Evolution of illicit opioid use among people with HIV infection in St Petersburg, Russia, in the period 2004-2015

HIV Med. 2019 Aug;20(7):450-455. doi: 10.1111/hiv.12741. Epub 2019 Apr 29.


Objectives: In the late 1990s, when the current Russian opioid epidemic began, illicit opioids used in Russia consisted almost exclusively of heroin. The type of opioids used has evolved in the early 21st Century. The objective of this study was to describe the evolution of illicit opioid use among people living with HIV (PLWH) reporting recent opioid use in St Petersburg, Russia.

Methods: We examined baseline data from four research studies conducted in the period 2004-2015 that included PLWH who used opioids [Partnership to Reduce the Epidemic Via Engagement in Narcology Treatment (PREVENT; 2004-2005; n = 17), HIV Evolution in Russia-Mitigating Infection Transmission and Alcoholism in a Growing Epidemic (HERMITAGE; 2007-2010; n = 281), Linking Infectious and Narcology Care (LINC; 2013-2014; n = 119) and Russia Alcohol Research Collaboration on HIV/AIDS (Russia ARCH; 2012-2015; n = 121)] and reported recent use of heroin and other opioids.

Results: Although these studies spanned more than a decade, the participants represented similar birth cohorts; the mean age was 24.5 years in 2004 and 33.3 years in 2014. The use of opioid types, however, evolved across cohorts, with the use of any illicit drug other than heroin increasing from 6% [95% confidence interval (CI) 000.2, 29%] in PREVENT (2004-2005) to 30% (95% CI 25, 36%) in HERMITAGE (2007-2010) to 70% (95% CI 61, 78%) in LINC (2013-2014) to 77% (95% CI 68, 84%) in ARCH (2012-2015). Any heroin use consistently decreased over the 10-year period in the cohorts, from 100% (95% CI 80, 100%) in 2004-2005 to 54% (95% CI 44, 63%) in 2012-2015.

Conclusions: Among PLWH who use opioids in St Petersburg, Russia, illicit use of opioids other than heroin appears to be more common than heroin use.

Keywords: HIV; people who inject drugs; Russia; opioid use.

MeSH terms

  • Adult
  • Analgesics, Opioid
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Heroin*
  • Humans
  • Male
  • Russia / epidemiology
  • Substance Abuse, Intravenous / classification
  • Substance Abuse, Intravenous / epidemiology*
  • Young Adult


  • Analgesics, Opioid
  • Heroin