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PLoS One. 2018 Nov 16;13(11):e0207402. doi: 10.1371/journal.pone.0207402. eCollection 2018.

Serodiscordant partnerships and opportunities for pre-exposure prophylaxis among partners of women and men living with HIV in St. Petersburg, Russia.

Author information

1
Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, Boston, MA, United States of America.
2
Department of Medicine, Division of Global Public Health, University of California San Diego School of Medicine, IOA Building, San Diego, CA, United States of America.
3
Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States of America.
4
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States of America.
5
Laboratory of Clinical Pharmacology of Addictions, First Pavlov State Medical University, St. Petersburg, Russian Federation.
6
Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, United States of America.
7
Smorodintsev Research Institute of Influenza, St. Petersburg, Russian Federation.
8
Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, St. Petersburg, Russian Federation.
9
Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine/Boston Medical Center, Boston, MA, United States of America.
10
HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States of America.
11
Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, MA, United States of America.
12
Department of Medicine, Section of General Internal Medicine, University of Washington School of Medicine and Harborview Hospital, Seattle, WA, United States of America.

Abstract

OBJECTIVE:

To describe the frequency of being partnered and having an HIV-negative partner, and whether this differed by gender, among a cohort of persons living with HIV (PLWH) who have ever injected drugs; to describe awareness of HIV pre-exposure prophylaxis (PrEP) and perceived partner interest in PrEP.

SETTING:

Secondary analyses of an observational cohort study of PLWH who have ever injected drugs in St. Petersburg, Russia.

METHODS:

Primary outcomes were 1) being partnered and 2) being in a serodiscordant partnership. The main independent variable was gender. Multivariable GEE logistic regression models were fit for binary outcomes, adjusted for age, income, education, and recent opioid use. Descriptive analyses were performed for partners' HIV status, substance use, sex risk behaviors, and awareness of PrEP for a subset of participants.

RESULTS:

At baseline, 50% (147/296) reported being in a partnership, and of those, 35% were in a serodiscordant partnership. After adjustment, women had significantly higher odds of being partnered compared to men (aOR = 3.12; 95% CI: 1.77, 5.51), but there were no significant gender differences in the odds of being in a serodiscordant partnership (aOR = 0.58; 95% CI: 0.27, 1.24). Among a sub-sample of participants queried (n = 56), 25% were aware of PrEP for prevention of sexual HIV transmission and 14% for prevention of injection-related transmission.

CONCLUSION:

Although half of our sample were partnered and one third of these partnerships were serodiscordant, PrEP awareness was low. Substantial opportunities for HIV prevention exist among PLWH who have ever injected drugs in Russia and their HIV-negative partners. Given the high proportion of HIV-negative partners among this ART-naïve sample, efforts to address the associated inherent risks, such as couples-based interventions, are needed to increase condom use, PrEP awareness, or uptake of other HIV-prevention modalities (e.g., ART for the HIV-positive partner).

Conflict of interest statement

The authors have declared that no competing interests exist.

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