Journal Mobile Options
Table of Contents
Vol. 14, No. 1, 2008
Issue release date: January 2008
Eur Addict Res 2008;14:19–25

Sexually Transmitted Infections, Sexual Risk Behaviors and the Risk of Heterosexual Spread of HIV among and beyond IDUs in St. Petersburg, Russia

Abdala N. · Krasnoselskikh T.V. · Durante A.J. · Timofeeva M.Y. · Verevochkin S.V. · Kozlov A.P.
aDepartment of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn., USA; bThe Biomedical Center, St. Petersburg, Russia

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Aims: This study investigates whether sexual transmitted behaviors and infections (STIs) among injection drug users (IDUs) may promote the spread of HIV among and beyond IDUs in Russia. Methods: We conducted a cross-sectional survey of behavior and tested for STIs in a convenience sample of 159 IDUs in St. Petersburg, Russia. Results: The median age was 27 and 57% were male. Almost all were sexually active, half had casual partners and 40% reported ≧2 sex partners in the previous 3 months. Of those who answered, 81% reported sex without condoms, 44% reported having sex with at least one partner who was not an IDU. Of 139 (87%) subjects who were actively injecting, 29% reported receptive syringe sharing. Twenty percent of subjects were seropositive for HIV-1 and 42% of HIV-1-negative subjects tested positive for an STI. Conclusions: The sample exhibited high levels of sexual risk behaviors and STIs, and a large proportion had sexual partners who were not IDUs. This population requires comprehensive interventions that ensures access to condoms and sterile injection supplies and that encourage safer sexual behaviors in an attempt to keep sexual transmission of HIV low.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. UNAIDS/WHO: AIDS Epidemic Update. Geneva, World Health Organisation, 2004.
  2. Field MG: HIV and AIDS in the Former Soviet Bloc. N Engl J Med 2004;351:117–120.
  3. Krupitsky EM, Zvartau EE, Lioznov DA, Tsoy MV, Egorova VY, Belyaeva TV, Antonova TV, Brazhenko NA, Zagdyn ZM, Verbitskaya EV, Zorina Y, Karandashova GF, Slavina TY, Grinenko AY, Samet JH, Woody GE: Co-morbidity of infectious and addictive diseases in St. Petersburg and the Leningrad Region, Russia. Eur Addict Res 2006;12:12–19.
  4. UNAIDS/WHO: AIDS Epidemic Update: December 2005. Geneva 2005.
  5. Lowndes CM, Renton A, Alary M, Rhodes T, Garnett G, Stimson G: Conditions for widespread heterosexual spread of HIV in the Russian Federation: implications for research, monitoring and prevention. Int J Drug Policy 2003;14:45–62.
  6. Grassly NC, Lowndes CM, Rhodes T, Judd A, Renton A, Garnett G: Modelling emerging HIV epidemics: the role of injecting drug use and sexual transmission in the Russian Federation, China and India. Int J Drug Policy 2003;14:25–43.
  7. Celum C, Levine R, Weaver M, Wald A: Genital herpes and human immunodeficiency virus: double trouble. Bull WHO 2004;82:447–453.
  8. Cohen MS: HIV and sexually transmitted diseases: lethal synergy. Top HIV Med 2004;12:104–107.

    External Resources

  9. Corey L, Wald A, Celum CL, Quinn TC: The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics. J Acquir Immune Defic Syndr 2004;35:435–445.
  10. Nusbaum MR, Wallace RR, Slatt LM, Kondrad EC: Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. J Am Osteopath Assoc 2004;104:527–535.

    External Resources

  11. Shaboltas AV, Toussova OV, Hoffman IF, Heimer R, Verevochkin SV, Ryder RW, Khoshnood K, Perdue T, Masse BR, Kozlov AP: HIV prevalence, sociodemographic, and behavioral correlates and recruitment methods among injection drug users in St. Petersburg, Russia. J Acquir Immune Defic Syndr 2006;41:657–663.
  12. Kozlov AP, Shaboltas AV, Toussova OV, Verevochkin SV, Masse BR, Perdue T, Beauchamp G, Sheldon W, Miller WC, Heimer R, Ryder RW, Hoffman IF: HIV incidence and factors associated with HIV acquisition among injection drug users in St. Petersburg, Russia. Aids 2006;20:901–906.
  13. Kelly JA, Amirkhanian YA, McAuliffe TL, Granskaya JV, Borodkina OI, Dyatlov RV, Kukharsky A, Kozlov AP, Kukharsky AA: HIV risk characteristics and prevention needs in a community sample of bisexual men in St. Petersburg, Russia. Predictors of HIV risk behavior among Russian men who have sex with men: an emerging epidemic. AIDS Care 2002;14:63–76.
  14. Somlai AM, Kelly JA, Benotsch E, Gore-Felton C, Ostrovski D, McAuliffe T, Kozlov AP: Characteristics and predictors of HIV risk behaviors among injection-drug-using men and women in St. Petersburg, Russia. AIDS Educ Prev 2002;14:295–305.
  15. Abdala N, Carney JM, Durante AJ, Klimov N, Ostrovski D, Somlai AM, Kozlov AP, Heimer R: Estimating the prevalence of syringe-borne and sexually transmitted diseases among injection drug users in St. Petersburg, Russia. Int J STD AIDS 2003;14:697–703.
  16. Golden MR, Ashley-Morrow R, Swenson P, Hogrefe WR, Handsfield HH, Wald A: Herpes simplex virus type 2 (HSV-2) Western blot confirmatory testing among men testing positive for HSV-2 using the focus enzyme-linked immunosorbent assay in a sexually transmitted disease clinic. Sex Transm Dis 2005;32:771–777.
  17. Morrow R, Nollkamper J, Robinson NJ, Bishop N, Smith J: Performance of focus ELISA tests for herpes simplex virus type 1 (HSV-1) and HSV-2 antibodies among women in ten diverse geographical locations. Clin Microbiol Infect 2004;10:530–536.
  18. Serwadda D, Gray RH, Sewankambo NK, Wabwire-Mangen F, Chen MZ, Quinn TC, Lutalo T, Kiwanuka N, Kigozi G, Nalugoda F, Meehan MP, Ashley Morrow R, Wawer MJ: Human immunodeficiency virus acquisition associated with genital ulcer disease and herpes simplex virus type 2 infection: a nested case-control study in Rakai, Uganda. J Infect Dis 2003;188:1492–1497.
  19. Aral SO, St Lawrence JS, Dyatlov R, Kozlov A: Commercial sex work, drug use, and sexually transmitted infections in St. Petersburg, Russia. Soc Sci Med 2005;60:2181–2190.
  20. Foxman B, Newman M, Percha B, Holmes KK, Aral SO: Measures of sexual partnerships: lengths, gaps, overlaps, and sexually transmitted infection. Sex Transm Dis 2006;33:209–214.
  21. Platt L, Rhodes T, Lowndes CM, Madden P, Sarang A, Mikhailova L, Renton A, Pevzner Y, Sullivan K, Khutorskoy M: Impact of gender and sex work on sexual and injecting risk behaviors and their association with HIV positivity among injecting drug users in an HIV epidemic in Togliatti City, Russian Federation. Sex Transm Dis 2005;32:605–612.
  22. Shakarishvili A, Dubovskaya LK, Zohrabyan LS, St Lawrence JS, Aral SO, Dugasheva LG, Okan SA, Lewis JS, Parker KA, Ryan CA: Sex work, drug use, HIV infection, and spread of sexually transmitted infections in Moscow, Russian Federation. Lancet 2005;366:57–60.
  23. Blanchard JF, Kang H, Emmanuel F, Sushena Reza Paul, MSA: AIDS in South Asia: Understanding and Responding to a Heterogenous Epidemic. Washington, University of Manitoba, Human Development Department, South Asia Region (SAR), World Bank Publications, Global HIV/AIDS Program, 2006.
  24. Chesson HW, Blandford JM, Pinkerton SD: Estimates of the annual number and cost of new HIV infections among women attributable to trichomoniasis in the United States. Sex Transm Dis 2004;31:547–551.
  25. Wald A, Langenberg AG, Krantz E, Douglas JM, Jr., Handsfield HH, DiCarlo RP, Adimora AA, Izu AE, Morrow RA, Corey L: The relationship between condom use and herpes simplex virus acquisition. Ann Intern Med 2005;143:707–713.
  26. Warner L, Newman DR, Austin HD, Kamb ML, Douglas JM Jr, Malotte CK, Zenilman JM, Rogers J, Bolan G, Fishbein M, Kleinbaum DG, Macaluso M, Peterman TA: Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status. Am J Epidemiol 2004;159:242–251.
  27. DiFranceisco W, Pinkerton SD, Dyatlov RV, Swain GR: Evidence of a brief surge in safer sex practices after HIV testing among a sample of high-risk men and women. J Acquir Immune Defic Syndr 2005;39:606–612.
  28. Gottlieb SL, Douglas JM, Jr., Foster M, Schmid DS, Newman DR, Baron AE, Bolan G, Iatesta M, Malotte CK, Zenilman J, Fishbein M, Peterman TA, Kamb ML: Incidence of herpes simplex virus type 2 infection in 5 sexually transmitted disease (STD) clinics and the effect of HIV/STD risk-reduction counseling. J Infect Dis 2004;190:1059–1067.
  29. Pinkerton SD, Layde PM, DiFranceisco W, Chesson HW: All STDs are not created equal: an analysis of the differential effects of sexual behaviour changes on different STDs. Int J STD AIDS 2003;14:320–328.
  30. Shain RN, Perdue ST, Piper JM, Holden AE, Champion JD, Newton ER, Korte JE: Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sex Transm Dis 2002;29:520–529.
  31. Aral SO, Hughes JP, Stoner B, Whittington W, Handsfield HH, Anderson RM, Holmes KK: Sexual mixing patterns in the spread of gonococcal and chlamydial infections. Am J Publ Hlth 1999;89:825–833.
  32. Morris M, Kretzschmar M: Concurrent partnerships and the spread of HIV. AIDS 1997;11:641–648.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50