Abstract
Russia has one of the fastest growing HIV epidemics in the world and is at the point of transitioning from injection drug use to sexual transmissions. We sought to identify factors associated with unprotected sex among men who have sex with men (MSM) in Russia, separately for Moscow, St. Petersburg and the rest of the country. Multivariable data from a national cross-sectional study (n = 5035) demonstrate that significant correlates of unprotected anal intercourse (UAI) with a non-steady partner across all areas were visiting sex-related venues (AOR range 1.35–1.96) and access to condoms (AOR range 0.37–0.52). In Moscow and St. Petersburg, being HIV-positive was correlated with UAI (AOR 2.13 and 2.69). The dynamics of the HIV epidemic among MSM in Russia appear to be both similar, and different, across various areas and factors associated with unprotected sex should be seen as part of an environment of exogenous factors impacting MSM’s sexual behaviors.
Resumen
El crecimiento de la epidemia del VIH en Rusia es uno de los más rápidos en el mundo y se encuentra en un estado de transición entre las drogas inyectables a las transmisiones sexuales. Buscamos identificar los factores asociados con la práctica del sexo sin protección entre hombres que tienen sexo con hombres (HSH, MSM en inglés) en Rusia, separando a Moscú, San Petersburgo y el resto del país. Los análisis multivariados de una encuesta nacional (n = 5035) demuestran que las correlaciones significativas entre el sexo anal sin protección con pareja no estable en todas las áreas del país fueron la visita a lugares relacionadas con el sexo (rango del ORA 1.35–1.96) y el acceso a los condones (rango del ORA 0.37–0,52). En Moscú y San Petersburgo, el tener un diagnóstico de VIH positivo se correlacionó con el sexo anal sin protección (ORA 2.13–2.69). La dinámica de la epidemia del VIH entre HSH en Rusia parece ser similar, y diferente, entre varias áreas y los factores asociados con la práctica del sexo sin protección deberían ser visto como parte de un ambiente de factores exógenos que impactan los comportamientos sexuales entre HSH.
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Acknowledgements
This study was funded by a Grant of the European Commission under the EU Health Programme 2008–2013. Further funding was received from CEEISCat (Centre d’Estudis Epidemiològics sobre les ITS/HIV/SIDA de Catalunya, Spain); Terrence Higgins Trust (CHAPS) for Department of Health for England; Maastricht University (The Netherlands); Regione del Veneto (Italy); and Robert Koch Institute (Germany). Further funding for the participation of men in specific countries was provided by: German Ministry of Health for Ukraine and Moldova; Finnish Ministry of Health for Finland; Norwegian Institute of Public Health for Norway; Swedish Board of Health and Welfare for Sweden; and Bundeszentrale für gesundheitliche Aufklärung (BZgA) for Germany.
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Berg, R.C., Skogen, V., Vinogradova, N. et al. Predictors of HIV Risk Behaviors Among a National Sample of Russian Men Who Have Sex with Men. AIDS Behav 21, 2904–2912 (2017). https://doi.org/10.1007/s10461-016-1653-x
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DOI: https://doi.org/10.1007/s10461-016-1653-x