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PLoS One. 2016 Nov 29;11(11):e0166539. doi: 10.1371/journal.pone.0166539. eCollection 2016.

Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia.

Author information

1
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
2
Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, United States of America.
3
Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America.
4
Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, United States of America.
5
Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, Massachusetts, United States of America.
6
First Pavlov State Medical University, St. Petersburg, Russian Federation.
7
North-West Regional AIDS Center, St. Petersburg, Russian Federation.
8
Bekhterev Research Psychoneurological Institute, St. Petersburg, Russian Federation.
9
Division of Global Public Health, University of California San Diego School of Medicine, La Jolla, California, United States of America.

Abstract

In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007-2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma) with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years). In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR) 2.60, 95% Confidence Interval (CI): 1.24-5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35-2.59). No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians.

PMID:
27898683
PMCID:
PMC5127495
DOI:
10.1371/journal.pone.0166539
[Indexed for MEDLINE]
Free PMC Article

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