Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

Wendee M Wechsberg,Rachel Middlesteadt Ellerson,Edwin Zvartau,Hendrée E Jones,Tracy L Kline,William A Zule,Evgeny Krupitsky,Georgiy Bobashev,Felicia A Browne,Tatiana Romanova

doi:10.1186/1747-597x-7-1

Abstract

BackgroundWith HIV prevalence estimated at 20% among female injecting drug users (IDUs) in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women's CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient detoxification drug treatment setting.MethodWomen (N = 100) were randomized into one of two one-hour long intervention conditions--the Woman-Focused intervention (n = 51) or a time and attention-matched Nutrition control condition (n = 49).ResultsThe results showed that 57% of the participants had been told that they were HIV-positive. At 3-month follow-up, both groups showed reduced levels of injecting frequency. However, participants in the Woman-Focused intervention reported, on average, a lower frequency of partner impairment at last sex act and a lower average number of unprotected vaginal sex acts with their main sex partner than the Nutrition condition.ConclusionThe findings suggest that improvements in sexual risk reduction are possible for these at-risk women and that more comprehensive treatment is needed to address HIV and drug risks in this vulnerable population.

Highlights

With HIV prevalence estimated at 20% among female injecting drug users (IDUs) in St
This study aimed (1) to characterize the risks for HIV associated with injecting drug use and sex behaviors among female IDUs in drug treatment in St
The interviews focused on learning more about drug use and risk, understanding sexual risk, and informing the adaptation of the Women’s CoOp intervention to the Russian context [24]

Summary

Introduction

With HIV prevalence estimated at 20% among female injecting drug users (IDUs) in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women’s CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient detoxification drug treatment setting. The geographical nexus of Russia’s HIV epidemic is St. Petersburg, with an HIV prevalence rate of 30-47% among injecting drug users (IDUs) [3]. 80-90% of the HIV cases in St. Petersburg are associated with IDUs, many of whom are unaware of their HIV status [4,5,6].

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Conclusion