Evolution of Illicit Opioid Use Among People With HIV Infection in St Petersburg, Russia, in the Period 2004–2015

Results

The baseline demographics and characteristics of each cohort are presented in Table 1. The mean age of participants was 24.5 (SD 3.6) years in the earliest study (PREVENT; 2004–2005) and increased to 33.3 (SD 4.6) years in the most recent study (ARCH; 2012–2015). The majority of participants in the cohorts were male (59% in PREVENT and HERMITAGE, 68% in LINC, and 71% in Russia ARCH). Employment decreased with each subsequent cohort: 35% reported unemployment in PREVENT and 65% in Russia ARCH. The majority of participants had completed secondary education in all cohorts.

Alcohol use was common in the cohorts; however, the entry criteria for some studies required alcohol use. Past month cannabis use was also common, with 47% reporting past 30-day cannabis use in 2004–2005, 37% in 2007–2010, 65% in 2013–2014, and 25% in 2012–2015. Among the three studies that assessed smoking, > 90% of participants in each cohort were regular smokers. Information on methadone use, specifically, was collected in two cohorts; in 2004–2005, 6% of participants reported past 30-day methadone use, and in 2012–2015, 80% of cohort participants reported methadone use in the past year (Table 1).

Use of only illicit opioids other than heroin appeared to increase over time, from 0% in PREVENT (2004–2005) to 4% (95% CI 2, 7%) in HERMITAGE (2007–2010) to 31% (95% CI 23, 40%) in LINC (2013–2014) to 46% (95% CI 37, 56%) in Russia ARCH (2012–2015). Furthermore, the use of other opioids in combination with heroin increased from 6% (95% CI 0, 29%) in PREVENT (2004–2005) to 26% (95% CI 21, 32%) in HERMITAGE (2007–2010) to 31% (95% CI 23, 40%) in Russia ARCH (2012–2015). Use of only heroin consistently decreased over the 10-year span, from 94% (95% CI 71, 100%) in PREVENT (2004–2005) to 70% (95% CI 64, 75%) in HERMITAGE (2007–2010) to 30% (95% CI 22, 39%) in LINC (2013–2014) to 23% (95% CI 16, 32%) in ARCH (2012–2015) (Figure 1).

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Figure 1.

Patterns of past 30-day opioid use, by cohort.

HIV Medicine. 2019;20(7):450-455. © 2019 Blackwell Publishing