Javier A Cepeda1, Linda M Niccolai2, Alexandra Lyubimova3, Trace Kershaw4, Olga Levina3, Robert Heimer2. 1. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, 135 College Street, New Haven, CT, USA. Electronic address: Javier.cepeda@yale.edu. 2. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, 135 College Street, New Haven, CT, USA. 3. NGO Stellit, 3 Mira Street, St. Petersburg, Russia. 4. Center for Interdisciplinary Research on AIDS, 135 College Street, New Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, USA.
Abstract
BACKGROUND: Injection drug use, infectious disease, and incarceration are inextricably linked in Russia. We aimed to identify factors associated with time to relapse (first opioid injection after release from prison) and using a non-sterile, previously used syringe at relapse in a sample of people who inject drugs in St. Petersburg. METHODS: We collected data on time from release to relapse among individuals with a history of incarceration, a subsample of a larger study among people who inject drugs. Proportional hazards and logistic regression were used to identify factors associated with time to relapse and injection with a non-sterile previously used syringe at relapse, respectively. RESULTS: The median time to relapse after release was 30 days. Factors that were independently associated with relapsing sooner were being a native of St. Petersburg compared to not being native (AHR: 1.64; 95% CI 1.15-2.33), unemployed at relapse compared to employed (AHR: 4.49; 95% CI 2.96-6.82) and receiving a previous diagnosis of HBV and HCV compared to no previous diagnosis (AHR: 1.49; 95% CI 1.03-2.14). Unemployment at relapse was also significant in modeling injection with a non-sterile, previously used syringe at relapse compared to those who were employed (AOR: 6.80; 95% CI 1.96-23.59). CONCLUSIONS: Unemployment was an important correlate for both resuming opioid injection after release and using a non-sterile previously used syringe at relapse. Linkage to medical, harm reduction, and employment services should be developed for incarcerated Russian people who inject drugs prior to release.
BACKGROUND: Injection drug use, infectious disease, and incarceration are inextricably linked in Russia. We aimed to identify factors associated with time to relapse (first opioid injection after release from prison) and using a non-sterile, previously used syringe at relapse in a sample of people who inject drugs in St. Petersburg. METHODS: We collected data on time from release to relapse among individuals with a history of incarceration, a subsample of a larger study among people who inject drugs. Proportional hazards and logistic regression were used to identify factors associated with time to relapse and injection with a non-sterile previously used syringe at relapse, respectively. RESULTS: The median time to relapse after release was 30 days. Factors that were independently associated with relapsing sooner were being a native of St. Petersburg compared to not being native (AHR: 1.64; 95% CI 1.15-2.33), unemployed at relapse compared to employed (AHR: 4.49; 95% CI 2.96-6.82) and receiving a previous diagnosis of HBV and HCV compared to no previous diagnosis (AHR: 1.49; 95% CI 1.03-2.14). Unemployment at relapse was also significant in modeling injection with a non-sterile, previously used syringe at relapse compared to those who were employed (AOR: 6.80; 95% CI 1.96-23.59). CONCLUSIONS: Unemployment was an important correlate for both resuming opioid injection after release and using a non-sterile previously used syringe at relapse. Linkage to medical, harm reduction, and employment services should be developed for incarcerated Russian people who inject drugs prior to release.
Authors: Evan Wood; Kathy Li; Will Small; Julio S Montaner; Martin T Schechter; Thomas Kerr Journal: Public Health Rep Date: 2005 Mar-Apr Impact factor: 2.792
Authors: Steffanie A Strathdee; Timothy B Hallett; Natalia Bobrova; Tim Rhodes; Robert Booth; Reychad Abdool; Catherine A Hankins Journal: Lancet Date: 2010-07-24 Impact factor: 79.321
Authors: Elijah Paintsil; Sergei V Verevochkin; Elena Dukhovlinova; Linda Niccolai; Russell Barbour; Edward White; Olga V Toussova; Louis Alexander; Andrei P Kozlov; Robert Heimer Journal: Addiction Date: 2009-08-27 Impact factor: 6.526
Authors: Elizabeth L C Merrall; Azar Kariminia; Ingrid A Binswanger; Michael S Hobbs; Michael Farrell; John Marsden; Sharon J Hutchinson; Sheila M Bird Journal: Addiction Date: 2010-06-23 Impact factor: 6.526
Authors: M-J S Milloy; Jane Buxton; Evan Wood; Kathy Li; Julio S G Montaner; Thomas Kerr Journal: BMC Public Health Date: 2009-05-27 Impact factor: 3.295
Authors: Javier A Cepeda; Marina V Vetrova; Alexandra I Lyubimova; Olga S Levina; Robert Heimer; Linda M Niccolai Journal: Int J Prison Health Date: 2015
Authors: Sarah K Calabrese; Sara E Burke; John F Dovidio; Olga S Levina; Anneli Uusküla; Linda M Niccolai; Robert Heimer Journal: AIDS Behav Date: 2016-01
Authors: Peter Meylakhs; Samuel R Friedman; Anastasia Meylakhs; Pedro Mateu-Gelabert; Danielle C Ompad; Alisa Alieva; Alexandra Dmitrieva Journal: AIDS Behav Date: 2019-12
Authors: Zoe Ward; Jack Stone; Chrissy Bishop; Viktor Ivakin; Ksenia Eritsyan; Anna Deryabina; Andrea Low; Javier Cepeda; Sherrie L Kelly; Robert Heimer; Robert Cook; Frederick L Altice; Taylor Litz; Assel Terlikbayeva; Nabila El-Bassel; Denis Havarkov; Alena Fisenka; Anelia Boshnakova; Andrey Klepikov; Tetiana Saliuk; Tetiana Deshko; Peter Vickerman Journal: Lancet HIV Date: 2021-12-09 Impact factor: 12.767
Authors: Jennifer P Jain; Steffanie A Strathdee; Brooke S West; Patricia Gonzalez-Zuniga; Gudelia Rangel; Eileen V Pitpitan Journal: Drug Alcohol Rev Date: 2020-08-14
Authors: Gabriel J Culbert; Veena Pillai; Joseph Bick; Haider A Al-Darraji; Jeffrey A Wickersham; Martin P Wegman; Alexander R Bazazi; Enrico Ferro; Michael Copenhaver; Adeeba Kamarulzaman; Frederick L Altice Journal: J Neuroimmune Pharmacol Date: 2016-05-24 Impact factor: 4.147
Authors: Joanne Csete; Adeeba Kamarulzaman; Michel Kazatchkine; Frederick Altice; Marek Balicki; Julia Buxton; Javier Cepeda; Megan Comfort; Eric Goosby; João Goulão; Carl Hart; Thomas Kerr; Alejandro Madrazo Lajous; Stephen Lewis; Natasha Martin; Daniel Mejía; Adriana Camacho; David Mathieson; Isidore Obot; Adeolu Ogunrombi; Susan Sherman; Jack Stone; Nandini Vallath; Peter Vickerman; Tomáš Zábranský; Chris Beyrer Journal: Lancet Date: 2016-03-24 Impact factor: 79.321
Authors: Frederick L Altice; Lyuba Azbel; Jack Stone; Ellen Brooks-Pollock; Pavlo Smyrnov; Sergii Dvoriak; Faye S Taxman; Nabila El-Bassel; Natasha K Martin; Robert Booth; Heino Stöver; Kate Dolan; Peter Vickerman Journal: Lancet Date: 2016-07-14 Impact factor: 79.321