HIV/AIDS in Russia: determinants of regional prevalence

Moran, Dominique; Jordaan, Jacob A.

doi:10.1186/1476-072x-6-22

Cited by 18 publications

(16 citation statements)

References 19 publications

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“…Several studies have examined the socioeconomic factors associated with HIV prevalence and injecting drug use in Russia. Moran et al investigated the relative importance of several variables in influencing HIV prevalence in a cross-sectional study based solely on Russian federal government statistics [ 78 ]. The authors found urbanization, mobility, crime, and income growth associated with HIV prevalence.…”

Section: Methodsmentioning

confidence: 99%

Internet Search Patterns of Human Immunodeficiency Virus and the Digital Divide in the Russian Federation: Infoveillance Study

Zheluk¹,

Quinn²,

Hercz³

et al. 2013

J Med Internet Res

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BackgroundHuman immunodeficiency virus (HIV) is a serious health problem in the Russian Federation. However, the true scale of HIV in Russia has long been the subject of considerable debate. Using digital surveillance to monitor diseases has become increasingly popular in high income countries. But Internet users may not be representative of overall populations, and the characteristics of the Internet-using population cannot be directly ascertained from search pattern data. This exploratory infoveillance study examined if Internet search patterns can be used for disease surveillance in a large middle-income country with a dispersed population.ObjectiveThis study had two main objectives: (1) to validate Internet search patterns against national HIV prevalence data, and (2) to investigate the relationship between search patterns and the determinants of Internet access.MethodsWe first assessed whether online surveillance is a valid and reliable method for monitoring HIV in the Russian Federation. Yandex and Google both provided tools to study search patterns in the Russian Federation. We evaluated the relationship between both Yandex and Google aggregated search patterns and HIV prevalence in 2011 at national and regional tiers. Second, we analyzed the determinants of Internet access to determine the extent to which they explained regional variations in searches for the Russian terms for “HIV” and “AIDS”. We sought to extend understanding of the characteristics of Internet searching populations by data matching the determinants of Internet access (age, education, income, broadband access price, and urbanization ratios) and searches for the term “HIV” using principal component analysis (PCA).ResultsWe found generally strong correlations between HIV prevalence and searches for the terms “HIV” and “AIDS”. National correlations for Yandex searches for “HIV” were very strongly correlated with HIV prevalence (Spearman rank-order coefficient [rs]=.881, P≤.001) and strongly correlated for “AIDS” (rs=.714, P≤.001). The strength of correlations varied across Russian regions. National correlations in Google for the term “HIV” (rs=.672, P=.004) and “AIDS” (rs=.584, P≤.001) were weaker than for Yandex. Second, we examined the relationship between the determinants of Internet access and search patterns for the term “HIV” across Russia using PCA. At the national level, we found Principal Component 1 loadings, including age (-0.56), HIV search (-0.533), and education (-0.479) contributed 32% of the variance. Principal Component 2 contributed 22% of national variance (income, -0.652 and broadband price, -0.460).ConclusionsThis study contributes to the methodological literature on search patterns in public health. Based on our preliminary research, we suggest that PCA may be used to evaluate the relationship between the determinants of Internet access and searches for health problems beyond high-income countries. We believe it is in middle-income countries that search methods can make the greatest contribution to public health.

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Section: Methodsmentioning

confidence: 99%

Internet Search Patterns of Human Immunodeficiency Virus and the Digital Divide in the Russian Federation: Infoveillance Study

Zheluk¹,

Quinn²,

Hercz³

et al. 2013

J Med Internet Res

View full text Add to dashboard Cite

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“…Integrating multiple-level influences requires methods that capture the processes that take place between distal and proximal antecedents of HIV-related behaviors and translate them into meaningful predictions. Observations of the trajectory of the AIDS epidemic and between-region comparisons have helped to identify the impact of several structural factors on the course of the HIV epidemic (e.g., increases in HIV prevalence during war [61] or higher HIV prevalence associated with income inequality [62, 63]). Prospective studies following structural changes could further discover how different levels of factors respond to new structural configurations.…”

Section: Discussionmentioning

confidence: 99%

Modeling Structural, Dyadic, and Individual Factors: The Inclusion and Exclusion Model of HIV Related Behavior

2010

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Changing HIV-related behaviors requires addressing the individual, dyadic, and structural influences that shape them. This supplement of AIDS & Behavior presents frameworks that integrate these three influences on behavior. Concepts from these frameworks were selected to model the processes by which structural factors affect individual HIV-related behavior. In the Inclusion/Exclusion Model, material and symbolic inclusions and exclusions (sharing versus denying resources) regulate individuals’ ability and motivation to detect, prevent, and treat HIV. Structural interventions create inclusions that increase one’s ability or motivation to perform these behaviors or exclusions that hinder one’s ability or motivation to execute counterproductive behaviors. The need to expand research regarding multilevel influences on HIV-related behavior is also discussed, particularly concerning further understanding of sustained behavior change and effective dissemination of evidence-based intervention strategies.

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“…While this paper has discussed some of the societal and attitudinal challenges that will need to be addressed when expanding HIV programmes in the former Soviet Union, it is important to remember that the factors that contributed to the spread of HIV in the region include the large-scale social and economic changes associated with transition (38), as well as the rapid diffusion of injecting drug use (19). Furthermore, it is worth noting that there are substantial differences across and within the different countries of this part of Europe.…”

Section: Discussionmentioning

confidence: 99%

HIV/AIDS in the Countries of the Former Soviet Union: Societal and Attitudinal Challenges

Rechel¹

2010

Cent Eur J Public Health

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For several years, some of the countries of the former Soviet Union have experienced the fastest growing HIV epidemic in the world, with the vast majority of reported infections contracted through injecting drug use. However, most governments of the region have been slow to recognize the severity of the problem. The scope and coverage of governmental HIV/AIDS programmes have remained very limited. Harm reduction programmes are mainly financed by external donors, while substitution treatment remains illegal in Russia and unavailable in some other countries of the region. Being based on a review of published and grey literature, this paper explores attitudinal and societal barriers to scaling up HIV programmes in the countries of the former Soviet Union. A major challenge in many countries is negative public attitudes towards people living with HIV, as well as towards those most at risk of contracting the disease: injecting drug users, sex workers, and men who have sex with men. This extends to the actions of state authorities which often pursue a punitive approach to drug users, with high rates of incarceration for minor drug offences. While many of the findings reported here relate to the Russian Federation, there is reason to believe that similar challenges exist in many other countries of the former Soviet Union. More needs to be done to document challenges to HIV prevention and treatment programmes across the region, so that policy interventions can be more effective.

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HIV/AIDS in Russia: determinants of regional prevalence

Cited by 18 publications

References 19 publications

Internet Search Patterns of Human Immunodeficiency Virus and the Digital Divide in the Russian Federation: Infoveillance Study

Internet Search Patterns of Human Immunodeficiency Virus and the Digital Divide in the Russian Federation: Infoveillance Study

Modeling Structural, Dyadic, and Individual Factors: The Inclusion and Exclusion Model of HIV Related Behavior

HIV/AIDS in the Countries of the Former Soviet Union: Societal and Attitudinal Challenges

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