Original Paper

AIDS and Behavior

, Volume 15, Issue 4, pp 767-777

People with HIV in HAART-Era Russia: Transmission Risk Behavior Prevalence, Antiretroviral Medication-Taking, and Psychosocial Distress

  • Yuri A. AmirkhanianAffiliated withDepartment of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of WisconsinInterdisciplinary Center for AIDS Research and Training Email author 
  • , Jeffrey A. KellyAffiliated withDepartment of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of WisconsinInterdisciplinary Center for AIDS Research and Training
  • , Anna V. KuznetsovaAffiliated withInterdisciplinary Center for AIDS Research and Training
  • , Wayne J. DiFranceiscoAffiliated withDepartment of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin
  • , Vladimir B. MusatovAffiliated withInterdisciplinary Center for AIDS Research and TrainingMunicipal Clinical Hospital of Infectious Diseases Named after S.P. Botkin
  • , Dmitry G. PirogovAffiliated withInterdisciplinary Center for AIDS Research and Training

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Abstract

Russia has seen one of the world’s fastest-growing HIV epidemics. Transmission risk behavior, HAART-taking, and psychosocial distress of the growing population of Russian people living with HIV (PLH) in the HAART era are understudied. Participants of a systematically-recruited cross-sectional sample of 492 PLH in St. Petersburg completed measures of sexual and drug injection practices, adherence, perceived discrimination, and psychosocial distress. Since learning of their status, 58% of participants had partners of HIV-negative or unknown serostatus (mean = 5.8). About 52% reported unprotected intercourse with such partners, with 30% of acts unprotected. Greater perceived discrimination predicted lower condom use. A 47% of IDU PLH still shared needles, predicted by having no primary partner, lower education, and more frequently-encountered discrimination. Twenty-five percentage of PLH had been refused general health care, 11% refused employment, 7% fired, and 6% forced from family homes. Thirty-nine percentage of participants had probable clinical depression, 37% had anxiety levels comparable to psychiatric inpatients, and social support was low. Of the 54% of PLH who were offered HAART, 16% refused HAART regimens, and 5% of those on the therapy took less than 90% of their doses. Comprehensive community services for Russian PLH are needed to reduce AIDS-related psychosocial distress and continued HIV transmission risk behaviors. Social programs should reduce stigma and discrimination, and promote social integration of affected persons and their families.

Keywords

Acquired immunodeficiency syndrome Russia Sexual behavior Needle sharing Mental health HAART adherence