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HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking

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Abstract

The link between HIV stigma with substance use is understudied. We characterized individuals with high HIV stigma and examined whether HIV stigma contributes to substance use among HIV-positive Russians reporting risky alcohol use. We analyzed data from HERMITAGE, a randomized controlled trial of 700 people living with HIV/AIDS (PLWHA) with past 6-month risky sex and risky alcohol use in St. Petersburg, Russia (2007–2011). Participants who were female and reported depressive symptoms and lower social support were more likely to endorse high HIV stigma (all p’s < 0.001). In adjusted models, high HIV stigma was not significantly associated with the primary outcome unhealthy substance use and was not consistently associated with secondary substance use outcomes. Interventions to enhance social and mental health support for PLWHA, particularly women, may reduce stigma, though such reductions may not correspond to substantial decreases in substance use among this population.

Resumen

El vínculo entre el estigma relacionado al VIH y el uso de sustancias ha sido poco estudiado. En este estudio caracterizamos individuos con elevado estigma relacionado al VIH y examinamos si este estigma relacionado al VIH contribuye al consumo de sustancias entre infectados por el VIH en Rusia con trastorno por uso de alcohol. Se analizaron los datos de HERMITAGE, un estudio randomizado de 700 personas infectadas por el VIH(PVVs) con relaciones sexuales de riesgo y consumo de riesgo de alcohol durante los 6 meses anteriores en San Petersburgo, Rusia (2007–2011). Los participantes que eran de sexo femenino y reportaron síntomas depresivos y un menor apoyo social reportaron valores de estigma relacionado al VIH significativamente mayores (p < 0.001). En los modelos ajustados, elevados valores de estigma asociado al VIH no estaba significativamente asociado con el uso no saludable de cualquier sustancia (análisis primario) y no estaba consistentemente asociado con el uso de sustancias (análisis secundario). Las intervenciones para mejorar los apoyos sociales y la salud mental dirigidas a las PVVs, especialmente las mujeres, pueden reducir el estigma, aunque tales reducciones pueden no corresponder a una disminución sustancial en el consumo de sustancias en esta población.

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Funding

This work was generously supported by grants from the National Institutes of Health (U01AA021989; R01AA016059; U24AA020778; U24AA020779; U01AA020780; P30AI042853; and R25DA013582). EJ Edelman was supported as a Yale Drug Abuse, Addiction and HIV Research Scholars (DAHRS) Program (K12DA033312-03) and K Lunze was supported by a NIDA mentored-career development award (K99DA041245).

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Authors and Affiliations

  1. Yale University School of Medicine, PO Box 208025, New Haven, CT, 06520-8088, USA

    E. Jennifer Edelman

  2. Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA

    E. Jennifer Edelman

  3. Boston University School of Medicine and Boston Medical Center, Boston, MA, USA

    Karsten Lunze, Natalia Gnatienko, Carly Bridden, Alexander Y. Walley & Jeffrey H. Samet

  4. Boston University School of Public Health, Boston, MA, USA

    Debbie M. Cheng, Emily Quinn, Christine E. Chaisson & Jeffrey H. Samet

  5. First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russian Federation

    Dmitry A. Lioznov & Evgeny M. Krupitsky

  6. St.-Petersburg Bekhterev Research Psychoneurological Institute, St. Petersburg, Russian Federation

    Evgeny M. Krupitsky

  7. University of California – San Diego, San Diego, CA, USA

    Anita Raj

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  1. E. Jennifer Edelman
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Correspondence to E. Jennifer Edelman.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The HERMITAGE study was approved by the Institutional Review Boards of Boston University and First St. Petersburg Pavlov State Medical University. All participants provided written informed consent.

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Edelman, E.J., Lunze, K., Cheng, D.M. et al. HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking. AIDS Behav 21, 2618–2627 (2017). https://doi.org/10.1007/s10461-017-1832-4

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