Sexually Transmitted Infections, Sexual Risk Behaviors and the Risk of Heterosexual Spread of HIV among and beyond IDUs in St. Petersburg, Russia

Abstract

Aims: This study investigates whether sexual transmitted behaviors and infections (STIs) among injection drug users (IDUs) may promote the spread of HIV among and beyond IDUs in Russia. Methods: We conducted a cross-sectional survey of behavior and tested for STIs in a convenience sample of 159 IDUs in St. Petersburg, Russia. Results: The median age was 27 and 57% were male. Almost all were sexually active, half had casual partners and 40% reported ≧2 sex partners in the previous 3 months. Of those who answered, 81% reported sex without condoms, 44% reported having sex with at least one partner who was not an IDU. Of 139 (87%) subjects who were actively injecting, 29% reported receptive syringe sharing. Twenty percent of subjects were seropositive for HIV-1 and 42% of HIV-1-negative subjects tested positive for an STI. Conclusions: The sample exhibited high levels of sexual risk behaviors and STIs, and a large proportion had sexual partners who were not IDUs. This population requires comprehensive interventions that ensures access to condoms and sterile injection supplies and that encourage safer sexual behaviors in an attempt to keep sexual transmission of HIV low.

Prevalence and Correlates of Sexual Risk Behaviors Among Drug Users in Western China: Implications for HIV Transmission

“…In Atlanta, Georgia, drug users exhibited high levels of sexual risk behaviors; 61% of drug-using men had two or more female partners in the preceding 3 months and 51% did not use a condom when they last had intercourse. 11 In Italy, Russia, and Uzbekistan, drug users were found to have multiple sex partners in the preceding months, [13][14][15] and most of them reported having sex without condoms. 14 In India and Vietnam (Asia) and in Kenya (Africa), drug users were more likely to have multiple sex partners compared with nondrug users 12,16,17 and were more likely to visit commercial sex workers 12 in the past year.…”

Estonia at the Threshold of the Fourth Decade of the AIDS Era in Europe

“…1,71,72 A high prevalence of HIV among IDUs and high sexual risk behavior among both IDUs and the general population can create a bridge for expansion of the epidemic via those who have unprotected sexual contacts with HIVpositive IDUs. 3,35,[72][73][74] Studies in several Eastern European countries have described IDUs as sexually active with a variety of primary, casual, and commercial sex partners, both injecting and noninjecting. 41,73,75,76 Although IDUs may be engaged in providing sex for money or drugs, the noninjecting primary sexual partners of IDUs appear to be particularly vulnerable to HIV infection due to higher frequency of unprotected vaginal and anal sex in these relationships, compared with other types of partnerships.…”

“…3,35,[72][73][74] Studies in several Eastern European countries have described IDUs as sexually active with a variety of primary, casual, and commercial sex partners, both injecting and noninjecting. 41,73,75,76 Although IDUs may be engaged in providing sex for money or drugs, the noninjecting primary sexual partners of IDUs appear to be particularly vulnerable to HIV infection due to higher frequency of unprotected vaginal and anal sex in these relationships, compared with other types of partnerships. 36,73 IDUs and their primary partners may constitute a sexual network not closely connected to the general population.…”

“…41,73,75,76 Although IDUs may be engaged in providing sex for money or drugs, the noninjecting primary sexual partners of IDUs appear to be particularly vulnerable to HIV infection due to higher frequency of unprotected vaginal and anal sex in these relationships, compared with other types of partnerships. 36,73 IDUs and their primary partners may constitute a sexual network not closely connected to the general population. In a study conducted in Estonia in 2007, recruiting IDUs and their main noninjecting sexual partners, 20% of the non-IDU primary sexual partners of IDUs reported having had casual partner(s) during the preceding 6 months, and, importantly, 57% of their casual partners were also IDUs.…”

HIV Prevention Interventions for Female Sexual Partners of Injection Drug Users in Hanoi, Vietnam: 24-Month Evaluation Results

“…Studies from Vietnam [3,[5][6][7], Thailand [8], China [9,10], South Asia [11], Indonesia [12], Russia [13], and the U.S. [8,14,15] reveal low rates of condom use by IDUs with their primary sexual partners, especially their wives and regular girlfriends. Most of this literature does not address the very serious dimension of HIV serodiscordance in primary sexual relationships.…”