Abstract
The epidemic of HIV in St. Petersburg, which is currently concentrated among injection drug users (IDUs), may be penetrating into the general population. Non-IDUs who have IDU sex partners (SP) could be potential bridges in an expanding epidemic. To investigate potential bridges, we accrued a convenience sample of 288 non-IDUs whose HIV diagnosis was attributed to sexual transmission and we determined the proportion that had IDUs among their SP. Having IDU SP ever (lifetime) and IDU SP in the last year were the key variables for the analysis of potential bridges in this study. The interaction of gender and age was found to be a significant predictor of having lifetime IDU SP (p = 0.006, χ 2 test) and IDU SP in the last year (p = 0.05, χ 2 test): females aged 26 and younger were more likely to have both lifetime IDU SP and IDU SP in the last year. Among the group of young females, 46% reported ever having an IDU SP. Out of young women reporting ever having an IDU SP, 85% also reported at least one lifetime non-IDU SP. Among the females aged 26 or younger, a lower level of education (odds ratio [OR] = 2.7, confidence interval [CI] = 1.1–6.7), being born in St. Petersburg (OR = 2.9, CI = 1.2–7.2), and alcohol use in the last 30 days (OR = 3.5, CI = 1.3–9.6) were significant correlates for ever having had an IDU SP. Urgent efforts are necessary to expand HIV prevention to target the potential bridging population to prevent further transmission.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dehne KL, Khodakevich L, Hamers FF, Schwartländer B. The HIV/AIDS epidemic in eastern Europe: recent patterns and trends and their implications for policy-making. AIDS. 1999; 13(7): 741–749 Review.
Kozlov AP, Shaboltas AV, Toussova OV, et al. HIV incidence and factors associated with HIV acquisition among injection drug users in St. Petersburg, Russia. AIDS. 2006; 20: 901–906.
Lowndes CM, Renton A, Alary M, Rhodes T, Garnett G, Stimson G. Conditions for widespread heterosexual spread of HIV in the Russian Federation: implications for research, monitoring and prevention. Int J Drug Pol. 2003; 14: 45–62.
Rhodes T, Stimson GV, Crofts N, Ball A, Dehne K, Khodakevich L. Drug injecting, rapid HIV spread, and the ‘risk environment’: implications for assessment and response. AIDS. 1999; 13(Suppl A): S259–S269.
Rhodes T, Platt L, Maximova S, et al. Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study. Addiction. 2006; 101(2): 252–266.
Zholobov VE, Dvorak SI, Uliukin IM, Vinogradova EN, Volkova GV, Tiusova OV. Current features of HIV-infection in St. Petersburg. Zh Mikrobiol Epidemiol Immunobiol. 2008; 3: 79–81.
Smolskaia TT, Tretiakova V, Ostrovski DV, Suvorova SV, Ogurtcova S. Three years of experience on HIV control in St. Petersburg among IDUs. XIV International Conference on AIDS. Barcelona, July 2002 [abstract WePeC6119].
Shaboltas AV, Toussova OV, Hoffman IF, et al. HIV prevalence, sociodemographic, and behavioral correlates and recruitment methods among injection drug users in St. Petersburg, Russia. J Acquir Immune Defic Syndr. 2006; 41: 657–663.
Niccolai LM, Toussova OV, Verevochkin SV, Barbour R, Heimer R, Kozlov AP. High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia. AIDS Behav. 2008;in press.
Long EF, Brandeau ML, Galvin CM, et al. Effectiveness and cost-effectiveness of strategies to expand antiretroviral therapy in St. Petersburg, Russia. AIDS. 2006; 20(17): 2207–2215.
Abdala N, Krasnoselskikh TV, Durante AJ, Timofeeva MY, Verevochkin SV, Kozlov AP. Sexually transmitted infections, sexual risk behaviors and the risk of heterosexual spread of HIV among and beyond IDUs in St. Petersburg, Russia. Eur Addict Res. 2008; 14(1): 19–25.
Aral SO, St Lawrence JS, Dyatlov R, Kozlov A. Commercial sex work, drug use, and sexually transmitted infections in St. Petersburg, Russia. Soc Sci Med. 2005; 60(10): 2181–2190.
Benotsch EG, Pinkerton SD, Dyatlov RV, et al. A comparison of HIV/AIDS knowledge and attitudes of STD clinic clients in St. Petersburg, Russia and Milwaukee, WI, USA. J Community Health. 2004; 29(6): 451–465.
Wall M, Tkatchenko-Schmidt E, Renton A. Sexual behaviour in Russia: who exhibits a higher risk? Evidence from longitudinal data. Int J STD AIDS. 2006; 17(11): 759–763.
Burchell AN, Calzavara LM, Orekhovsky V, Ladnaya NN. Characterization of an emerging heterosexual HIV epidemic in Russia. Sex Transm Dis. 2008; 35(9): 807–813.
Field MG. HIV and AIDS in the former Soviet Bloc. N Engl J Med. 2004;351:117–120.
Gerber TP, Berman D. Heterogeneous condom use in contemporary Russia. Stud Fam Plann. 2008; 39(1): 1–17.
Ellen JM. The next generation of HIV prevention for adolescent females in the United States: linking behavioral and epidemiologic sciences to reduce incidence of HIV. J Urban Health. 2003; 80(4 Suppl 3): iii40–iii49.
Acknowledgments
This work was supported by a grant from the National Institutes of Health (U01DA017387) to Yale School of Medicine and The Biomedical Center. The authors acknowledge the great dedication and enthusiasm of the SATH-CAP research team at The Biomedical Center including E. Fedorova, L. Senkovski, and I. Romanenko and the staff of the Municipal AIDS Center in St. Petersburg, Russia. The authors also thank the investigators at other sites of the SATH-CAP research project and RAND Corporation for the careful attention and interest to this site-specific part of the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Toussova, O., Shcherbakova, I., Volkova, G. et al. Potential Bridges of Heterosexual HIV Transmission from Drug Users to the General Population in St. Petersburg, Russia: Is it Easy to be a Young Female?. J Urban Health 86 (Suppl 1), 121–130 (2009). https://doi.org/10.1007/s11524-009-9364-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11524-009-9364-5