Risk factors for recent nonfatal overdose among HIV-infected Russians who inject drugs

AIDS Care. 2014;26(8):1013-8. doi: 10.1080/09540121.2013.871218. Epub 2014 Jan 2.


Overdoses and HIV infection are common among Russians who inject drugs, yet risk factors have not been studied. We analyzed baseline data of 294 participants with 30-day injection drug use from an HIV secondary prevention trial for persons reporting "heavy" alcohol use (National Institute on Alcohol Abuse and Alcoholism [NIAAA] risky drinking definition) and risky sex in the past 6 months. The outcome was any self-reported overdose in the previous 3 months. We examined demographic, HIV-related, criminal justice, mental health, substance use, and injection risk factors. Participants' characteristics included median age 29 years, 117/294 (40%) female, and median CD4 cell count 345/µl. Over three quarters 223/294 (76%) reported a history of overdose and 47/294 (16%) reported overdose in the past 3 months. Past month injection frequency (adjusted odds ratio [AOR] 4.77, 95% confidence interval [CI]: 1.63-14.0 highest vs. lowest quartile; AOR 3.58, 95% CI: 1.20-10.69 second highest vs. lowest quartile) and anti-retroviral therapy (ART) at time of interview (AOR 3.96 95% CI: 1.33-11.83) were associated with 3-month overdose. Nonfatal overdose among HIV-infected Russians who inject drugs is common. Risk factors include injection frequency and anti-retroviral therapy (ART), which warrant further study. Overdose prevention efforts are needed among HIV-infected Russians who inject drugs.

Keywords: HIV; Russia; anti-retroviral therapy; injection drug use; overdose.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcoholism / epidemiology*
  • Alcoholism / prevention & control
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Confidence Intervals
  • Cross-Sectional Studies
  • Drug Overdose / epidemiology*
  • Drug Overdose / prevention & control
  • Female
  • HIV Infections / psychology*
  • Humans
  • Male
  • Odds Ratio
  • Risk Factors
  • Risk-Taking*
  • Russia / epidemiology
  • Self Disclosure
  • Substance Abuse, Intravenous / epidemiology*
  • Substance Abuse, Intravenous / prevention & control