Psychosocial needs, mental health, and HIV transmission risk behavior among people living with HIV/AIDS in St Petersburg, Russia

Objectives: The number of new HIV infections in Russia has doubled annually since 1996. A total of 232 424 HIV infections have been officially recorded but the actual number probably exceeds one million. Very little is known about the social, psychological, behavioral, and health care service access of persons living with HIV in Russia. Design: A cross-sectional sample of 470 persons with HIV/AIDS recruited in 2002 using a representative sampling plan in major St. Petersburg HIV care and service agencies. Methods: Participants completed anonymous self-administered questionnaires that elicited detailed information about social and psychological characteristics, HIV serostatus disclosure and discrimination experiences, and risk practices since learning of their HIV positive status. Results: Most participants were young (mean age, 25.3 years), knew of their HIV positive status for about 2 years, and had histories of injecting drug use as well as sexual risk behavior. A large proportion reported encountering discrimination including being forced to sign documents acknowledging their HIV status (47.9%), refusal of general health care (29.6%), being fired from their jobs (9.9%), and being forced from their family homes (9.0%). Over one-third had probable clinical depression. Most remained sexually active since learning of their HIV positive serostatus, approximately half engaged in unprotected sex with HIV negative partners, and condoms were not used one-third of the time with discordant partners. A majority of injecting drug users in the sample still shared needles. Conclusions: HIV-infected persons in Russia experience a wide range of social, psychological, and care access problems. Improved services are urgently needed for persons living with HIV/AIDS in Russia. (C) 2003 Lippincott Williams Wilkins.