The HIV/AIDS Epidemic among Drug Injectors in Eastern Europe: Patterns, Trends and Determinants

Dehne, Karl L.; Grund, Jean‐Paul C.; Khodakevich, L.; Kobyshcha, Yuri

doi:10.1177/002204269902900402

Cited by 42 publications

(35 citation statements)

References 39 publications

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“…Issues concerning the treatment of drug dependence and its co-morbidities are important in Russia and elsewhere since IDU is a major risk factor for HIV in many parts of the world, particularly in the Russian Federation, where it is synonymous with heroin dependence [1][2][3][4] . Though there is a clear association between drug and alcohol dependence, hepatitis B and C [5] , and TB [6] , the degree to which one or more of these diseases co-occur has not been systematically evaluated in Russia.…”

Section: Co-morbidity Of Infectious Andmentioning

confidence: 99%

Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia

et al. 2005

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The Russian health care system is organized around specific diseases, with relatively little focus on integration across specialties to address co-morbidities. This organizational structure presents new challenges in the context of the recent epidemics of injection drug use (IDU) and HIV. This paper uses existing and new data to examine the prevalence of reported new cases of drug dependence (heroin) and HIV over time as well as associations between drug dependence and alcoholism, hepatitis B and C, and tuberculosis in the City of St. Petersburg and the Leningrad region. We found a sharp rise in reported cases of IDU beginning in 1991 and continuing until 2002/2003, followed by a sharp rise in newly reported cases of HIV. These rises were followed by a drop in new cases of HIV and drug addiction in 2002/2003 and a drop in the proportion of HIV-positve individuals with IDU as a risk factor. Infection with hepatitis B and C were common, especially among injection drug users (38 and 85%, respectively), but also in alcoholics (7 and 14%). Tuberculosis was more common in alcoholics (53%) than in persons with alcoholism and drug dependence (10%), or with drug dependence alone (4%). Though these data have many limitations, they clearly demonstrate that drug dependence and/or alcoholism, HIV, hepatitis, and tuberculosis frequently co-occur in St. Petersburg and the Leningrad Region. Prevention and treatment services across medical specialties should be integrated to address the wide range of issues that are associated with these co-morbidities.

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Section: Co-morbidity Of Infectious Andmentioning

confidence: 99%

Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia

et al. 2005

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“…With the withdrawal of the Soviet Union in December 1991, police controls became ineffective, drugs more readily available, and corruption uncontrolled (Hamers and Downs 2003;Dehne et al 1999;Atlani et al 2000). Locally produced opiates and amphetamines proliferated (Rhodes et al 1999;UNIDCP 1997) as did the number of substance users.…”

Section: Introductionmentioning

confidence: 99%

Stimulant Injectors in Ukraine: The Next Wave of the Epidemic?

et al. 2008

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This study was designed to assess differences in drug and sex-related risk behaviors between injectors of opiates only, opiate/sedative mix only and stimulants only. Participants were current out-of-treatment injection drug users (IDUs), unaware of their HIV status, recruited through street outreach in Kiev, Odessa and Makeevka/Donetsk, Ukraine. Overall, 22% tested positive for HIV, including 39% among opiate/sedative injectors, 19% among opiate injectors and 17% among stimulant injectors. Despite these differences, stimulant injectors were at higher risk than other IDUs in sharing a used needle/syringe, always injecting with others, injecting a drug solution drawn from a common container, having an IDU sex partner, not using condoms during vaginal or anal sex and on composite measures of injection and sex risks. After controlling for age differences, stimulant injectors remained at higher risk in their needle and sex risk behaviors. Without intervention, it is likely that HIV will increase among stimulant injectors.

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“…Relaxation of law enforcement control over obtaining and using hard drugs, wider availability of drugs, as well as the creation of drug trafficking networks have all contributed to the emerging IDU problem in Russia (Atlani et al, 2000;Dehne et al, 1999;Latyshev and Rechnov, 1998). Slavic fatalism (i.e., not having personal control over how one's life unfolds) may also be a factor, especially among young, unemployed, male IDUs who share needles and/or equipment (Daniszewski, 2002).…”

Section: Introductionmentioning

confidence: 99%

Demographic Characteristics, Treatment History, Drug Risk Behaviors, and Condom Use Attitudes for U.S. and Russian Injection Drug Users: The Need for Targeted Sexual Risk Behavior Interventions

et al. 2005

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Two separate databases, one on Russian (n = 444) injection drug users (IDUs), and the other on U.S. IDUs (n = 241), were merged, and responses were compared. Results indicated that Russian IDUs perceived themselves to be at greater risk for HIV/AIDS based upon behaviors over the past 90 days. U.S. IDUs were more likely to be tested for HIV, report a negative HIV result, and know more people with HIV. U.S. IDUs consumed greater amounts of alcohol and marijuana, and made more alcohol/drug treatment attempts than Russian IDUs. Russian IDUs injected more frequently, although were more likely to recently use clean needles. Russian and U.S. IDUs responded significantly differently to eight AIDS knowledge questions. Eight condom attitude questions were asked of each group, and each revealed significantly different responses. Gender differences for Russian IDUs were also observed. There is a clear need to create culturally targeted sexual risk reduction interventions.

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The HIV/AIDS Epidemic among Drug Injectors in Eastern Europe: Patterns, Trends and Determinants

Cited by 42 publications

References 39 publications

Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia

Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia

Stimulant Injectors in Ukraine: The Next Wave of the Epidemic?

Demographic Characteristics, Treatment History, Drug Risk Behaviors, and Condom Use Attitudes for U.S. and Russian Injection Drug Users: The Need for Targeted Sexual Risk Behavior Interventions

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