Rapid assessment of HIV infection and associated risk behaviors among men who have sex with men in Russia, 2008
Background: The majority of early cases of HIV in Russia were among men who have sex with men (MSM). Despite this and the current resurgence of HIV among MSM globally, little systematic work has been done to assess current HIV risks among these men. We conducted a rapid assessment of HIV and associated risk behaviors among MSM in Russia.
Methods: An anonymous, cross-sectional study was performed among MSM in Moscow and St. Petersburg in January 2008. Participants were enrolled by local NGO partners via peer-recruitment, underwent a brief behavioral survey, and were offered rapid HIV testing with a commercial salivary assay. Statistical analyses were performed using logistic regression.
Results: A total of 401 participants were enrolled. HIV prevalence was comparable in the two cities (6.0% in Moscow, 5.5% in St. Petersburg). Approximately half (49.3%) were under age 25, 75% of all men reported unprotected anal intercourse (UAI) and 20% reported engaging in exchange sex in the 12 months prior to the survey. HIV infection was the highest (7.7%) among MSM aged 18-22 years. Univariate analyses indicated statistically significant associations (p<0.05) between HIV infection and never having tested for HIV, ever injecting drugs, and ever receiving an STD diagnosis. Multivariate logistic regression resulted in never having tested for HIV (AOR=7.5; 95% C.I.: 1.9, 29.9) and ever injecting drugs (AOR=9.8; 95% C.I.: 2.0, 47.3) being independently associated with HIV infection.
Conclusions: We found significant overall HIV prevalence (5.7%) among MSM in Moscow and St. Petersburg, particularly among the youngest men. Never having been tested and ever having injected drugs were independent risks for HIV infection. The majority of men reported ongoing high risk behaviors, indicating the potential for further spread. HIV prevention efforts need to specifically focus on urban MSM in Russia, encourage testing, and target injection risks to address this epidemic.
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