Study shows complexities of reducing HIV rates in Russia

Results of a new study conducted in St. Petersburg, Russia, show that decreasing HIV transmission among Russian HIV-infected drinkers will require creative and innovative approaches.

While new HIV infections globally have declined, HIV rates remain high in Russia. This is due in large part to injection drug use and spread via heterosexual sex transmission. Alcohol use also has been shown to be related to risky sexual behaviors and sexually transmitted infections (STIs).

Published online in Addiction, the study showed that a behavioral intervention did not lead to a reduction of STIs and HIV risk behaviors in Russian HIV-infected heavy drinkers when compared to the control group. This study was led by researchers from Boston University School of Medicine (BUSM), Boston Medical Center (BMC) and First St. Petersburg Pavlov State Medical University, Russia.

In this study, HIV’s Evolution in Russia - Mitigating Infection Transmission and Alcoholism in a Growing Epidemic (HERMITAGE), the researchers adapted a Centers for Disease Control and Prevention-best evidence risk reduction intervention for a Russian clinical setting and assessed its ability to reduce STIs and HIV risk behaviors among 700 HIV-infected heavy drinkers. The intervention stressed disclosure of HIV serostatus and condom use in two individual sessions and three small group sessions. Participants had a laboratory test at a 12-month follow up appointment to determine if they had contracted STIs. They also answered questions about risky behaviors, including unprotected sex, drinking alcohol or injecting drugs.

At the 12-month follow-up assessment, STIs occurred in 20 subjects (8 percent) in the intervention group and 28 subjects (12 percent) in the control group. Both groups, however, reported having decreased their participation in risky behaviors.

In Russia, New HIV Strain Spreading Rapidly
A scientific research center in Siberia said Wednesday that it discovered a new strain of HIV - the virus that causes AIDS - and that it is spreading throughout Russia “at a rapid rate,” RIA Novosti newswire reported today.

The subtype was detected in the Siberian city of Novosibirsk in 2006 and now accounts for more than 50% of new HIV infections in the region, Novosibirsk’s Koltsovo science city said in a statement. The number of HIV-positive people living in the Novosibirsk Region has leaped from about 2,000 in 2007 up to 15,000 in 2012, according to Russia’s Federal AIDS Center.

Natalya Gashnikova, head of the retroviruses department at the Vektor state biotechnology research center at Koltsovo said this might be the worst HIV strain in Russia. RIA reported her saying that the virus spreads much faster than Russia’s current leading HIV strain. This new strain is not limited Siberia. It has also been found in patient lab tests in Chechnya, Kyrgyzstan and Kazakhstan, the institute said.

According to the United Nations, Eastern Europe and Central Asia are the only regions in the world where the HIV infection is on the rise. Fifty-two percent of the HIV-positive people that live across that area are in Russia.  The World Bank estimates that in 2020, Russia will lose 20,000 people per month to AIDS. The country has experienced the fastest-spreading HIV/AIDS epidemics in any one country in history, but there remains a lack of effective preventative measures to slow it down-in both schools and in the larger anti-gay society.

In a country of 143 million people, roughly one million are HIV-positive. That means Russia has one of the highest percentages of HIV-infected people in the world outside sub-Saharan Africa, according to reporting by the Pulitzer Center.  Most of the spread of AIDS began with the fall of the Soviet Union and Russia’s interest in all things Western society, like sex and drugs. The only thing missing from these liberties were understanding the risks of unprotected sex and sharing needles used to shoot up heroine.

Study shows complexities of reducing HIV rates in Russia “Addressing prevention of HIV transmission from HIV-infected Russian drinkers, a group at particularly high risk for disease transmission, requires creative approaches and aggressive uptake of antiretroviral therapy,” said Jeffrey Samet, MD, MA, MPH, professor of medicine at BUSM and chief of the section of general internal medicine at Boston Medical Center. “This study shows that we need to explore other options to help stem the growing epidemic.”


Funding for this study was provided in part by the National Institute on Alcohol Abuse and Alcoholism under grant award number R01AA016059.

Russia spoils world HIV/AIDS statistics
The number of HIV infected Russians may grow by 70,000 by the end of this year, head of the Federal HIV/AIDS Prevention and Treatment Center Vadim Pokrovsky said.

“The number of new HIV infections and the mortality rates are growing here. As of October 1, 2013, this country had 780,000 HIV-infected people. Some 51,000 new HIV infections were recorded in the first eight months of 2013.

We are expecting more than 70,000 new HIV infections before the end of this year, which is practically 200 new HIV infections per day,” Pokrovsky told a press conference on Thursday ahead of the World AIDS Day. Russia failing to test vulnerable groups for HIV Opinion: Russia failing to test vulnerable groups for HIV “More than 0.8 percent of Russia’s population is HIV-infected,” the expert said.

The number of new HIV infections has been declining across the globe but growing in Russia, Pokrovsky said. “The world is witnessing a decline in new HIV infections. Alas, our country lags behind and spoils world statistics,” he noted. The AIDS mortality rate is also increasing in Russia. “We had 20,000 AIDS deaths last year.

The number will stand at approximately 25,000 this year, and it will be equal with the rate of car accident moralities,” Pokrovsky said. He explained the high mortality rates with late treatment.


Jenny Eriksen Leary
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Boston University Medical Center

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