Center for Technology and Health, National Development and Research Institutes, Inc, New York, NY 10010, USA.
Subst Abuse Treat Prev Policy. 2012 Jan 12;7:2. doi: 10.1186/1747-597X-7-2.
Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection.
In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes.
The "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services.
Several behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities.
几个前苏联国家见证了注射吸毒（IDU）和相关 HIV/HCV 的重大疫情迅速出现，这表明来自前苏联（FSU）的移民可能面临类似问题的风险增加。这项探索性研究考察了在美国使用阿片类药物的鲜为人知的 FSU 移民群体的物质使用模式，以及可能增加这些移民对阿片类药物滥用和 HIV/HCV 感染易感性的社会背景因素。
对 10 名居住在纽约市的 FSU 移民进行了深入访谈，他们在青少年或年轻成人时期开始使用阿片类药物，同时对 6 名从事该人群药物治疗的提供者进行了访谈。访谈记录采用扎根理论方法进行了归纳编码和分析，以确定关键主题。
参与者强调，移民/文化适应经历的“创伤”在激发阿片类药物使用方面起着关键作用。访谈数据表明，在前苏联高风险环境中形成的物质使用模式可能会在前苏联移民社区中作为行为规范持续存在，包括青少年中使用海洛因的倾向、注射的高流行率以及在使用物质的同伴网络中容忍共用注射器。多个层面的社会背景可能会重现 FSU 移民对药物滥用和疾病的易感性，例如：参与者通常使用阿片类药物的基于同伴的互动性环境；一些参与者在其中接触和获得阿片类药物的社区工作场所环境；以及文化规范，其根源在于苏联时代的社会政策，对药物滥用的污名化可能导致移民不愿意寻求疾病预防和药物治疗服务。
一些行为和背景因素似乎增加了 FSU 移民滥用阿片类药物、IDU 和传染病的风险。需要对使用阿片类药物的 FSU 移民进行进一步研究，这可能有助于防止这些社区中 HIV/HCV 流行率的增加。
