Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin 53202, USA.
AIDS Behav. 2011 May;15(4):767-77. doi: 10.1007/s10461-010-9793-x.
Russia has seen one of the world's fastest-growing HIV epidemics. Transmission risk behavior, HAART-taking, and psychosocial distress of the growing population of Russian people living with HIV (PLH) in the HAART era are understudied. Participants of a systematically-recruited cross-sectional sample of 492 PLH in St. Petersburg completed measures of sexual and drug injection practices, adherence, perceived discrimination, and psychosocial distress. Since learning of their status, 58% of participants had partners of HIV-negative or unknown serostatus (mean = 5.8). About 52% reported unprotected intercourse with such partners, with 30% of acts unprotected. Greater perceived discrimination predicted lower condom use. A 47% of IDU PLH still shared needles, predicted by having no primary partner, lower education, and more frequently-encountered discrimination. Twenty-five percentage of PLH had been refused general health care, 11% refused employment, 7% fired, and 6% forced from family homes. Thirty-nine percentage of participants had probable clinical depression, 37% had anxiety levels comparable to psychiatric inpatients, and social support was low. Of the 54% of PLH who were offered HAART, 16% refused HAART regimens, and 5% of those on the therapy took less than 90% of their doses. Comprehensive community services for Russian PLH are needed to reduce AIDS-related psychosocial distress and continued HIV transmission risk behaviors. Social programs should reduce stigma and discrimination, and promote social integration of affected persons and their families.
俄罗斯的艾滋病疫情呈全球增长最快趋势之一。在抗逆转录病毒疗法（HAART）时代，有关俄罗斯艾滋病毒感染者（PLHIV）人群的传播风险行为、接受 HAART 治疗的情况以及心理社会困境的研究还很少。在圣彼得堡，通过系统招募的 492 名 PLHIV 横断面样本中，参与者完成了性行为和药物注射行为、遵医行为、感知歧视和心理社会困境的评估。自从得知自己的病情后，58%的参与者有 HIV 阴性或未知血清状况的性伴侣（平均=5.8）。大约 52%的人报告与这些伴侣发生过无保护性行为，其中 30%的行为没有保护措施。感知到的歧视越严重，使用安全套的可能性就越低。47%的 IDU PLHIV 仍在共用针头，这与没有主要伴侣、受教育程度较低以及更频繁地受到歧视有关。25%的 PLHIV 曾被拒绝接受一般医疗保健，11%的人拒绝就业，7%的人被解雇，6%的人被赶出家庭。39%的参与者患有可能的临床抑郁症，37%的人焦虑水平与精神病住院患者相当，社会支持度较低。在被提供 HAART 的 54%的 PLHIV 中，有 16%拒绝了 HAART 方案，而在接受治疗的人中，有 5%的人服用的剂量不到 90%。俄罗斯 PLHIV 需要综合的社区服务，以减少艾滋病相关的心理社会困境和持续的艾滋病毒传播风险行为。社会项目应减少污名和歧视，促进受影响者及其家庭的社会融合。
