The Potential for Bridging of HIV Transmission in the Russian Federation: Sex Risk Behaviors and HIV Prevalence among Drug Users (DUs) and their Non-DU Sex Partners

The HIV epidemic that began in Russia in the mid-1990s has been concentrated mostly among drug users (DUs). Recent evidence of increasing HIV cases among non-DUs attributed to sexual behavior raises potential concern about a more generalized epidemic. The purpose of this analysis is to examine the p...

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Bibliographic Details
Published in:Journal of urban health 2009-07, Vol.86 (Suppl 1), p.131-143
Main Authors: Niccolai, Linda M., Shcherbakova, Irina S., Toussova, Olga V., Kozlov, Andrei P., Heimer, Robert
Format: Article
Language:English
Subjects:
Adult
Disease transmission
Drug abuse
Epidemics
Epidemiology
Female
Health Informatics
HIV
HIV Infections - epidemiology
HIV Infections - transmission
Homelessness
Human immunodeficiency virus
Humans
Interviews as Topic
Male
Medicine
Medicine & Public Health
Public Health
Risk taking
Russia - epidemiology
Sexual Behavior
Sexually transmitted diseases
STD
Studies
Substance-Related Disorders
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Summary:The HIV epidemic that began in Russia in the mid-1990s has been concentrated mostly among drug users (DUs). Recent evidence of increasing HIV cases among non-DUs attributed to sexual behavior raises potential concern about a more generalized epidemic. The purpose of this analysis is to examine the potential for HIV transmission from DUs to their non-DU sex partners. Analyses are conducted using data collected during 2005–2008 in St. Petersburg, Russia. A total of 631 DUs were recruited into the sample with an HIV prevalence of 45%. A majority (84%) of DUs reported being sexually active in the past 6 months, and the DU status of their sex partners was reported as follows: 54% DU, 40% non-DU, and 6% unknown DU status. In 41% of partnerships with an HIV-negative or unknown status partner not known to be DU (potential bridging partnerships), the last reported intercourse was unprotected. Female DUs with potential bridging partnerships were more likely than male DUs to be younger and report homelessness and to have multiple or new sex partners. Many non-DU sex partners of DUs enrolled in the study reported new sex partners in the past 6 months (66%), unprotected intercourse at last sex (60%), and multiple sex partners in the past 6 months (48%). HIV prevalence in this group was 15% (eight out of 53). The high prevalence of HIV among DUs, their sexual contact with non-DUs, and the high-risk sexual behaviors of this potential bridging population together indicate the real potential for an increasingly generalized epidemic. The degree to which there will be further transmission from non-DU sex partners of DUs who exhibit high levels of sex risk behaviors to other non-DU sex partners deserves further study.
ISSN:1099-3460
1468-2869
DOI:10.1007/s11524-009-9369-0