Alcohol Use, Sexual Risk Behavior, and HIV among People Living in Russia: A Systematic Review

Alcohol consumption in Russia is among the highest per capita in the world and HIV in Russia has increased dramatically over the past three decades, accounting for nearly 70% of the known infections in Eastern Europe and Central Asia. The purpose of this systematic review was to examine the prevalence of alcohol use, sexual risk behaviors, and HIV among Russians. Comprehensive electronic searches were conducted to locate studies that sampled Russians, assessed alcohol use and either a behavioral measure of risk (e.g., unprotected sex) or a biological measure of HIV incidence, and reported sufficient statistical information. Of the 618 studies identified through database searches, 19 met inclusion criteria. Study samples included 22,912 participants living in Russia (M = 30 years of age; 37% women; 13% MSM). Participants were recruited via clinical contact (47%; e.g., sexually transmitted infection clinic, drug treatment); 21% recruited participants from high-risk settings (e.g., sexual or drug networks), and a single study recruited participants from schools. Findings indicate that a substantial proportion of the participants used substances: alcohol (72%; 63% heavy drinking) and drugs (42%; 39% injecting drugs). Most participants (90%) were sexually active and many of them engage in sexual risk behaviors (57% unprotected sex; 53% multiple sexual partners). Nearly half (48%) of all participants reported using alcohol before sex. Of the five studies testing participants for HIV, 11% of participants tested positive. These findings support the need and potential benefit of integrating alcohol use as a risk factor in programs to prevent HIV among Russians.