Skip to main content

Advertisement

SpringerLink
Log in

A New Generation of Drug Users in St. Petersburg, Russia? HIV, HCV, and Overdose Risks in a Mixed-Methods Pilot Study of Young Hard Drug Users

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Russia has a widespread injection drug use epidemic with high prevalence of HIV and HCV among people who inject drugs (PWID). We conducted a mixed methods study of young (age 18–26) hard drug users in St. Petersburg. Thirty-nine structured and 10 semi-structured interviews were conducted. No HIV cases and two HCV cases were detected among the PWID subsample (n = 29). Amphetamine and other stimulants were common (70%), opioid use was rare and episodic. Consistent condom use was 10%. No PWID reported syringe-sharing, 51% reported other drug paraphernalia sharing. Most (89%) never or rarely communicated with older (30 +) opiate users. A new cohort of drug users in St. Petersburg may have emerged, which is much safer in its injection practices compared to previous cohorts. However, risky sexual practices among this new cohort may expose them to the possibility of sexual transmission of HIV and widespread drug paraphernalia sharing to the HCV epidemic.

Resumen

Rusia tiene una epidemia generalizada de consumo de drogas inyectables con una alta prevalencia de VIH y Hepatitis C (VHC) entre las personas que se inyectan drogas (PQID). Realizamos un estudio de métodos mixtos de jóvenes (de 18 a 26 años) usuarios de drogas duras en San Petersburgo. Se realizaron 39 entrevistas estructuradas y 10 semiestructuradas. Entre la submuestra de PQID (n = 29) se detectaron dos casos de VHC y ninguno de VIH. La anfetamina y otros estimulantes eran comunes (70%), el uso de opioides era raro y episódico. El uso consistente del condón fue del 10%. Ninguna PQID reportó uso compartido de jeringas, el 51% reportó uso compartido de otra parafernalia para inyección de drogas. El 89% nunca o rara vez se comunicó con usuarios de opiáceos mayores de 30 años. Es posible que haya surgido una nueva cohorte de usuarios de drogas en San Petersburgo que, en comparación con cohortes anteriores, es mucho más segura en sus prácticas de inyección. Sin embargo, las prácticas sexuales de riesgo de esta nueva cohorte pueden exponerlas a la posibilidad de transmisión sexual de VIH y compartir la parafernalia de drogas puede exponerla a la epidemia del VHC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2015. Stockholm: ECDC; 2016.

    Google Scholar 

  2. Burchell AN, Calzavara LM, Orekhovsky V, Ladnaya NN. Russian HIV response network. Characterization of an emerging heterosexual HIV epidemic in Russia. Sex Transm Dis. 2008;35(9):807–13.

    Article  PubMed  Google Scholar 

  3. Kozlov AP, Skochilov RV, Toussova OV, Verevochkin SV, Krasnoselskikh TV, Malov SV, et al. HIV incidence and behavioral correlates of HIV acquisition in a cohort of injection drug users in St Petersburg, Russia. Medicine (Baltimore). 2016;95(44):e5238.

    Article  Google Scholar 

  4. Petrostat. Statistical bulletin “Wage in St. Petersburg and Leningrad oblast in January-December, 2016.” Saint-Petersburg: The Federal Service for State Statistics in St. Petersburg and Leningrad Oblast; 2017.

  5. Heimer R, White E. Estimation of the number of injection drug users in St. Petersburg Russia. Drug Alcohol Depend. 2010;109(1–3):79–83.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rhodes T, Platt L, Maximova S, Koshkina E, Latishevskaya N, Hickman M, et al. Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study. Addiction. 2006;101(2):252–66.

    Article  PubMed  Google Scholar 

  7. Eritsyan K, Heimer R, Barbour R, Odinokova V, White E, Rusakova MM, et al. Individual-level, network-level and city-level factors associated with HIV prevalence among people who inject drugs in eight Russian cities: a cross-sectional study. BMJ Open. 2013;3(6):e002645.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kruse GR, Barbour R, Heimer R, Shaboltas AV, Toussova OV, Hoffman IF, et al. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg Russia. Harm Reduct J. 2009;6:22.

    Article  PubMed  Google Scholar 

  9. Niccolai LM, Verevochkin SV, Toussova OV, White E, Barbour R, Kozlov AP, et al. Estimates of HIV incidence among drug users in St. Petersburg Russia: continued growth of a rapidly expanding epidemic. Eur J Public Health. 2011;21(5):613–9.

    Article  PubMed  Google Scholar 

  10. Toussova O, Shcherbakova I, Volkova G, Niccolai L, Heimer R, Kozlov A. 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 Bull N Y Acad Med. 2009;86(Suppl 1):121–30.

    Article  Google Scholar 

  11. Heimer R, Lyubimova A, Barbour R, Levina OS. Emergence of methadone as a street drug in St. Petersburg, Russia. Int J Drug Policy. 2016;27:97–104.

    Article  PubMed  Google Scholar 

  12. Uusküla A, Raag M, Vorobjov S, Rüütel K, Lyubimova A, Levina OS, et al. Non-fatal overdoses and related risk factors among people who inject drugs in St. Petersburg, Russia and Kohtla-Järve Estonia. BMC Public Health. 2015;15:1255.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Cepeda JA, Niccolai LM, Lyubimova A, Kershaw T, Levina O, Heimer R. High-risk behaviors after release from incarceration among people who inject drugs in St. Petersburg, Russia. Drug Alcohol Depend. 2015;147:196–202.

    Article  PubMed  Google Scholar 

  14. Abdala N, Carney JM, Durante AJ, Klimov N, Ostrovski D, Somlai AM, et al. Estimating the prevalence of syringe-borne and sexually transmitted diseases among injection drug users in St Petersburg, Russia. Int J STD AIDS. 2003;14(10):697–703.

    Article  PubMed  Google Scholar 

  15. Shaboltas AV, Toussova OV, Hoffman IF, Heimer R, Verevochkin SV, Ryder RW, et al. HIV prevalence sociodemographic and behavioral correlates and recruitment methods among injection drug users in St. Petersburg Russia. J Acquir Immune Defic Syndr 1999. 2006;41(5):657–63.

    Google Scholar 

  16. 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. 2010;14(4):932–41.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Heimer R, Eritsyan K, Barbour R, Levina OS. Hepatitis C virus seroprevalence among people who inject drugs and factors associated with infection in eight Russian cities. BMC Infect Dis. 2014;14(Suppl 6):S12.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Golub A, Johnson BD, Dunlap E. Subcultural evolution and illicit drug use. Addict Res Theory. 2005;13(3):217–29.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bekker L-G, Hosek S. HIV and adolescents focus on young key populations. J Int AIDS Soc. 2015;18(2 Suppl 1):20076.

    PubMed Central  Google Scholar 

  20. Fennema JSA, Van Ameijden EJC, van Den Hoek A, Coutinho RA. Young and recent-onset injecting drug users are at higher risk for HIV. Addiction. 1997;92(11):1457–65.

    Article  CAS  PubMed  Google Scholar 

  21. WHO. HIV and young people who inject drugs: a technical brief. Geneva: Inter-Agency Working Group on Key Populations; 2015. p. 34.

    Google Scholar 

  22. Ministry of Health, Viet Nam. Results from the HIV/STI integrated biolgoical and behavioral surveillance (IBBS) in Viet Nam 2005-2006. Hanoi: Ministry of Health, Viet Nam; 2006.

    Google Scholar 

  23. Atkinson J, McCurdy S, Williams M, Mbwambo J, Kilonzo G. HIV risk behaviors, perceived severity of drug use problems, and prior treatment experience in a sample of young heroin injectors in Dar es Salaam. Tanzania. Afr J Drug Alcohol Stud. 2011;10(1):1–9.

    PubMed  Google Scholar 

  24. Kissin DM, Zapata L, Yorick R, Vinogradova EN, Volkova GV, Cherkassova E, et al. HIV seroprevalence in street youth, St Petersburg. Russia. AIDS. 2007;21(17):2333–40.

    Article  PubMed  Google Scholar 

  25. Kornilova MS, Batluk JV, Yorick RV, Baughman AL, Hillis SD, Vitek CR. Decline in HIV seroprevalence in street youth 2006–2012, St. Petersburg, Russia: moving toward an AIDS-free generation. Int J STD AIDS. 2017;28(4):345–56.

    Article  PubMed  Google Scholar 

  26. EHRN. Young people and injecting drug use in selected countries of Central and Eastern Europe. Vilnius: Eurasian Harm Reduction Network; 2009.

    Google Scholar 

  27. Broz D, Pham H, Spiller M, Wejnert C, Le B, Neaigus A, et al. Prevalence of HIV infection and risk behaviors among younger and older injecting drug users in the United States, 2009. AIDS Behav. 2014;18(3):284–96.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cedarbaum ER, Banta-Green CJ. Health behaviors of young adult heroin injectors in the Seattle area. Drug Alcohol Depend. 2016;158(158):102–9.

    Article  PubMed  Google Scholar 

  29. Kral AH, Lorvick J, Edlin BR. Sex- and drug-related risk among populations of younger and older injection drug users in adjacent neighborhoods in San Francisco. J Acquir Immune Defic Syndr 1999. 2000;24(2):162–7.

    Article  CAS  Google Scholar 

  30. Des Jarlais DC, Diaz T, Perlis T, Vlahov D, Maslow C, Latka M, et al. Variability in the incidence of human immunodeficiency virus, Hepatitis B virus, and Hepatitis C virus infection among young injecting drug users in New York City. Am J Epidemiol. 2003;157(5):467–71.

    Article  PubMed  Google Scholar 

  31. UNICEF. Biological and behavioural survey among injection drug users. Bosnia and Herzegovina: UNICEF Bosnia and Herzegovina; 2007.

    Google Scholar 

  32. UNICEF Serbia. The estimation of the prevalence of HIV and viral hepatitis C infection, risk factors, risk behavior and the use of services among the population of young injecting drug users in Belgrade, Novi Sad and Nis; 2009.

  33. Amundsen EJ, Bretteville-Jensen AL. Hard drug use in Norway. Nord Stud Alcohol Drugs. 2010;27(1):87–94.

    Article  Google Scholar 

  34. Creswell JW, Clark VLP. Designing and conducting mixed methods research. Cincinnati: Sage publications; 2017.

    Google Scholar 

  35. Greene JC, Caracelli VJ, Graham WF. Toward a conceptual framework for mixed-method evaluation designs. Educ Eval Policy Anal. 1989;11(3):255–74.

    Article  Google Scholar 

  36. Patton MQ. Qualitative evaluation and research methods. Thousands Oaks, CA: Sage Publication; 2002.

    Google Scholar 

  37. Heckathorn DD, Semaan S, Broadhead RS, Hughes JJ. Extensions of respondent-driven sampling: a new approach to the study of injection drug users aged 18–25. AIDS Behav. 2002;6(1):55–67.

    Article  Google Scholar 

  38. Abdul-Quader AS, Heckathorn DD, McKnight C, Bramson H, Nemeth C, Sabin K, et al. Effectiveness of respondent-driven sampling for recruiting drug users in New York City: findings from a pilot study. J Urban Health Bull N Y Acad Med. 2006;83(3):459–76.

    Article  Google Scholar 

  39. Karakayali N. Social distance and affective orientations. Sociol Forum. 2009;24(3):538–62.

    Article  Google Scholar 

  40. Guest G, MacQueen KM, Namey EE. Applied thematic analysis. Thousand Oaks: Sage; 2011.

    Google Scholar 

  41. Corp. IBM. IBM SPSS Statistics for Windows version 22.0. Armonk, NY: IBM Corp.; 2013.

    Google Scholar 

  42. Mannheim K. The problem of generations. In: Kecskemeti P, editor. Essays in the sociology of knowledge (pp 276–322). Boston: Routledge & Kegan Paul; 1952.

    Google Scholar 

  43. Meylakhs P, Aasland A, Grønningsæter A. “Until people start dying in droves, no actions will be taken”: perception and experience of HIV-preventive measures among people who inject drugs in northwestern Russia. Harm Reduct J. 2017;14:33.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Uusküla A, Des Jarlais DC, Kals M, Rüütel K, Abel-Ollo K, Talu A, et al. Expanded syringe exchange programs and reduced HIV infection among new injection drug users in Tallinn, Estonia. BMC Public Health. 2011;11:517.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Vitek CR, Čakalo J-I, Kruglov YV, Dumchev KV, Salyuk TO, Božičević I, et al. Slowing of the HIV epidemic in Ukraine: evidence from case reporting and key population surveys, 2005-2012. PLoS ONE. 2014;9(9):e103657.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  46. Friedman SR, Sandoval M, Mateu-Gelabert P, Meylakhs P, Des Jarlais DC. Symbiotic goals and the prevention of blood-borne viruses among injection drug users. Subst Use Misuse. 2011;46(2–3):307–15.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Meylakhs P, Friedman SR, Mateu-Gelabert P, Sandoval M, Meylakhs N. Taking care of themselves: how long-term injection drug users remain HIV and Hepatitis C free. Sociol Health Illn. 2015;37(4):626–41.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Hall W, Darke S, Ross M, Wodak A. Patterns of drug use and risk-taking among injecting amphetamine and opioid drug users in Sydney, Australia. Addict Abingdon Engl. 1993;88(4):509–16.

    Article  CAS  Google Scholar 

  49. Kozlov AP, Shaboltas AV, Toussova OV, Verevochkin SV, Masse BR, Perdue T, et al. HIV incidence and factors associated with HIV acquisition among injection drug users in St Petersburg, Russia. AIDS Lond Engl. 2006;20(6):901–6.

    Article  Google Scholar 

  50. Lorvick J, Martinez A, Gee L, Kral AH. Sexual and injection risk among women who inject methamphetamine in San Francisco. J Urban Health Bull N Y Acad Med. 2006;83(3):497–505.

    Article  Google Scholar 

  51. Braine N, Des Jarlais DC, Goldblatt C, Zadoretzky C, Turner C. HIV risk behavior among amphetamine injectors at U.S. syringe exchange programs. AIDS Educ Prev Off Publ Int Soc AIDS Educ. 2005;17(6):515–24.

    Article  Google Scholar 

  52. Van den Berg C, Smit C, Van Brussel G, Coutinho R, Prins M. Full participation in harm reduction programmes is associated with decreased risk for human immunodeficiency virus and hepatitis C virus: evidence from the Amsterdam Cohort Studies among drug users. Addiction. 2007;102(9):1454–62.

    Article  Google Scholar 

  53. Wodak A, Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse. 2006;41(6–7):777–813.

    Article  PubMed  Google Scholar 

  54. Reuter P. Ten YEARS after the United Nations general assembly special session (UNGASS): assessing drug problems, policies and reform proposals. Addict Abingdon Engl. 2009;104(4):510–7.

    Article  Google Scholar 

  55. Friedman SR, Pouget ER, Chatterjee S, Cleland CM, Tempalski B, Brady JE, et al. Drug Arrests and Injection Drug Deterrence. Am J Public Health. 2011;101(2):344–9.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Friedman SR, Tempalski B, Brady JE, West BS, Pouget ER, Williams LD, et al. Income inequality, drug-related arrests, and the health of people who inject drugs: reflections on seventeen years of research. Int J Drug Policy. 2016;32:11–6.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Golub A, Brownstein HH. Drug Generations in the 2000 s: An Analysis of Arrestee Data. J Drug Issues. 2013;43(3):335–56.

    Article  Google Scholar 

  58. Curtis R. The improbable transformation of inner-city neighborhoods: crime, violence, drugs, and youth in the 1990s. J Crim Law Criminol. 1997;1998(88):1233.

    Google Scholar 

  59. Furst RTD, Johnson B, Dunlap E, Curtis R. The stigmatized image of the”crack head”: a sociocultural exploration of a barrier to cocaine smoking among a cohort of youth in New York City. Deviant Behav. 1999;20(2):153–81.

    Article  Google Scholar 

  60. Golub AL, Johnson BD. Cohort changes in illegal drug use among arrestees in Manhattan: from the Heroin Injection Generation to the Blunts Generation. Subst Use Misuse. 1999;34(13):1733–63.

    Article  CAS  PubMed  Google Scholar 

  61. Douglas M. Purity and Danger, 1966. New York: Routedge; 2002.

    Google Scholar 

  62. Douglas M. Risk and blame. London: Routledge; 2013.

    Book  Google Scholar 

  63. Friedman SR, Des Jarlais DC, Jose B, Neaigus A, Goldstein M. Seroprevalence, Seroconversion, and the History of the HIV Epidemic among Drug Injectors. In: Nicolosi A, editor. HIV Epidemiology: Models and Methods. New York: Raven Press; 1994. p. 137–50.

    Google Scholar 

  64. Friedman SR, Friedmann P, Telles P, Bastos F, Bueno R, Mesquita F, et al. New injectors and HIV-1 risk. Drug injecting and HIV infection: global dimensions and local responses. London: UCL Press; 1998. p. 76–90.

    Google Scholar 

  65. Bancroft A, Reid PS. Concepts of illicit drug quality among darknet market users: purity, embodied experience, craft and chemical knowledge. Int J Drug Policy. 2016;35:42–9.

    Article  PubMed  Google Scholar 

  66. Becker HS. Becoming a marihuana user. Am J Sociol. 1953;59(3):235–42.

    Article  Google Scholar 

  67. Zinberg NE. Drug set and setting: the basis for controlled intoxicant use. New Haven: Yale University Press; 1986.

    Google Scholar 

  68. Bourgois P. Anthropology and epidemiology on drugs: the challenges of cross-methodological and theoretical dialogue. Int J Drug Policy. 2002;13(4):259–69.

    Article  Google Scholar 

  69. Krug A, Hildebrand M, Sun N. “We don’t need services. We have no problems” exploring the experiences of young people who inject drugs in accessing harm reduction services. J Int AIDS Soc. 2015;18:n/a–n/a.

    Article  Google Scholar 

  70. Friedman SR, Maslow C, Bolyard M, Sandoval M, Mateu-Gelabert P, Neaigus A. Urging others to be healthy: “intravention” by injection drug users as a community prevention goal. AIDS Educ Prev Off Publ Int Soc AIDS Educ. 2004;16(3):250–63.

    Article  Google Scholar 

  71. Mateu-Gelabert P, Guarino H, Quinn K, Meylakhs P, Campos S, Meylakhs A, et al. Young drug users: a vulnerable population and an underutilized resource in HIV/HCV prevention. Curr HIV/AIDS Rep. 2018;15(6):423–30.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to acknowledge The Center for Drug Use and HIV Research (CDUHR) at New York University (Grant No. P30DA011041). The article was prepared as a result of a research project “Complex Research on Evaluation of Quality of Life Related with Russian People’s Health and Behavior Patterns” supported by the National Research University Higher School of Economics, St. Petersburg in 2019.

Author information

Authors and Affiliations

  1. Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, Kantemirovskaya St. 3a, St. Petersburg, Russia, 194100

    Peter Meylakhs, Anastasia Meylakhs & Alisa Alieva

  2. National Development and Research Institutes, Inc., New York, USA

    Samuel R. Friedman & Pedro Mateu-Gelabert

  3. College of Global Public Health, New York University, New York, USA

    Danielle C. Ompad

  4. Center for Drug Use and HIV Research, New York University, New York, NY, USA

    Danielle C. Ompad

  5. Support, Research and Development Center, Kyiv, Ukraine

    Alexandra Dmitrieva

Authors
  1. Peter Meylakhs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samuel R. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anastasia Meylakhs
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pedro Mateu-Gelabert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Danielle C. Ompad
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alisa Alieva
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexandra Dmitrieva
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Meylakhs.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meylakhs, P., Friedman, S.R., Meylakhs, A. et al. A New Generation of Drug Users in St. Petersburg, Russia? HIV, HCV, and Overdose Risks in a Mixed-Methods Pilot Study of Young Hard Drug Users. AIDS Behav 23, 3350–3365 (2019). https://doi.org/10.1007/s10461-019-02489-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02489-6

Keywords

Palabras Clave

Search

Navigation