title: Implications of cannabis use and heavy alcohol use on HIV drug risk behaviors in Russian heroin users.
abstract: Cannabis and heavy alcohol use potentially increase HIV transmission by increasing risky drug behaviors. We studied 404 subjects entering treatment for heroin dependence, in St. Petersburg, Russia. We used the HIV Risk Assessment Battery (RAB) drug subscale to measure risky drug behavior. Although all heavy alcohol users had risky drug behaviors, their drug RAB scores did not differ from non-heavy alcohol users in unadjusted or adjusted analyses. Cannabis use was significantly associated with drug RAB scores in unadjusted analyses (mean difference 1.7 points) and analyses adjusted for age, sex, and employment (mean difference 1.3 points). When also adjusting for stimulant use, the impact of cannabis use was attenuated and no longer statistically significant (mean difference 1.1 points). Because of the central role of risky drug behaviors in the Russian HIV epidemic, it is important to understand how the use of multiple substances, including cannabis and alcohol, impacts risky drug behaviors.
authors.affiliation: Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, 91 E. Concord St., Suite 200, Boston, MA 02118, USA. awalley@bu.edu
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Walley
authors.forename: Evgeny M
authors.initials: EM
authors.lastname: Krupitsky
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
authors.forename: Erika M
authors.initials: EM
authors.lastname: Edwards
authors.forename: Carly
authors.initials: C
authors.lastname: Bridden
authors.forename: Valentina Y
authors.initials: VY
authors.lastname: Egorova
authors.forename: Edwin E
authors.initials: EE
authors.lastname: Zvartau
authors.forename: George E
authors.initials: GE
authors.lastname: Woody
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D002188:Cannabis; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006556:Heroin Dependence / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000627:therapeutic use; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D012725:Sexual Behavior; D016896:Treatment Outcome
chemical_list: D009271:Naltrexone