People with HIV in HAART-era Russia: transmission risk behavior prevalence, antiretroviral medication-taking, and psychosocial distress.
Russia has seen one of the world's fastest-growing HIV epidemics. Transmission risk behavior, HAART-taking, and psychosocial distress of the growing population of Russian people living with HIV (PLH) in the HAART era are understudied. Participants of a systematically-recruited cross-sectional sample of 492 PLH in St. Petersburg completed measures of sexual and drug injection practices, adherence, perceived discrimination, and psychosocial distress. Since learning of their status, 58% of participants had partners of HIV-negative or unknown serostatus (mean = 5.8). About 52% reported unprotected intercourse with such partners, with 30% of acts unprotected. Greater perceived discrimination predicted lower condom use. A 47% of IDU PLH still shared needles, predicted by having no primary partner, lower education, and more frequently-encountered discrimination. Twenty-five percentage of PLH had been refused general health care, 11% refused employment, 7% fired, and 6% forced from family homes. Thirty-nine percentage of participants had probable clinical depression, 37% had anxiety levels comparable to psychiatric inpatients, and social support was low. Of the 54% of PLH who were offered HAART, 16% refused HAART regimens, and 5% of those on the therapy took less than 90% of their doses. Comprehensive community services for Russian PLH are needed to reduce AIDS-related psychosocial distress and continued HIV transmission risk behaviors. Social programs should reduce stigma and discrimination, and promote social integration of affected persons and their families.
Amirkhanian
Yuri A
YA
Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin 53202, USA. yuri@mcw.edu
Kelly
Jeffrey A
JA
Kuznetsova
Anna V
AV
DiFranceisco
Wayne J
WJ
Musatov
Vladimir B
VB
Pirogov
Dmitry G
DG
D000223:Adaptation, Psychological; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology* / Q000635:transmission*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008603:Mental Health; D016485:Needle Sharing; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D012944:Social Support; D013315:Stress, Psychological; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult
AIDS. 2007 Nov 12;21(17):2333-40
18090282
J Pers Soc Psychol. 1989 Oct;57(4):723-30
2795439
AIDS. 2002 Jan 25;16(2):135-49
11807297
Sex Transm Infect. 2000 Oct;76(5):350-4
11141850
Psychosom Med. 2008 Jun;70(5):593-7
18519882
JAMA. 2009 Jun 10;301(22):2380-2
19509386
AIDS Educ Prev. 2001 Feb;13(1):42-54
11252453
J Acquir Immune Defic Syndr. 2010 Jun;54(2):197-203
20035231
AIDS. 2009 Nov 27;23(18):2485-95
19898216
J Acquir Immune Defic Syndr. 2004 Aug 15;36(5):1057-66
15247559
J Acquir Immune Defic Syndr. 2007 Dec 15;46(5):574-80
18193499
J Nerv Ment Dis. 2000 Oct;188(10):662-70
11048815
Ann Intern Med. 2000 Jul 4;133(1):21-30
10877736
Patient Educ Couns. 2002 Feb;46(2):93-108
11867239
J Acquir Immune Defic Syndr. 2002 May 1;30(1):105-10
12048370
Am J Psychiatry. 1993 Nov;150(11):1679-86
8214177
AIDS. 2003 Nov 7;17(16):2367-74
14571189
AIDS Behav. 2010 Apr;14(2):252-62
20013043
Health Psychol. 1993 May;12(3):215-9
8500451