Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, Boston, MA, United States of America.
Department of Medicine, Division of Global Public Health, University of California San Diego School of Medicine, IOA Building, San Diego, CA, United States of America.
PLoS One. 2018 Nov 16;13(11):e0207402. doi: 10.1371/journal.pone.0207402. eCollection 2018.
To describe the frequency of being partnered and having an HIV-negative partner, and whether this differed by gender, among a cohort of persons living with HIV (PLWH) who have ever injected drugs; to describe awareness of HIV pre-exposure prophylaxis (PrEP) and perceived partner interest in PrEP.
Secondary analyses of an observational cohort study of PLWH who have ever injected drugs in St. Petersburg, Russia.
Primary outcomes were 1) being partnered and 2) being in a serodiscordant partnership. The main independent variable was gender. Multivariable GEE logistic regression models were fit for binary outcomes, adjusted for age, income, education, and recent opioid use. Descriptive analyses were performed for partners' HIV status, substance use, sex risk behaviors, and awareness of PrEP for a subset of participants.
At baseline, 50% (147/296) reported being in a partnership, and of those, 35% were in a serodiscordant partnership. After adjustment, women had significantly higher odds of being partnered compared to men (aOR = 3.12; 95% CI: 1.77, 5.51), but there were no significant gender differences in the odds of being in a serodiscordant partnership (aOR = 0.58; 95% CI: 0.27, 1.24). Among a sub-sample of participants queried (n = 56), 25% were aware of PrEP for prevention of sexual HIV transmission and 14% for prevention of injection-related transmission.
Although half of our sample were partnered and one third of these partnerships were serodiscordant, PrEP awareness was low. Substantial opportunities for HIV prevention exist among PLWH who have ever injected drugs in Russia and their HIV-negative partners. Given the high proportion of HIV-negative partners among this ART-naïve sample, efforts to address the associated inherent risks, such as couples-based interventions, are needed to increase condom use, PrEP awareness, or uptake of other HIV-prevention modalities (e.g., ART for the HIV-positive partner).
描述曾注射过毒品的艾滋病毒感染者（PLWH）队列中，按性别划分的伴侣关系和阴性伴侣的频率，以及这是否存在差异；描述对 HIV 暴露前预防（PrEP）的认知以及对 PrEP 的伴侣兴趣。
在俄罗斯圣彼得堡对曾注射过毒品的 PLWH 进行的一项观察性队列研究的二次分析。
主要结局为 1）有伴侣关系和 2）处于血清不一致的伴侣关系。主要自变量为性别。使用多变量广义估计方程逻辑回归模型对二元结局进行拟合，调整了年龄、收入、教育程度和近期阿片类药物使用情况。对一小部分参与者的伴侣 HIV 状况、物质使用、性风险行为和 PrEP 意识进行了描述性分析。
在基线时，50%（147/296）报告处于伴侣关系中，其中 35%处于血清不一致的伴侣关系中。调整后，与男性相比，女性有更高的伴侣关系可能性（调整后的优势比[aOR] = 3.12；95%置信区间[CI]：1.77，5.51），但在血清不一致的伴侣关系可能性方面没有显著的性别差异（aOR = 0.58；95% CI：0.27，1.24）。在接受询问的参与者亚样本中（n = 56），25%知道 PrEP 可预防性传播 HIV，14%知道 PrEP 可预防注射相关的 HIV 传播。
尽管我们的样本中有一半人有伴侣，其中三分之一的伴侣关系是血清不一致的，但 PrEP 意识很低。在俄罗斯曾注射过毒品的 PLWH 及其 HIV 阴性伴侣中，存在大量的 HIV 预防机会。鉴于该 ART 初治样本中 HIV 阴性伴侣的比例较高，需要努力解决相关的固有风险，如夫妻为基础的干预措施，以提高避孕套使用率、PrEP 意识，或采取其他 HIV 预防方法（例如，为 HIV 阳性伴侣提供 ART）。
