Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug;26(8):755-63.
doi: 10.1016/j.drugpo.2015.04.017. Epub 2015 Apr 25.

Current and recent drug use intensifies sexual and structural HIV risk outcomes among female sex workers in the Russian Federation

Andrea L Wirtz  1 , Alena Peryshkina  2 , Vladimir Mogilniy  2 , Chris Beyrer  3 , Michele R Decker  4
Affiliations

Current and recent drug use intensifies sexual and structural HIV risk outcomes among female sex workers in the Russian Federation

Andrea L Wirtz et al. Int J Drug Policy. 2015 Aug.

Abstract

Background: Female sex workers (FSW) and people who inject drugs (PWID) are at high risk for HIV infection, with FSW-PWID at even greater risk. HIV-related research often focuses on the primary mode of transmission - sexual or parenteral transmission for FSW and PWID, respectively - with less known on how sex work and injection drug use (IDU) are collectively associated with the risk environment experienced by sex workers. We investigated this relationship among FSW in three Russian cities.

Methods: In 2011, FSWs (N=754) in Tomsk, Krasnoyarsk, and Kazan were recruited via respondent-driven sampling and completed a survey and rapid HIV screening. Multivariable models evaluated the role of injection history (classified as active: last 6 months, former: prior to last 6 months, and never) with a set of sexual and structural HIV risk outcomes.

Results: IDU was common: 11% actively injected drugs and 11% were former injectors. HIV infection was most prevalent among active injectors (AOR: 6.7; 95% CI: 2.4-18.9) and former injectors (AOR:4.5; 95%CI: 1.7-11.6), compared to non-injectors. Some 6-8% of non-injecting FSWs reported recent physical or sexual client violence and 23% police extortion. Compared to these non-injectors, active injecting was associated with unprotected anal sex (AOR: 2.8, 95%CI: 1.2-6.4), client violence (AOR: 7.3, 95%CI: 2.1-24.7), and police extortion (AOR: 3.0 95%CI: 1.5-5.9%). Self-reported sexual and structural risk outcomes were also more prevalent among active compared to former injectors; however, few differences existed between former and non-injectors.

Conclusions: FSW experience sexual, structural, and HIV risk outcomes and these risks are amplified for actively injecting FSWs. FSW who stopped injecting drugs demonstrated risk profiles closer to those of sex workers who had no history of injection. HIV prevention programs and outreach can provide opportunities to include harm reduction interventions and linkage to treatment for FSW to move FSWs towards lower risk environments.

Keywords: Female sex worker; HIV; Injection drug use; Prevention; Russian Federation; Violence.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest:

The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
Dynamic movement between sex work and injecting drug use risk environments
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abdala N, Krasnoselskikh TV, Durante J, Timofeeva MY, Verevochkin SV, Kozlov AP. Sexually transmitted infections, sexual risk behaviors and the risk of heterosexual spread of HIV among and beyond IDUs in St. Petersburg, Russia. European Addiction Research. 2008;14:19–25. doi: 10.1159/000110407. - DOI - PubMed
    1. Abdala N, White E, Toussova OV, Krasnoselskikh TV, Verevochkin S, Kozlov AP, Heimer R. Comparing sexual risks and patterns of alcohol and drug use between injection drug users (IDUs) and non-IDUs who report sexual partnerships with IDUs in St. Petersburg, Russia. BMC Public Health. 2010;10:676. doi: 10.1186/1471-2458-10-676. - DOI - PMC - PubMed
    1. 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(10):2181–2190. doi: 10.1016/j.socscimed.2004.10.009. - DOI - PubMed
    1. Aral SO, St Lawrence JS, Tikhonova L, Safarova E, Parker KA, Shakarishvili A, Ryan CA. The social organization of commercial sex work in Moscow, Russia. Sexually Transmitted Diseases. 2003;30(1):39–45. - PubMed
    1. Arps FS, Golichenko M. Sex workers, unite! (Litigating for sex workers’ freedom of association in Russia) Health Hum Rights. 2014;16(2):E24–34. - PubMed

Publication types