Association between Pregnancy and Active Injection Drug Use and Sex Work among Women Injection Drug Users in Saint Petersburg, Russia.

P Girchenko,D C Ompad,L Gensburg,D Bikmukhametov

doi:10.1007/s11524-015-9954-3

Abstract

Widespread use of unsafe sexual practices among women injecting drugs both practicing and not practicing sex work leads to high levels of unplanned pregnancies in this population. The goal of this study was to investigate the association between pregnancy and active drug use and sex work. Data were collected using a convenience sample of 500 women in Saint Petersburg, Russia, in 2013. All women had recent experience of drug use, of which 200 were pregnant at the time of the study. The study consisted of a structured interview followed by a rapid HIV test. Pregnancy was protective against both active drug use and sex work. For HIV-positive women, these associations were stronger than for HIV-negative women: drug use prevalence ratio (PR) was 0.59 vs 0.85; for sex work, the PRs were 0.36 vs 0.64. Higher levels of education were associated with a lower prevalence ratio for active drug use and sex work in all models. Having children was not associated with active drug use or sex work. Pregnancy might be an optimal time for conducting interventions aimed at cessation of drug use and sex work among women injecting drugs.

Highlights

The HIVepidemic in the Russian Federation continues to remain one of the fastest growing HIV epidemics worldwide.[1]
Heterosexual HIV transmission is increasing: Girchenko and Gensburg are with the Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA; Ompad is with the Global Institute of Public Health, New York University, New York, NY, USA; Ompad is with the Center for Drug Use and HIV Research, New York University, New York, NY, USA; Ompad is with the Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA; Bikmukhametov is with the German Doctor Exchange, Bonn, Germany
Other studies conducted in Saint Petersburg have demonstrated that women IDUs (WIDUs) need comprehensive intervention programs aimed at primary, secondary, and tertiary prevention of HIV infection;[30,31] prevention of unplanned and unwanted pregnancies;[11,12] and assistance in changing risk behaviors in pregnant WIDUs

Summary

Introduction

The HIVepidemic in the Russian Federation continues to remain one of the fastest growing HIV epidemics worldwide.[1]. From the beginning of the HIV epidemic in the Russian Federation, injection drug users (IDUs) were the most affected group with the main route of HIV transmission through infected syringes.[5] Presently, heterosexual HIV transmission is increasing: Girchenko and Gensburg are with the Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA; Ompad is with the Global Institute of Public Health, New York University, New York, NY, USA; Ompad is with the Center for Drug Use and HIV Research, New York University, New York, NY, USA; Ompad is with the Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA; Bikmukhametov is with the German Doctor Exchange, Bonn, Germany

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Results

Discussion

Conclusion