Countries of the former
Soviet Union are experiencing the steepest
increases in annual HIV incidence in the world. Over 80% of registered
HIV cases in Russia have occurred among intravenous drug users (IDUs),
but current conditions set the stage for a heterosexually-transmitted
epidemic. IDUs who also trade sex for money or drugs may serve as a
conduit, or 'bridge' group, through which HIV could make inroads into
the general Russian population. The present study examined the
prevalence of sex trading among female Russian IDUs, and further
examined drug use, sexual behaviour, and perceived vulnerability in
this group. Female IDUs (n=100) in St Petersburg, Russia
participated; 37% reported a history of sex trading. This group
reported a mean of 49.5 male sexual partners in the previous month and
an average of 15.4 unprotected vaginal intercourse acts in the previous
30 days. A significant minority (44%) also reported sharing injection
equipment with others. Mathematical models to calculate risk estimates
for HIV seroconversion indicated that participants were at significant
risk of contracting HIV and infecting sexual partners. Despite
significant rates of risk behaviours, most participants perceived
themselves to be at little risk of contracting HIV. Effective HIV
prevention programmes targeted at this group are urgently needed and
are likely to be a cost-effective step in curtailing the spread of HIV
in the region.
©
Royal Society of Medicine Press Limited 2004