or stopping breathing. In Kohtla-Järve, 28 % (95 % CI 24–31 %) of participants and, in St Petersburg, 16 % (95 % CI 14–19 %) of participants reported an overdose within the previous 12 months. Characteristics of injection drug use practice (longer duration of injection drug use, main drug injected), correlates of high-risk injection behaviour (higher injecting frequency, sharing), and problem alcohol use were associated with the risk of overdose within the previous 12 months. The significant factors effects did not differ between the sites.

Conclusions

PWID are at high risk for overdose. Effective overdose prevention efforts at the public health scale are therefore warranted.

Table 1

Socio-demographic, injection drug use, HIV prevalence and care and environmental characteristics of current injection drug users participating and the prevalence of self-reported non lethal overdose within the last 12 months from cross sectional studies in Kohtla-Järve, Estonia (in 2012) and St Petersburg, Russia (in 2012 – 2013)

	Kohtla-Järve (Estonia), N = 588			St Petersburg (Russia), N = 811
Characteristics	n	%	Overdose last 12 months (%)	n	%	Overdose last 12 months (%)
Socio-demographi indicators
Age			p = 0.134			p = 0.337
29 or less	295	50 %	25 %	245	30 %	18 %
30 or more	293	50 %	30 %	566	70 %	15 %
Gender			p = 0.833			p = 0.423
Male	435	74 %	27 %	631	78 %	16 %
Female	152	26 %	28 %	180	22 %	18 %
Main source of income (last 6 months)			p = 0.239			p = 0.021
Work (full/part time)	192	33 %	23 %	590	73 %	14 %
Social benefits	263	45 %	30 %	22	3 %	14 %
Other	127	22 %	31 %	199	25 %	23 %
Drug use characteristics
Duration of injecting			p < 0.001			p = 0.008
< = 9 years	230	39 %	16 %	170	21 %	9 %
= > 10 years	356	61 %	35 %	640	79 %	18 %
Frequency of injecting (last 4 weeks)			p < 0.001			p < 0.001
< Daily	447	76 %	24 %	524	65 %	11 %
Daily +	139	24 %	40 %	287	35 %	26 %
Main drug injected (last 4 weeks)			p < 0.001			p = 0.116
Amphetamine	195	35 %	14 %	27	3 %	4 %
Fentanyl	350	62 %	34 %	4	0 %	25 %
Heroin	1	0 %		563	69 %	18 %
Methadone	0	0 %		217	27 %	14 %
Injecting multiple drugs (last 4 weeks)			p = 0.124			p = 0.003
No	378	64 %	25 %	495	61 %	8 %
Yes	210	36 %	31 %	316	39 %	21 %
Non-injecting drug use (last 4 weeks)			p = 0.575			p = 0.037
No	324	57 %	27 %	755	93 %	15 %
Yes	246	43 %	29 %	56	7 %	27 %
Sharing (last 4 weeks)			p < 0.001			p < 0.001
No	492	85 %	24 %	277	34 %	7 %
Yes	88	15 %	49 %	534	66 %	21 %
Problem alcohol use			p = 0.009			p < 0.001
No	247	42 %	22 %	275	34 %	8 %
Yes	341	58 %	32 %	536	66 %	21 %
Mental health (MHI 5)			p = 0.003			p < 0.001
> = 52	362	62 %	23 %	536	66 %	13 %
<52	221	38 %	35 %	275	34 %	23 %
Structural (environmental) characteristics
Homelessness (current)			p = 0.619			p = 0.454
No	583	99 %	27 %	798	98 %	16 %
Yes	5	1 %	40 %	13	2 %	14 %
Ever been in prison			p < 0.001			p = 0.368
No	266	45 %	19 %	537	66 %	17 %
Yes	322	55 %	35 %	274	34 %	15 %
Main source of syringes (last 4 weeks)			p = 0.0018			p = 0.0121
Needle and syringe program (NSP)	445	77 %	30 %	119	15 %	11 %
Pharmacy	76	13 %	16 %	615	76 %	19 %
Other	26	5 %	35 %	30	4 %	10 %
None	29	5 %	7 %	46	6 %	4 %
Currently receiving drug treatment			p > 0.9			p = 0.133
No	216	68 %	32 %	563	97 %	18 %
Yes	102	32 %	32 %	19	3 %	32 %
HIV infection and care
HIV infected			p = 0.013			p = 0.021
No	218	37 %	22 %	359	44 %	13 %
Yes	370	63 %	31 %	452	56 %	19 %
Currently on ART			p = 0.342			p = 0.051
No	247	67 %	33 %	403	90 %	20 %
Yes	123	33 %	28 %	47	10 %	9 %

Full article at:   http://goo.gl/3bJM3D

By:   Anneli Uusküla, Mait Raag, Sigrid Vorobjov, Kristi Rüütel, Alexandra Lyubimova, Olga S. Levina, and Robert Heimer

Department of Public Health, University of Tartu, Ravila st 19, 50409 Tartu, Estonia

Infectious Diseases and Drug Monitoring Department, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia

NGO Stellit, St Petersburg, Russian Federation

Department of Epidemiology of Microbial Diseases and the Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, 60 College St, New Haven, CT 06510 USA

Anneli Uusküla, Phone: + 3727374195, Email: ee.tu@aluksuu.ilenna.

Contributor Information.

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