Elena Blokhina
E. Blokhina1, D. Cheng2, T. Yaroslavtseva1, E. Quinn3, N. Bushara1, V. Truong4, K. Lunze4, A. Raj5, E. Krupitsky1,6, J.H. Samet4,7. 1Pavlov University, St. Petersburg, Russia; 2Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States; 3Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, United States; 4Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States; 5University of California at San Diego, United States; 6Department of Addictions, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia; 7Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
Aim: In recent years, non-prescribed methadone use has surpassed heroin use among people who inject drugs (PWID) in St. Petersburg, Russia. This study explored the association between specific injection opioid use (i.e., methadone and heroin) and use of contaminated equipment among HIV-positive Russians.
Methods: We examined baseline data from two research studies [LINC, n=174; LINC-II, n=129] including HIV+ people who recently (within past month) injected illicit opioids in St. Petersburg, Russia. The main independent variable was any recent (past 30 days) non-prescribed methadone or other illicit opioid use; secondary independent variables were any recent heroin use and drug injection frequency. The primary outcome was recent use of contaminated equipment. We fit multiple logistic regression models controlling for age, gender, recent alcohol and stimulant use, hepatitis C and craving for opioids.
Results: Among 303 participants (mean age 35.3±4.7 years; 80% male; 31% unemployed; 96% with hepatitis C), 79% had recently used non-prescribed methadone or other illicit opioids. People using methadone appeared to have fewer injections and less craving compared to those who did not (36±30 injections per month vs 60±29; craving score 46±33 vs. 58±31). The odds of using contaminated equipment appeared higher for methadone users compared to non-methadone users, although the results were not statistically significant (AOR 1.67, 95%CI: 0.94, 2.99; p=0.08). Heroin users had significantly lower odds of using contaminated equipment compared to non-heroin users (AOR 0.6, 95%CI: 0.38, 0.95; p=0.03). Recent drug injection frequency was not significantly associated with use of contaminated equipment (AOR 0.99, 95%CI: 0.99, 1.00; p=0.12).
Conclusion: Among HIV+ Russian PWID, use of contaminated equipment appeared more common among patients using non-prescribed methadone or other illicit opioids compared to those who did not and less common among heroin users than non-heroin users. Future research should explore the interrelationship between methadone, heroin and injection risk behavior.