HIV Transmission from Drug Injectors to Partners Who Do Not Inject, and Beyond: Modelling the Potential for a Generalized Heterosexual Epidemic in St. Petersburg, Russia

Overview

Journal Drug Alcohol Depend

Publisher Elsevier

Specialty Psychiatry

Date 2013 May 23

PMID 23692991

Citations 11

Authors

Harriet L Mills

Edward White

Caroline Colijn

Peter Vickerman

Robert Heimer

Affiliations

Soon will be listed here.

Abstract

Background: HIV infection is prevalent among drug injectors in St. Petersburg and their non-injecting heterosexual partners (PIDUs). There are fears that sexual transmission of HIV from IDUs to PIDUs may portend a self-sustaining, heterosexual epidemic in Russia.

Methods: Our model combines a network model of sexual partnerships of IDUs and non-IDUs to represent sexual transmission of HIV and a deterministic model for parenteral transmission among IDUs. Behavioural parameters were obtained from a survey of St. Petersburg IDUs and their sexual partners. We based our model fits on two scenarios for PIDU prevalence in 2006 (5.6% and 15.1%, calculated excluding and including HCV co-infected PIDUs respectively) and compared predictions for the general population HIV prevalence.

Results: Results indicate that sexual transmission could sustain a non-IDU HIV epidemic. The model indicates that general population prevalence may be greater than current estimates imply. Parenteral transmission drives the epidemic and the PIDU bridge population plays a crucial role transferring infection to non-IDUs. The model indicates that the high PIDU prevalence is improbable because of the high risk behaviour this implies; the lower prevalence is possible.

Conclusion: The model implies that transmission through PIDUs will sustain a heterosexual epidemic, if prevalence among IDUs and PIDUs is as high as survey data suggest. We postulate that current estimates of population prevalence underestimate the extent of the HIV epidemic because they are based on the number of registered cases only. Curtailing transmission among injectors and PIDUs will be vital in controlling heterosexual transmission.

Citing Articles

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Ward Z, Stone J, Bishop C, Ivakin V, Eritsyan K, Deryabina A Lancet HIV. 2021; 9(1):e42-e53.

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A review of network simulation models of hepatitis C virus and HIV among people who inject drugs.

Bellerose M, Zhu L, Hagan L, Thompson W, Randall L, Malyuta Y Int J Drug Policy. 2019; 88:102580.

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Potential impact of implementing and scaling up harm reduction and antiretroviral therapy on HIV prevalence and mortality and overdose deaths among people who inject drugs in two Russian cities: a modelling study.

Cepeda J, Eritsyan K, Vickerman P, Lyubimova A, Shegay M, Odinokova V Lancet HIV. 2018; 5(10):e578-e587.

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Stigmatization of people who inject drugs (PWID) by pharmacists in Tajikistan: sociocultural context and implications for a pharmacy-based prevention approach.

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Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia.

Calabrese S, Burke S, Dovidio J, Levina O, Uuskula A, Niccolai L AIDS Behav. 2015; 20(1):85-97.

PMID: 26050155 PMC: 4793904. DOI: 10.1007/s10461-015-1100-4.

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