Increased Substance Use among Russian Women with HIV and Hepatitis C Co-Infection: Implications for Assessment and Intervention

Background: HIV and Hepatitis C (HCV) co-infection are associated with additional health complications (e.g., cirrhosis) and increased mortality.  Current medical guidelines for HIV/HCV co-infected individuals include alcohol abstinence and reduction in HIV transmission behaviors (e.g., injection drug use, unprotected sex). The aim of this study was to characterize patterns of substance use between HIV/HCV co-infected Russian women and those only with HIV infection to inform future assessment and intervention practices. 

Methods: HIV-infected women (N=247; M age = 30.0) receiving medical care in St. Petersburg, Russia, completed an audio computer-assisted self-interview (ACASI) that assessed substance use, the co-occurrence of substance use and sexual behaviors, and measures of problematic substance use (e.g., AUDIT). Medical chart review established HCV diagnosis. Logistic and linear regression analyses compared HIV/HCV co-infected participants’ patterns of substance use to those only infected with HIV. 

Results: More than half of the sample (57.1%) was HIV/HCV co-infected. HIV/HCV co-infected participants reported more frequent binge drinking (β=.15, p=.05), problem drinking based on the AUDIT (β=.15, p=.01), greater substance use problems based on the DAST (β=.19, p=.03), and increased likelihood of unprotected sex when drinking at the last sexual encounter (AOR=2.2, p=.007).

Conclusions: HIV/HCV co-infection was prevalent among this sample and was associated with increased substance use and the co-occurrence of substance use and sexual risk behaviors. Findings highlight the need for ongoing substance use and HIV risk behavior assessment and development and evaluation of interventions targeting both substance use and HIV risk among HIV/HCV co-infected Russian women.