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

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.

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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.

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Correspondence to Peter Meylakhs.

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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

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Keywords

  • People who inject drugs (PWID)
  • HIV
  • Russia
  • Mixed-methods study
  • Young drug users

Palabras Clave

  • Personas que se inyectan drogas (PQID)
  • VIH
  • Rusia
  • estudio de métodos mixtos
  • jóvenes usuarios de drogas