title: Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia.
abstract: The Russian Federation is experiencing a very high rate of HIV infection among people who inject drugs (PWID). However, few studies have explored characteristics of people with co-occurring opioid use disorders and HIV, including psychiatric symptom presentations and how these symptoms might relate to quality of life. The current study therefore explored a.) differences in baseline psychiatric symptoms among HIV+ and HIV- individuals with opioid use disorder seeking naltrexone treatment at two treatment centers in Saint Petersburg, Russia and b.) associations between psychiatric symptom constellations and quality of life.
  
  
  
  Participants were 328 adults enrolling in a randomized clinical trial evaluating outpatient treatments combining naltrexone with different drug counseling models. Psychiatric symptoms and quality of life were assessed using the Brief Symptom Inventory and The World Health Organization Quality of Life-BREF, respectively.
  
  
  
  Approximately 60% of participants were HIV+. Those who were HIV+ scored significantly higher on BSI anxiety, depression, psychoticism, somatization, paranoid ideation, phobic anxiety, obsessive-compulsive, and GSI indexes (all p<0.05) than those HIV-. A K-means cluster analysis identified three distinct psychiatric symptom profiles; the proportion of HIV+ was significantly greater and quality of life indicators were significantly lower in the cluster with the highest psychiatric symptom levels.
  
  
  
  Higher levels of psychiatric symptoms and lower quality of life indicators among HIV+ (compared to HIV-) individuals injecting drugs support the potential importance of combining interventions that target improving psychiatric symptoms with drug treatment, particularly for HIV+ patients.
authors.affiliation: Yale School of Medicine, United States. Electronic address: alethea.desrosiers@yale.edu.
authors.forename: Alethea
authors.initials: A
authors.lastname: Desrosiers
authors.affiliation: First Pavlov State Medical University, The Russian Federation.
authors.forename: Elena
authors.initials: E
authors.lastname: Blokhina
authors.affiliation: First Pavlov State Medical University, The Russian Federation; Saint Petersburg Bekhterev Research Psychoneurological Institute, The Russian Federation.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Krupitsky
authors.affiliation: First Pavlov State Medical University, The Russian Federation.
authors.forename: Edwin
authors.initials: E
authors.lastname: Zvartau
authors.affiliation: Yale School of Medicine, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Schottenfeld
authors.affiliation: Yale School of Medicine, United States.
authors.forename: Marek
authors.initials: M
authors.lastname: Chawarski
mesh_terms: D000328:Adult; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012426:Russia / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: HIV; Injection drug use; Psychiatric symptoms; Quality of life; Russia