Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia Public Deposited

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Creator
  • Kozlov, Andrei P
    • Other Affiliation: The Biomedical Center, St. Petersburg, Russia
  • Heimer, Robert
    • Other Affiliation: Department of Epidemiology & Public Health and the Center for Interdisciplinary Research on AIDS, Yale School of Public Health, PO Box 208034, 60 College Street New Haven, CT 06520-8034 USA; The Biomedical Center, St. Petersburg, Russia
  • Kruse, Gina
    • Other Affiliation: Baylor College of Medicine, Houston, TX, USA; Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
  • Hoffman, Irving
    • Affiliation: School of Medicine, Division of Infectious Diseases, Department of Medicine
  • Shaboltas, Alla V
    • Other Affiliation: The Biomedical Center, St. Petersburg, Russia; Faculty of Psychology, St. Petersburg State University, St. Petersburg, Russia
  • Barbour, Russell
    • Other Affiliation: Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
  • Toussova, Olga V
    • Other Affiliation: The Biomedical Center, St. Petersburg, Russia
Abstract
  • Abstract Background The HIV epidemic in Russia has been driven by the unsafe injection of drugs, predominantly heroin and the ephedrine derived psychostimulants. Understanding differences in HIV risk behaviors among injectors associated with different substances has important implications for prevention programs. Methods We examined behaviors associated with HIV risk among 900 IDUs who inject heroin, psychostimulants, or multiple substances in 2002. Study participants completed screening questionnaires that provided data on sociodemographics, drug use, place of residence and injection- and sex-related HIV risk behaviors. HIV testing was performed and prevalence was modeled using general estimating equation (GEE) analysis. Individuals were clustered by neighborhood and disaggregated into three drug use categories: Heroin Only Users, Stimulant Only Users, and Mixed Drug Users. Results Among Heroin Only Users, younger age, front/backloading of syringes, sharing cotton and cookers were all significant predictors of HIV infection. In contrast, sharing needles and rinse water were significant among the Stimulant Only Users. The Mixed Drug Use group was similar to the Heroin Only Users with age, front/back loading, and sharing cotton significantly associated with HIV infection. These differences became apparent only when neighborhood of residence was included in models run using GEE. Conclusion The type of drug injected was associated with distinct behavioral risks. Risks specific to Stimulant Only Users appeared related to direct syringe sharing. The risks specific to the other two groups are common to the process of sharing drugs in preparation to injecting. Across the board, IDUs could profit from prevention education that emphasizes both access to clean syringes and preparing and apportioning drug with these clean syringes. However, attention to neighborhood differences might improve the intervention impact for injectors who favor different drugs.
Date of publication
Identifier
  • doi:10.1186/1477-7517-6-22
  • 19646255
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Gina Kruse et al.; licensee BioMed Central Ltd.
License
Journal title
  • Harm Reduction Journal
Journal volume
  • 6
Journal issue
  • 1
Page start
  • 22
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1477-7517
Bibliographic citation
  • Harm Reduction Journal. 2009 Jul 31;6(1):22
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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