Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, RussiaReportar como inadecuado




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Harm Reduction Journal

, 6:22

First Online: 31 July 2009Received: 07 January 2009Accepted: 31 July 2009

Abstract

BackgroundThe 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.

MethodsWe 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.

ResultsAmong 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.

ConclusionThe 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7517-6-22 contains supplementary material, which is available to authorized users.

Gina Rae Kruse, Russell Barbour contributed equally to this work.

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Autor: Gina Rae Kruse - Russell Barbour - Robert Heimer - Alla V Shaboltas - Olga V Toussova - Irving F Hoffman - Andrei P Ko

Fuente: https://link.springer.com/







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