title: Risk factors for recent nonfatal overdose among HIV-infected Russians who inject drugs.
abstract: Overdoses and HIV infection are common among Russians who inject drugs, yet risk factors have not been studied. We analyzed baseline data of 294 participants with 30-day injection drug use from an HIV secondary prevention trial for persons reporting "heavy" alcohol use (National Institute on Alcohol Abuse and Alcoholism [NIAAA] risky drinking definition) and risky sex in the past 6 months. The outcome was any self-reported overdose in the previous 3 months. We examined demographic, HIV-related, criminal justice, mental health, substance use, and injection risk factors. Participants' characteristics included median age 29 years, 117/294 (40%) female, and median CD4 cell count 345/µl. Over three quarters 223/294 (76%) reported a history of overdose and 47/294 (16%) reported overdose in the past 3 months. Past month injection frequency (adjusted odds ratio [AOR] 4.77, 95% confidence interval [CI]: 1.63-14.0 highest vs. lowest quartile; AOR 3.58, 95% CI: 1.20-10.69 second highest vs. lowest quartile) and anti-retroviral therapy (ART) at time of interview (AOR 3.96 95% CI: 1.33-11.83) were associated with 3-month overdose. Nonfatal overdose among HIV-infected Russians who inject drugs is common. Risk factors include injection frequency and anti-retroviral therapy (ART), which warrant further study. Overdose prevention efforts are needed among HIV-infected Russians who inject drugs.
authors.affiliation: a Clinical Addiction Research and Education Unit, Section of General Internal Medicine , Boston University School of Medicine, Boston Medical Center , Boston , MA , USA.
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Walley
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Coleman
authors.forename: Evgeny
authors.initials: E
authors.lastname: Krupitsky
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
authors.forename: Elena
authors.initials: E
authors.lastname: Blokhina
authors.forename: Carly
authors.initials: C
authors.lastname: Bridden
authors.forename: Christine E
authors.initials: CE
authors.lastname: Chaisson
authors.forename: Marlene C
authors.initials: MC
authors.lastname: Lira
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D012650:Self Disclosure; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000517:prevention & control
keywords: HIV; Russia; anti-retroviral therapy; injection drug use; overdose