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Healthcare Utilization Among Persons with HIV and Unhealthy Alcohol Use in St. Petersburg, Russia

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Abstract

Few studies have examined the association between healthcare utilization and heavy alcohol use in Russia among persons with HIV (PWH), a group with high healthcare needs. This study analyzed the association between unhealthy alcohol use (defined as AUDIT score ≥ 8) and healthcare utilization among PWH with heavy alcohol use and daily smoking in St. Petersburg, Russia. This secondary analysis used data from a randomized controlled trial addressing alcohol use. The primary outcome was seeing an infectionist for HIV care in the past year. Outcomes were measured at baseline, 6 months, and 12 months. We assessed the association between unhealthy alcohol use and healthcare utilization outcomes with a repeated measures logistic regression model, controlling for relevant covariates. Nearly all (96.0%) participants had unhealthy alcohol use at baseline, and 90.0% had seen an infectionist for HIV care in the past year. In adjusted analyses, unhealthy alcohol use was associated with a 36% decrease in seeing an infectionist for HIV care (aOR = 0.64, 95% CI 0.43–0.95). Participants reported low levels of emergency department visits and hospitalizations. Understanding how to engage this population in alcohol use disorder treatment and HIV care is an important next step for improving health outcomes for this population.

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Funding

This work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in support of URBAN ARCH: U01AA020780, U24AA020779, U24AA020778. Ms. Biondi and Ms. Freibott are supported by the National Institute of Drug Abuse (T32DA041898).

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Authors and Affiliations

  1. Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Talbot Building, Boston, MA, 02118, USA

    Breanne E. Biondi, Christina E. Freibott & Michael D. Stein

  2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Debbie M. Cheng

  3. First Pavlov State Medical, University of St. Petersburg, St. Petersburg, Russian Federation

    Elena Blokhina, Dmitry Lioznov & Evgeny Krupitsky

  4. Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA

    Lindsey Rateau & Gregory J. Patts

  5. Department of Medicine, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA

    Sally Bendiks & Natalia Gnatienko

  6. Division of Internal Medicine & Public Health and Vanderbilt Ingram Cancer Center (VICC), Vanderbilt Center for Tobacco, Addiction and Lifestyle (VITAL), Vanderbilt University Medical Center, Nashville, TN, USA

    Hilary A. Tindle

  7. Cardiovascular Division, Vanderbilt Center for Clinical Cardiovascular Trials Evaluation (V-C3REATE), Vanderbilt University Medical Center, Nashville, TN, USA

    Matthew S. Freiberg

  8. Department of Addictions, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russian Federation

    Evgeny Krupitsky

  9. Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA

    Jeffrey H. Samet

  10. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA

    Jeffrey H. Samet

Authors
  1. Breanne E. Biondi
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  2. Christina E. Freibott
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  3. Debbie M. Cheng
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  4. Elena Blokhina
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  6. Lindsey Rateau
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  7. Gregory J. Patts
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  8. Sally Bendiks
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  9. Natalia Gnatienko
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  10. Hilary A. Tindle
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  11. Matthew S. Freiberg
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  13. Jeffrey H. Samet
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  14. Michael D. Stein
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Contributions

BEB: conceptualization, writing—original draft; CEF: review and editing; DMC: methodology, review and editing; EB: review and editing; DL: review and editing; LR: software, formal analysis, review and editing; GP: software, formal analysis, review and editing; SB: project administration, review and editing; NG: project administration, review and editing; HT: review and editing, funding acquisition; MF: review and editing, funding acquisition, EK: review and editing; JHS: review and editing funding acquisition, supervision; MDS: review and editing, supervision.

Corresponding author

Correspondence to Breanne E. Biondi.

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The authors have no conflicts of interest to disclose.

Ethics Approval

The St PETER study was approved by the Institutional Review Boards of Boston University Medical Campus, Vanderbilt University Medical Center, and Pavlov University.

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Informed consent was obtained from all participants included in the study.

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Biondi, B.E., Freibott, C.E., Cheng, D.M. et al. Healthcare Utilization Among Persons with HIV and Unhealthy Alcohol Use in St. Petersburg, Russia. AIDS Behav 28, 19–25 (2024). https://doi.org/10.1007/s10461-023-04161-6

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