Key risk factors for populations especially vulnerable to HIV infection

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614.8.026.1
Authors: 

M.V. Piterskiy1, A.V. Semenov1, Yu.A. Zakharova3, O.Y. Yarantseva1, O.A. Khodakov1, V.I. Evseeva2, M.O. Greisman2

Organization: 

1Federal Scientific Research Institute of Viral Infections ‘Virome’, 23 Letnyaya St., Ekaterinburg, 620030, Russian Federation
2‘New Life’ Regional public fund for assistance to various categories of the population of the Sverdlovsk region, 104 Sel’korovskaya St., Ekaterinburg, 620103, Russian Federation
3F.F. Erisman’s Federal Scientific Centre of Hygiene, 18 Nauchnyi proezd, Moscow, 117246, Russian Federation

Abstract: 

Since 2012, no data can be found on any scientific research accomplished in correction facilities of the Russian Federal Penitentiary Service with its aim being to identify HIV risk factors and adherence to antiretroviral therapy (ART) among prisoners. In correction facilities of the Sverdlovsk oblast, each fifth prisoner is HIV-positive and in future this means a grave HIV burden for the regional population. Between 2020 and 2022, an anonymous survey was accomplished within an observational analytical cross-sectional study. Overall, 302 men participated in it; they were all former prisoners who applied for aid to a socially-oriented nonprofit organization during their social adaptation.

Injection drug use (IDU) was established to be the basic factor able to cause HIV in the analyzed group. Among HIV-positive respondents, 94.3 % had such experience prior to and during their service; among other prisoners, 55.6 % reported IDU (p < 0.001). Twenty-eight point nine percent of prisoners continued to use narcotics in prison. According to the survey results, 87.9 % of HIV-positive men only ‘sometimes’ used barrier protection during sexual intercourse or didn’t use it at all. Seventy-three point five percent of them had more than 10 sexual partners during their lifetime and 29.3 % had sexually transmitted diseases in their case history. It is noteworthy that 82.9 % of the HIV-positive respondents had sexual contacts already during the first six months after being released from prison.

The study established a growing share of people who got antiretroviral therapy (ART) after release from the penitentiary system, from 63.1 % to 75.4 %; however, only 33.0 % of the patients who received ART were able to confirm they had never stopped doing it. Therefore, we have detected a high risk HIV spread among prisoners during their service with subsequent active HIV transmission into the general population.

Keywords: 
HIV, injection drug users, prison, prisoners, risky behavior, risk factors, correction facilities, antiretroviral therapy, especially vulnerable population groups
Piterskiy M.V., Semenov A.V., Zakharova Yu.A., Yarantseva O.Y., Khodakov O.A., Evseeva V.I., Greisman M.O. Key risk factors for populations especially vulnerable to HIV infection. Health Risk Analysis, 2023, no. 4, pp. 104–115. DOI: 10.21668/health.risk/2023.4.10.eng
References: 
  1. Sayyah M., Rahim F., Kayedani G.A., Shirbandi K., Saki-Malehi A. Global View of HIV Prevalence in Prisons: A Systematic Review and Meta-Analysis. Iran. J. Public Health, 2019, vol. 48, no. 2, pp. 217–226.
  2. Golrokhi R., Farhoudi B., Taj L., Pahlaviani F.G., Mazaheri-Tehrani E., Cossarizza A., SeyedAlinaghi S., Mohraz M., Voltarelli F.A. HIV Prevalence and Correlations in Prisons in Differ-ent Regions of the World: A Review Article. Open AIDS J., 2018, vol. 12, pp. 81–92. DOI: 10.2174/1874613601812010081
  3. Dolan K., Wirtz A.L., Moazen B., Ndeffo-mbah M., Galvani A., Kinner S.A., Courtney R., McKee M. [et al.]. Global Burden of HIV, Viral Hepatitis, and Tuberculosis in Prisoners and Detainees. The Lancet, 2016, vol. 388, no. 10049, pp. 1089–1102. DOI: 10.1016/S0140-6736(16)30466-4
  4. Obzor informatsii o deyatel'nosti FSIN Rossii za I polugodie 2021 goda [Review of infor-mation on the activities of the Federal Penitentiary Service of Russia over the first half of 2021]. Federal Penitentiary Service of Russia. Available at: https://fsin.gov.ru/statistics/obzor-informatsii-o-deyatelnosti-fsin-ros... (September 1, 2022) (in Russian).
  5. Altice F.L., Azbel L., Stone J., Brooks-Pollock E., Smyrnov P., Dvoriak S., Taxman F.S., El-Bassel N. [et al.]. The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central Asia. The Lancet, 2016, vol. 388, no. 10050, pp. 1228–1248. DOI: 10.1016/S0140-6736(16)30856-X
  6. Mikhaylova Yu.V., Nechaeva O.B., Samarina E.A., Tikhonova Yu.V., Shikina I.B. The infectious socially significant diseases in places of imprisonment. Zdravookhranenie Rossiiskoi Federatsii, 2017, vol. 61, no. 1, pp. 29–35. DOI: 10.18821/0044-197Х-2017-61-1-29-35 (in Russian).
  7. Dolan K., Moazen B., Noori A., Rahimzadeh S., Farzadfar F., Hariga F. People who inject drugs in prison: HIV prevalence, transmission and prevention. Int. J. Drug Policy, 2015, vol. 26, suppl. 1, pp. S12–S15. DOI: 10.1016/j.drugpo.2014.10.012
  8. Carpentier C., Royuela L., Montanari L., Davis P. Chapter 2: The Global Epidemiology of Drug Use in Prison. In book: Drug use in prisoners. Epidemiology, implications, and policy responses. In: S.A. Kinner, J.D.J. Rich eds. Oxford University Press, 2018, pp. 17–42.
  9. Štulhofer A., Jwehan I., AbuRabie R. HIV and HCV prevalence and incarceration-related risks among injecting drug users in three West Bank governorates. AIDS Care, 2016, vol. 28, no. 9, pp. 1159–1165. DOI: 10.1080/09540121.2016.1154132
  10. Culbert G.J., Pillai V., Bick J., Al-Darraji H.A., Wickersham J.A., Wegman M.P., Bazazi A.R., Ferro E. [et al.]. Confronting the HIV, Tuberculosis, Addiction, and Incarceration Syndemic in Southeast Asia: Lessons Learned from Malaysia. J. Neuroimmune Pharmacol., 2016, vol. 11, no. 3, pp. 446–455. DOI: 10.1007/s11481-016-9676-7
  11. Izenberg J.M., Bachireddy C., Wickersham J.A., Soule M., Kiriazova T., Dvoriak S., Altice F.L. Within-prison drug injection among HIV-infected Ukrainian prisoners: prevalence and correlates of
    an extremely high-risk behavior. Int. J. Drug Policy, 2014, vol. 25, no. 5, pp. 845–852. DOI: 10.1016/j.drugpo.2014.02.010
  12. Khajehkazemi R., Haghdoost A., Navadeh S., Setayesh H., Sajadi L., Osooli M., Mostafavi E. Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs. Sex. Health, 2014, vol. 11, no. 6, pp. 568–574. DOI: 10.1071/SH14165
  13. Kirwan A., Curtis M., Dietze P., Aitken C., Woods E., Walker S., Kinner S., Ogloff J. [et al.]. The Prison and Transition Health (PATH) Cohort Study: Study Protocol and Baseline Characteristics of a Cohort of Men with a History of Injecting Drug Use Leaving Prison in Australia. J. Urban Health, 2019, vol. 96, no. 3, pp. 400–410. DOI: 10.1007/s11524-019-00353-5
  14. Łukaszek M. HIV/AIDS – the problem in Polish prisons. HIV & AIDS Review, 2019, vol. 18, no. 3, pp. 199–206. DOI: 10.5114/hivar.2019.88195
  15. Richters J., Butler T., Schneider K., Yap L., Kirkwood K., Grant L., Richards A., Smith A.M.A., Donovan B. Consensual Sex Between Men and Sexual Violence in Australian Prisons. Arch. Sex. Behavior., 2012, vol. 41, no. 2, pp. 517–524. DOI: 10.1007/s10508-010-9667-3
  16. Wise A., Finlayson T., Sionean C., Paz-Bailey G. Incarceration, HIV Risk–Related Beha-viors, and Partner Characteristics Among Heterosexual Men at Increased Risk of HIV Infection, 20 US Cities. Public Health Rep., 2019, vol. 134, suppl. 1, pp. 63S–70S. DOI: 10.1177/0033354919833435
  17. Khan M.R., Behrend L., Adimora A.A., Weir S.S., White B.L., Wohl D.A. Dissolution of Primary Intimate Relationships During Incarceration and Implications for Post-Release HIV Transmission. J. Urban Health, 2011, vol. 88, no. 2, pp. 365–375. DOI: 10.1007/s11524-010-9538-1
  18. Fuge T.G., Tsourtos G., Miller E.R. Factors affecting optimal adherence to antiretroviral therapy and viral suppression amongst HIV-infected prisoners in South Ethiopia: a comparative cross-sectional study. AIDS Res. Ther., 2022, vol. 19, no. 1, pp. 5. DOI: 10.1186/s12981-022-00429-4
  19. Fuge T.G., Tsourtos G., Miller E.R. A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people. PLoS One, 2020, vol. 15, no. 5, pp. e0233355. DOI: 10.1371/journal.pone.0233355
  20. Seyedalinaghi S., Farhoudi B., Harandi H., Mahalleh M., Dadras O., Alipour A., Alijani M. A study of barriers to adherence of antiretroviral treatment in prisoners living with HIV in Tehran, Iran. Iranian Journal of Health Sciences, 2020, vol. 8, no. 2, pp. 23–31. DOI: 10.18502/jhs.v8i2.4026
  21. Hammer Ø., Harper D.A.T., Ryan P.D. PAST: Paleontological Statistics Software Package for Education and Data Analysis. Palaeontologia Electronica, 2001, vol. 4, no. 1, pp. 1–9.
  22. Larney S., Leung J., Grebely J., Hickman M., Vickerman P., Peacock A., Stone J., Trickey A. [et al.]. Global Systematic Review and Ecological Analysis of HIV in People Who Inject Drugs:
    National Population Sizes and Factors Associated With HIV Prevalence. Int. J. Drug Policy, 2020, vol. 77, pp. 102656. DOI: 10.1016/j.drugpo.2019.102656
  23. Pokrovskii V.V., Ladnaya N.N., Sokolova E.V. VICh-infektsiya. Informatsionnyi byulleten' [HIV infection. News bulletin]. Moscow, FNMTs PB SPID Publ., 2021, 83 p. (in Russian).
  24. Teokharov A.K. Factors influencing HIV situation in correctional institutions. Viktimologiya, 2018, no. 1 (15), pp. 76–85 (in Russian).
  25. Moazen B., Saeedi Moghaddam S., Silbernagl M.A., Lotfizadeh M., Bosworth R.J., Alammehrjerdi Z., Kinner S.A., Wirtz A.L. [et al.]. Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates. Epidemiologic Reviews, 2018, vol. 40, no. 1, pp. 58–69. DOI: 10.1093/epirev/mxy002
  26. Michel L., Trouiller P., Chollet A., Molinier M., Duchesne L., Jauffret-Roustide M., ANRS-Coquelicot Study Group. Self-reported Injection Practices Among People Who Use Drugs in French Prisons: Public Health Implications (ANRS-Coquelicot Survey 2011–2013). Drug Alcohol Rev., 2018, vol. 37, suppl. 1, pp. S268–S276. DOI: 10.1111/dar.12620
  27. Krstić M., Ivanović I., Vasić M., Sulovic M.Z. Risk Behaviour and Risk Factors for HIV and other STI Among Prisoners in Serbia. Sexually Transmitted Infections, 2013, vol. 89, suppl. 1, pp. A287.1–A287. DOI: 10.1136/sextrans-2013-051184.0893
  28. Kassaian N., Adibi P., Kafashaian A., Yaran M., Nokhodian Z., Shoaei P., Hassannjead R., Babak A., Ataei B. Hepatitis C Virus and Associated Risk Factors Among Prison Inmates with History of Drug Injection in Isfahan, Iran. Int. J. Prev. Med., 2012, vol. 3, suppl. 1, pp. S156–S161.
  29. Culbert G.J., Waluyo A., Iriyanti M., Muchransyah A.P., Kamarulzaman A., Altice F.L. Within-prison Drug Injection Among HIV-Infected Male Prisoners in Indonesia: A Highly Constrained Choice. Drug Alcohol Depend., 2015, vol. 149, pp. 71–79. DOI: 10.1016/j.drugalcdep.2015.01.018
  30. Pollini R.A., Alvelais J., Gallardo M., Vera A., Lozada R., Magis-Rodriquez C., Strathdee S.A. The Harm Inside: Injection During Incarceration Among Male Injection Drug Users in Tijuana, Mexico. Drug Alcohol Depend., 2009, vol. 103, no. 1–2, pp. 52–58. DOI: 10.1016/j.drugalcdep.2009.03.005
  31. Wright N.M.J., Tompkins C.N.E., Farragher T.M. Injecting Drug Use in Prison: Prevalence and Implications for Needle Exchange Policy. Int. J. Prison. Health, 2015, vol. 11, no. 1, pp. 17–29. DOI: 10.1108/IJPH-09-2014-0032
  32. Staton-Tindall M., Harp K.L.H., Minieri A., Oser C., Webster J.M., Havens J., Leukefeld C. An Exploratory Study of Mental Health and HIV Risk Behavior Among Drug-Using Rural Women in Jail. Psychiatr. Rehabil. J., 2015, vol. 38, no. 1, pp. 45–54. DOI: 10.1037/prj0000107
  33. Lloyd A.R., Clegg J., Lange J., Stevenson A., Post J.J., Lloyd D., Rudge G., Boonwaat L. [et al.]. Safety and Effectiveness of a Nurse-Led Outreach Program for Assessment and Treatment of Chronic Hepatitis C in the Custodial Setting. Clin. Infect. Dis., 2013, vol. 56, no. 8, pp. 1078–1084. DOI: 10.1093/cid/cis1202
  34. Azbel L., Polonsky M., Wegman M., Shumskaya N., Kurmanalieva A., Asanov A., Wickersham J.A., Dvoriak S., Altice F.L. Intersecting Epidemics of HIV, HCV, and Syphilis Among Soon-To-Be Released Prisoners in Kyrgyzstan: Implications for Prevention and Treatment. Int. J. Drug
    Policy, 2016, vol. 37, pp. 9–20. DOI: 10.1016/j.drugpo.2016.06.007
  35. Fernandes de Oliveira Santos B., Oliveira de Santana N., Collado Franca A.V. Prevalence, Genotypes and Factors Associated with HCV Infection Among Prisoners in Northeastern Brazil. World J. Gastroenterol., 2011, vol. 17, no. 25, pp. 3027–3034. DOI: 10.3748/wjg.v17.i25.3027
  36. Knittel A.K., Snow R.C., Riolo R.L., Griffith D.M., Morenoff J. Modeling the Community-Level Effects of Male Incarceration on the Sexual Partnerships of Men and Women. Soc. Sci. Med., 2015, vol. 147, pp. 270–279. DOI: 10.1016/j.socscimed.2015.11.005
  37. Ruiz M.S., Heimer R., Levina O.S., Badosova N.V., Rassokhin V.V., Belyakov A.N., Belyakov N.A. HIV-care Access Among People with Incarceration Experience in St. Petersburg, Russia. Eur. J. Public Health, 2018, vol. 28, no. 1, pp. 145–149. DOI: 10.1093/eurpub/ckx122
  38. End inequalities. End AIDS. Global AIDS Strategy 2021–2026. UNAIDS. Geneva, WHO, 2021, 164 p.
  39. Nettles R.E., Kieffer T.L., Kwon P., Monie D., Han Y., Parsons T., Cofrancesco J., Gallant J.E. [et al.]. Intermittent HIV-1 Viremia (Blips) and Drug Resistance in Patients Receiving HAART. JAMA, 2005, vol. 293, no. 7, pp. 817–829. DOI: 10.1001/jama.293.7.817
Received: 
04.07.2023
Approved: 
20.10.2023
Accepted for publication: 
20.12.2023

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