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.