HIV incidence and factors associated with HIV acquisition among injection drug users in St Petersburg, Russia

Kozlov, Andrei P.; Шаболтас, Алла Вадимовна; Toussova, Olga; Verevochkin, Sergei V.; Mâsse, Benoît; Perdue, Tom; Beauchamp, Geetha; Sheldon, Wayne; Miller, William C.; Heimer, R.; Ryder, Robert W.; Hoffman, Irving

doi:10.1097/01.aids.0000218555.36661.9c

Cited by 97 publications

(98 citation statements)

References 9 publications

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“…13 Our finding that IDUs practicing higher injection-related risk behavior are more likely to be practicing higher sexual risk behavior is consistent with other research findings. [14][15][16][17][18][19] There is some evidence from other studies in line with our results that those injecting buprenorphine might have lower HIV-related risky injection practices.…”

Section: Discussionsupporting

confidence: 92%

Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

Chikovani

Božičević²,

Goguadze

et al. 2011

J Urban Health

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Injection drug users (IDUs) are at risk for acquiring human immunodeficiency virus (HIV) through parenteral and sexual transmission. In this paper, we describe the prevalence and correlates of unsafe drug injecting and sexual behaviors among IDUs recruited across five cities in Georgia in 2009. IDUs were administered a questionnaire collecting information on demographics, drug use, sexual behaviors, and HIV testing behaviors. Correlates of risky injecting and sexual behaviors were determined using logistic regression. Of 1,127 IDUs, the majority (98.7%) were men, and the median duration of injecting drugs was 7 years. Unsafe injecting behavior at last injection was reported by 51.9% of IDUs, while 16.8% reported both unsafe injecting behavior and not using condoms with last occasional and/or commercial partner. In the multivariate analysis, independent correlates of unsafe injecting behavior at last injection were types of drugs injected [p=0.0096; (for ephedrine, adjusted odds ratio (aOR)=7.38; 95% CI, 1.50-36.26)] and not using condoms at last commercial sex (aOR =2.29, 1.22-4.32). The following variables were significantly associated with unsafe injecting behavior at last injection and not using condoms at last sex with commercial and/or occasional partners in the multivariate analysis: marital status [p = 0.0002; (for divorced, widowed, and separated aOR =2.62, 1.62-4.25; for single aOR =1.61, 1.08-2.39)], being a member of a regular injecting group (aOR=0.62, 0.44-0.88), types of drugs injected in the past month [p =0.0024; (for buprenorphine aOR =0.34, 0.18-0.63)], city of residence (p=0.0083), and not receiving information on HIV (aOR=1.82, 1.07-3.09). Though only ephedrine was injected by a smaller number of IDUs (9.1%), the vast majority of these (81.4%) reported unsafe injecting practices at last injection. High prevalence of unsafe injecting behaviors and diverse and at-risk sexual partnerships highlight the need to implement complex and targeted HIV interventions among IDUs in Georgia.

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Section: Discussionsupporting

confidence: 92%

Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

Chikovani

Božičević²,

Goguadze

et al. 2011

J Urban Health

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“…Social and economic factors (including high youth unemployment, a boom in drug trafficking, and the growth of informal economies) associated with the disintegration of the former Soviet Union have fuelled rampant injecting drug use in the Russian Federation (Rhodes et al, 2006). A study in St Petersburg, for example, has found that almost two thirds (62%) of drug users are un-or underemployed (Kozlov et al, 2006).…”

Section: E a S T E R N E U R O P E A N D C E N T R A L A S Imentioning

confidence: 99%

“…Up to two thirds of the injecting drug users testing HIV-positive in such studies were unaware that they had been infected (Rhodes et al, 2006). More recently, in St Petersburg, HIV incidence of 5% was found among injecting drug users, the majority of whom (79%) reported using non-sterile equipment (Kozlov et al, 2006). In some cities of Russia, more harm reduction projects are now in operation, but they are too few in number and too small in scale to significantly affect overall HIV trends.…”

Section: E a S T E R N E U R O P E A N D C E N T R A L A S Imentioning

confidence: 99%

“…In some cities, notably St Petersburg, there is a strong association between injecting drug use and sex work: one in three female injecting drug users there have reported selling sex for money or drugs (Kozlov et al, 2006). Meanwhile, the very high HIV prevalence found among sex workers in that city (48%) is largely due to the fact that the majority of sex workers also inject drugs and therefore potentially also use non-sterile equipment for injection .…”

Section: E a S T E R N E U R O P E A N D C E N T R A L A S Imentioning

confidence: 99%

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Grand challenges in chronic non-communicable diseases

Daar

Сингер

Persad

et al. 2007

Nature

557

379

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“…In addition, among HIV infected women who have never injected drugs, almost half have had sex with an IDU [5]. HIV prevalence and incidence rates among IDU in St. Petersburg have been consistently high, with a 30% prevalence and an incidence of 4.5 per 100 person-years in 2003 [6,7], 14 per 100 person-years incidence in 2008 [8], and 35% prevalence and 7.2 per 100 person-years incidence in 2010 [9].…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of an Intensive Case Management Program for Injection Drug Users on Antiretroviral Therapy in St. Petersburg, Russia

et al. 2014

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Background: The majority of HIV-infected individuals requiring antiretroviral therapy (ART) in Russia are Injection Drug Users (IDU). Substitution therapy used as part of a comprehensive harm reduction program is unavailable in Russia. Past data shows that only 16% of IDU receiving substance abuse treatment completed the course without relapse, and only 40% of IDU on ART remained on treatment at 6 months. Our goal was to determine if it was feasible to improve these historic outcomes by adding intensive case management (ICM) to the substance abuse and ART treatment programs for IDU. Methods: IDU starting ART and able to involve a "supporter" who would assist in their treatment plan were enrolled. ICM included opiate detoxification, bi-monthly contact and counseling with the case, weekly group sessions, monthly contact with the "supporter" and home visits as needed. Full follow-up (FFU) was 8 months. Stata v10 (College Station, TX) was used for all analysis. Descriptive statistics were calculated for all baseline demographic variables, baseline and follow-up CD4 count, and viral load. Median baseline and follow-up CD4 counts and RNA levels were compared using the Kruskal-Wallis test. The proportion of participants with RNA < 1000 copies mL at baseline and follow-up was compared using Fisher's Exact test. McNemar's test for paired proportions was used to compare the change in proportion of participants with RNA < 1000 copies mL from baseline to follow-up.

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HIV incidence and factors associated with HIV acquisition among injection drug users in St Petersburg, Russia

Abstract: The high incidence of HIV infection places St Petersburg among the worst IDU-concentrated epidemics in Europe. Interventions targeting psychostimulant and heroin users and their accompanying behaviors such as frequent injections and increased sexual activity are needed immediately.

Cited by 97 publications

References 9 publications

Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

Grand challenges in chronic non-communicable diseases

The Feasibility of an Intensive Case Management Program for Injection Drug Users on Antiretroviral Therapy in St. Petersburg, Russia

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