Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 12/2019

01-12-2019 | Opioids | Original Paper

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

Authors: Peter Meylakhs, Samuel R. Friedman, Anastasia Meylakhs, Pedro Mateu-Gelabert, Danielle C. Ompad, Alisa Alieva, Alexandra Dmitrieva

Published in: AIDS and Behavior | Issue 12/2019

Login to get access

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.
Literature
1.
European Centre for Disease Prevention and Control, WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2015. Stockholm: ECDC; 2016.
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.PubMedCrossRef
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.CrossRef
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.
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.PubMedCrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.CrossRef
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.PubMedCrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
18.
19.
Bekker L-G, Hosek S. HIV and adolescents focus on young key populations. J Int AIDS Soc. 2015;18(2 Suppl 1):20076.PubMedCentral
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.PubMedCrossRef
21.
WHO. HIV and young people who inject drugs: a technical brief. Geneva: Inter-Agency Working Group on Key Populations; 2015. p. 34.
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.
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
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.PubMedCrossRef
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.PubMedCrossRef
26.
EHRN. Young people and injecting drug use in selected countries of Central and Eastern Europe. Vilnius: Eurasian Harm Reduction Network; 2009.
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.PubMedPubMedCentralCrossRef
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.PubMedCrossRef
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.CrossRef
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.PubMedCrossRef
31.
UNICEF. Biological and behavioural survey among injection drug users. Bosnia and Herzegovina: UNICEF Bosnia and Herzegovina; 2007.
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.CrossRef
34.
Creswell JW, Clark VLP. Designing and conducting mixed methods research. Cincinnati: Sage publications; 2017.
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.CrossRef
36.
Patton MQ. Qualitative evaluation and research methods. Thousands Oaks, CA: Sage Publication; 2002.
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.CrossRef
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.CrossRef
39.
Karakayali N. Social distance and affective orientations. Sociol Forum. 2009;24(3):538–62.CrossRef
40.
Guest G, MacQueen KM, Namey EE. Applied thematic analysis. Thousand Oaks: Sage; 2011.
41.
Corp. IBM. IBM SPSS Statistics for Windows version 22.0. Armonk, NY: IBM Corp.; 2013.
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.
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
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.CrossRef
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.CrossRef
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.CrossRef
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.CrossRef
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.CrossRef
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.CrossRefPubMed
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.CrossRef
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.PubMedPubMedCentralCrossRef
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.PubMedPubMedCentralCrossRef
57.
Golub A, Brownstein HH. Drug Generations in the 2000 s: An Analysis of Arrestee Data. J Drug Issues. 2013;43(3):335–56.CrossRef
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.
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.CrossRef
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.PubMedCrossRef
61.
Douglas M. Purity and Danger, 1966. New York: Routedge; 2002.
62.
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.
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.
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.PubMedCrossRef
66.
67.
Zinberg NE. Drug set and setting: the basis for controlled intoxicant use. New Haven: Yale University Press; 1986.
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.CrossRef
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.CrossRef
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.CrossRef
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.CrossRef
Metadata
Title
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
Authors
Peter Meylakhs
Samuel R. Friedman
Anastasia Meylakhs
Pedro Mateu-Gelabert
Danielle C. Ompad
Alisa Alieva
Alexandra Dmitrieva
Publication date
01-12-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 12/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02489-6

Other articles of this Issue 12/2019

AIDS and Behavior 12/2019 Go to the issue

Original Paper

Depression Symptom Trajectories Among Mothers Living with HIV in Rural Uganda

Original Paper

Distributive Syringe Sharing and Use of Syringe Services Programs (SSPs) Among Persons Who Inject Drugs

Original Paper

If You Build It, Will They Use It? Preferences for Antiretroviral Therapy (ART) Adherence Monitoring Among People Who Inject Drugs (PWID) in Kazakhstan

Original Paper

A Latent Class Analysis of the Social Determinants of Health Impacting Heavy Alcohol Consumption Among Women Living with HIV in Canada: The Canadian HIV Women’s Sexual and Reproductive Health Cohort Study

Original Paper

Characteristics of Persons Who Inject Drugs with Recent HIV Infection in the United States: National HIV Behavioral Surveillance, 2012

Original Paper

Mental health, social support, and HIV-related sexual risk behaviors among HIV-negative adolescent sexual minority males: three U.S. cities, 2015
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits