Injecting Equipment Sharing Among Injecting Drug Users in Togliatti City, Russian Federation

Rhodes, Tim; Judd, Ali; Mikhailova, Larissa; Sarang, Anya; Khutorskoy, Mikhail; Platt, Lucy; Lowndes, Catherine M; Renton, Adrian

doi:10.1097/00126334-200403010-00011

Cited by 44 publications

(32 citation statements)

References 33 publications

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“…Disclosure and secondary prevention are rare among IDUs in some Eastern European countries (Booth et al 2004;Gore-Felton et al 2003;Amirkhanian et al 2003;Rhodes et al 2004b). In this study, we found strong disclosure and secondary prevention norms for HIV, HBV and HCV.…”

Section: Discussionsupporting

confidence: 48%

“…Hungarian IDUs' perception of risk and their injecting and sex risk behaviors are based on trust and on personal risk assessment: equipment sharing "never" occurs -except with few close and trusted friends (Rhodes et al 2004a), and condoms are rarely used in their monogamous sexual relationships. In Russia and the Ukraine, even though many IDUs perceive their infection risk as low, they often have high-risk injecting and sex behaviors and networks: they commonly share syringes, even with people whom they do not know well (Abdala et al 2003;Booth et al 2004;Amirkhanian et al 2003;Rhodes et al 2004b), and they have large numbers of sex partners and concurrent partners (Hamers and Downs, 2003). However, sharing spoons and filters was common and viewed as less risky among participants of this study (Huo et al 2005;Millson et al 2003).…”

Section: Discussionmentioning

confidence: 70%

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Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Gyarmathy

Neaigus

Újhelyi

et al. 2006

Drug and Alcohol Dependence

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Ethnographic interviews and focus groups were conducted (05/2003-01/2004) among injecting drug users (IDUs; n=29) in Budapest, Hungary to assess HIV, Hepatitis B and C (HBV and HCV) related knowledge, norms, attitudes and behaviors. Participants perceived themselves at low risk for infection with HIV but high risk for hepatitis through injection but not sexual exposure. They reported strong disclosure norms for HIV and hepatitis infections, while sexual and injecting risk behaviors were influenced by trust about partners' self-report of infection status. Injecting networks were small, with infrequent syringe sharing among a few close friends. Cookers and drug filters were often shared, and filters were re-used as a backup drug supply. Most sexual relationships were monogamous, where condoms were rarely used. Although participant norms supported HIV/HBV/HCV testing, the lack of available testing facilities was a barrier to getting tested. Strong norms for infection disclosure and for getting tested coexist with engaging in risk behaviors with injecting and sex partners who are close friends. Network interventions among IDUs in Hungary should build on disclosure norms and trust to reduce injecting and sex risk. Testing services should be expanded and access increased so that IDUs can act on and reinforce their norms for testing.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 70%

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Gyarmathy

Neaigus

Újhelyi

et al. 2006

Drug and Alcohol Dependence

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“…This seems to differ from sex partner turnover among young IDUs found by some studies in the US and in Russia, where some young IDUs have more frequent turnover and/or concurrent partnerships in their sexual networks than do the young IDUs in Budapest that are reported on here. [20][21][22][23][24][25][26] We found the difference in how and why SI-IDUs and M-IDUs stop using drugs noteworthy, especially the role of being in drug treatment and incarceration among M-IDUs. 27 M-IDUs reported stopping injecting when in prison, which is consistent with our previous work among Hungarian inmates indicating little drug use and/or drug injecting in Hungarian prisons.…”

Section: Discussionmentioning

confidence: 79%

Marginalized and Socially Integrated Groups of IDUs in Hungary: Potential Bridges of HIV Infection

Gyarmathy

Neaigus

2005

Journal of Urban Health: Bulletin of the New York Academy of Me

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The discrepancy in HIV rates among Eastern and Central European injecting drug users (IDUs) suggests that, in addition to risk behaviors, social contact patterns also play an important role. We identify two groups of IDUs in Budapest, Hungary, marginalized IDUs (M-IDUs) and socially integrated IDUs (SI-IDUs), and compare their HIV/HBV/HCV social and risk network characteristics, risk behaviors, and travel patterns. Between 05/2003 and 01/2004, 29 non-treatmentrecruited young IDUs in Budapest participated in ethnographic interviews and focus groups. The mean age was 23.6 years (SD=3.6); eight were female and two Roma/Gypsy. Most injected heroin (n=23) and/or amphetamines (n=10) in the past 30 days. M-IDUs had no legal employment, injected heroin and sniffed glue, and stopped using drugs in treatment/prison. SI-IDUs had regular jobs or were students, injected heroin and sniffed cocaine, and stopped using drugs before exams/tests. Both M-IDUs and SI-IDUs shared injecting equipment on occasion and used condoms rarely. M-IDUs had a large social network of "buddies" and a small risk network of "friends". SI-IDUs had two separate large social networks of "buddies": a M-IDU and a non-IDU network; and a small risk network of "friends". Both groups reported monogamous sexual relationships. M-IDUs traveled within Hungary whereas SI-IDUs traveled to Western Europe. If an HIV epidemic among IDUs in Hungary is not prevented, SI-IDUs may form a potential "bridge" of HIV infection between highrisk IDU populations and the low-risk, general population, while M-IDUs may become cores of infection. Different approaches may be appropriate for M-IDUs and SI-IDUs to prevent HIV.

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“…In summary, current research indicates that IDUs and risky drinkers in Russia are experiencing notable rates of HIV/STI and report notable HIV risks, including multiple partners, sex trade involvement and unprotected sex (Benotsch et al 2004;Krupitsky et al 2004;Platt et al 2005;Rhodes et al 2004;Somlai et al 2002;Takacs et al 2006;Karapetyan et al 2002). Such research has not, however, examined associations between HIV/STI risk histories and condom use.…”

Section: Sexual Transmission Of Hiv Infection Within Russia Is Assumementioning

confidence: 92%

“…Studies with IDUs recruited from urban centers within Russia have found that the majority reports recent sexual activity, multiple partners and non-condom use, particularly with steady sex partners (Rhodes et al 2004;Somlai et al 2002;Takacs et al 2006). The epidemic has been propelled even further via the link between injection drug use and sex work, particularly for female IDUs.…”

Section: Sexual Transmission Of Hiv Infection Within Russia Is Assumementioning

confidence: 99%

Correlates of Any Condom Use Among Russian Narcology Patients Reporting Recent Unprotected Sex

et al. 2008

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The purpose of this study was to assess whether HIV/sexually transmitted infection (STI) risk factors: risky sex (multiple sex partners and sex trade involvement), past HIV or STI diagnosis and substance use (at risk drinking and injection drug use) are associated with the outcome any condom use in the past 6 months among Russian narcology hospital patients. Participants (N = 178) included only those who reported unprotected sex in the past 6 months and were aged 18-55 years and 76% male. Any condom use in the past 6 months was reported by 55% of the sample. History of STIs was reported by 43% of participants; 15% were HIV-infected. Regression analyses adjusted for demographics demonstrated that those reporting multiple sex partners (OR adj = 4.2, 95% CI = 2.0-8.7) and sex trade involvement (OR adj = 2.4, 95% CI = 1.1-5.1) in the past 6 months had significantly higher odds of reporting any condom use in this same timeframe. HIV/STI and substance use were not associated with increased odds of condom use.

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Injecting Equipment Sharing Among Injecting Drug Users in Togliatti City, Russian Federation

Abstract: Findings highlight the delicate balance in HIV prevention between potentially competing strategies of law enforcement and syringe distribution.

Cited by 44 publications

References 33 publications

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Marginalized and Socially Integrated Groups of IDUs in Hungary: Potential Bridges of HIV Infection

Correlates of Any Condom Use Among Russian Narcology Patients Reporting Recent Unprotected Sex

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