Association of Substance Abuse, Violence, HIV/AIDS (SAVA) Syndrome with STI and HIV-Infection Among Injecting Drug Users in Six Cities of Russian Federation
Authors:   Federal State Budgetary Educational Institution for Higher Training ", Barinova A. N. ,   North-Western State Medical University named after I.I. Mechnikov",   Ministry of Health of the Russian Federation, St. Petersburg, Russia, Lebedeva A. A. ,   Federal State Budgetary Educational Institution for Higher Training "North-Western State Medical University named after I.I. Mechnikov" Ministry of Health of the Russian Federation, St. Petersburg, Russia, Ladnaya N. N. ,   Federal Budget Institution of Science "Central research institute of epidemiology" of The Federal Service on Customers' Rights Protection and Human Well-being Surveillance, Moscow, Russia, Tayts B. M. ,   Federal State Budgetary Educational Institution for Higher Training "North-Western State Medical University named after I.I. Mechnikov" Ministry of Health of the Russian Federation, St. Petersburg, Russia, Zaytseva E. E. ,   Open Health Institute Foundation, Moscow, Russia, Leonova O. N. ,   Federal State Budgetary Educational Institution for Higher Training "First Saint-Petersburg State Medical University named after I. P. Pavlov" Ministry of Health of the Russian Federation, St. Petersburg, Russia, Plavinskii S. L. ,   Federal State Budgetary Educational Institution for Higher Training "North-Western State Medical University named after I.I. Mechnikov" Ministry of Health of the Russian Federation, St. Petersburg, Russia
Published: August 2021

Introduction. Described at the beginning of HIV epidemics in the USA syndrome (or syndemia) of substance abuse, violence and AIDS (SAVA) still continue to be an important risk factor for HIV-infection acquisition. The goal of this study was to analyze association between SAVA and STI and also new cases of HIV infection among IDU in six cities in Russian Federation. Materials and methods. Analysis is based on the data from bio-behavioral survey conducted in six Russian cities with help of respondent-driven sampling. Results. It was found no statistically significant association between SAVA and STI after correction for sampling, but without correction STI prevalence in group without SAVA was 4.1% and in group with SAVA and binge drinking – 9,2% (р=0.04). Stratified analysis showed that it is impossible to combine data from males and females and in case of separate analysis statistically significant association between SAVA and STI exists in females (р=0,027). Analysis with adjustment for interview site, gender and age SAVA with binge drinking significantly elevates STI risk (OR=2.69 [95%CI=1.21... 5.99], р=0.016). Study of association between SAVA components and new cases of HIV found that experience of physical and/or sexual violence combined with binge drinking increase risk of HIV acquisition (adjusted for interview site, gender, age, needle/syringe sharing, education and sex work OR=4.03 [95%CI=1.19...13.69], р=0.026). Experience of physical and/or sexual violence combined with binge drinking was significantly associated with such HIV risk factors as needle and syringe sharing (OR=3.07 [95%CI=1.02...9.24], p=0.046) and sex work (OR=17.29 [95%CI=3.83...77.96], p<0.001). Conclusion. SAVA existence should be taken into account when planning preventive measures in Russian Federation and existing programs of comprehensive prevention should have components designed to decrease consequences of syndemia.