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Attitudes Toward Addiction, Methadone Treatment, and Recovery Among HIV-Infected Ukrainian Prisoners Who Inject Drugs: Incarceration Effects and Exploration of Mediators

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Abstract

In this study, we use data from a survey conducted in Ukraine among 196 HIV-infected people who inject drugs, to explore attitudes toward drug addiction and methadone maintenance therapy (MMT), and intentions to change drug use during incarceration and after release from prison. Two groups were recruited: Group 1 (n = 99) was currently incarcerated and Group 2 (n = 97) had been recently released from prison. This paper’s key finding is that MMT treatment and addiction recovery were predominantly viewed as mutually exclusive processes. Group comparisons showed that participants in Group 1 (pre-release) exhibited higher optimism about changing their drug use, were less likely to endorse methadone, and reported higher intention to recover from their addiction. Group 2 participants (post-release), however, reported higher rates of HIV stigma. Structural equation modeling revealed that in both groups, optimism about recovery and awareness of addiction mediated the effect of drug addiction severity on intentions to recover from their addiction.

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Acknowledgments

This research received funding from the National Institute on Drug Abuse for research (R01 DA029910 and R01 DA033679) and career development (K24 DA017072), the Yale University School of Medicine’s Office of Student Research, the Yale University Global Health Initiative, the International Renaissance Foundation, and the NIH Fogarty Research Training Grant (R25 TW009338). No funding source had any role in study design, collection or analysis of data, writing or review of the manuscript, or decision to submit this paper for publication.

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Authors and Affiliations

  1. Section of Infectious Diseases, Yale University School of Medicine, 135 College St. Suite 323, New Haven, CT, 06510-2283, USA

    Maxim Polonsky, Julia Rozanova & Frederick L. Altice

  2. London School of Hygiene and Tropical Medicine, London, UK

    Lyuba Azbel

  3. Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Chethan Bachireddy

  4. Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Jacob Izenberg

  5. Ukrainian Institute on Public Health Policy, Kiev, Ukraine

    Tetiana Kiriazova & Sergii Dvoryak

  6. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA

    Frederick L. Altice

  7. University of Malaya, Centre of Excellence on Research in AIDS (CERiA), Kuala Lumpur, Malaysia

    Frederick L. Altice

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  1. Maxim Polonsky
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  2. Julia Rozanova
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  3. Lyuba Azbel
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  4. Chethan Bachireddy
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  5. Jacob Izenberg
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  7. Sergii Dvoryak
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  8. Frederick L. Altice
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Correspondence to Maxim Polonsky.

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Maxim Polonsky and Julia Rozanova first co-authors listed in alphabetical order.

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Polonsky, M., Rozanova, J., Azbel, L. et al. Attitudes Toward Addiction, Methadone Treatment, and Recovery Among HIV-Infected Ukrainian Prisoners Who Inject Drugs: Incarceration Effects and Exploration of Mediators. AIDS Behav 20, 2950–2960 (2016). https://doi.org/10.1007/s10461-016-1375-0

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