Background Alcohol use is particularly deleterious for HIV-infected individuals and thus accurate assessment of alcohol consumption is crucial in this population. Phosphatidylethanol (PEth) provides an objective assessment of drinking and can be compared to self-reported alcohol assessments to detect underreporting. The purpose of this study was to identify underreporting and its potential predictors in an HIV-infected sample of young Russian women. Methods The current study examined the concordance between a quantitative measure of PEth and self-reported recent alcohol consumption in a prospective sample of HIV-infected young women (N = 204) receiving medical care in Saint Petersburg, Russia. Results At baseline, 53% of participants who denied drinking in the prior 30 days tested positive for PEth (i.e., underreporters), although this rate decreased significantly at a three-month follow-up assessment. Further exploration did not identify consistent predictors of underreporting status. Quantitative PEth levels showed, at best, modest overlap to self-reported alcohol consumption among those reporting alcohol use (e.g., Spearman’s r = .27 between PEth and total drinks past-30 days at baseline). Conclusions Objective measures of alcohol consumption demonstrate modest overlap with self-report measures of use in HIV-infected young Russian women. Incorporating objective and quantifiable biological markers are essential for valid assessments of alcohol use.

Cigarette smoking among people living with HIV/AIDS is associated with significant morbidity and mortality, but findings regarding the association between cigarette smoking and HIV viral load and CD4+ lymphocyte counts have been inconsistent. This study characterized the prevalence of cigarette smoking among HIV-infected Russian women and examined the association between smoking frequency and quantity and HIV viral load and CD4+ lymphocyte counts. HIV-infected Russian women (N=250; M age = 30.0) in St. Petersburg, Russia, completed an audio computer-assisted self-interview survey assessing cigarette use, antiretroviral medication adherence, and provided blood samples assayed for HIV viral load and CD4+ lymphocyte counts. The majority (60.4%) reported cigarette smoking in the past month; 49.0% of recent smokers were classified as moderate or heavy smokers, defined as smoking ≥10 cigarettes daily. Viral load status did not differ between infrequent smokers and regular smokers. However, moderate/heavy smokers (relative to light smokers) were more likely to have a detectable viral load (AOR = 2.3, 95% CI: 1.1, 5.1). There were no significant differences in CD4+ lymphocyte counts by smoking frequency or quantity of cigarettes smoked. Results highlight the need for additional research to examine the association between cigarette smoking and virologic suppression and markers of HIV disease progression. Adverse health consequences of cigarette smoking coupled with a potential link between heavy smoking and poor virologic suppression highlight the need for assessment of cigarette use and provision of evidence-based smoking-cessation interventions within HIV medical care.

Individuals with HIV and hepatitis C virus (HCV) co-infection may experience substance use related health complications. This study characterized substance use patterns between HIV/HCV co-infected and HIV mono-infected Russian women. HIV-infected women (N = 247; M age = 30.0) in St. Petersburg, Russia, completed a survey assessing substance use, problematic substance use, and the co-occurrence of substance use and sexual behaviors. Covariate adjusted logistic and linear regression analyses indicated that HIV/HCV co-infected participants (57.1 %) reported more lifetime drug use (e.g., heroin: AOR: 13.2, 95 % CI 4.9, 35.3, p < .001), problem drinking (β = 1.2, p = .05), substance use problems (β = 1.3, p = .009), and increased likelihood of past injection drug use (AOR: 26.4, 95 % CI 8.5, 81.9, p < .001) relative to HIV mono-infected individuals. HIV/HCV co-infection was prevalent and associated with increased substance use and problematic drug use. Findings highlight the need for ongoing substance use and HIV/HCV risk behavior assessment and treatment among HIV/HCV co-infected Russian women.

ABSTRACT. Objective: Alcohol use is a prominent factor correlated with HIV risk behavior engagement. Hazardous drinking is prevalent among Russian women and may contribute to decreased condom use. Event-based studies suggest that HIV risk behaviors may vary based on situational factors including partner characteristics and alcohol use.

Prior to 2010, medical care for people living with HIV/AIDS was provided at an outpatient facility near the center of St. Petersburg. Since then, HIV specialty clinics have been establish in more outlying regions of the city. The study examined the effect of this decentralization of HIV care on patients’ satisfaction with care in clinics of St. Petersburg, Russia. We conducted a cross-sectional study with 418 HIV-positive patients receiving care at the St. Petersburg AIDS Center or at District Infectious Disease Departments (centralized and decentralized models, respectively). Face-to-face interviews included questions about psychosocial characteristics, patient’s satisfaction with care, and clinic-related patient experience. Abstraction of medical records provided information on patients’ viral load. To compare centralized and decentralized models of care delivery we performed bivariate and multivariate analysis. Clients of District Infectious Disease Departments spent less time in lines and traveling to reach the clinic, and they had stronger relationships with their doctor. The overall satisfaction with care was high, with 86% of the sample reporting high level of satisfaction. Nevertheless, satisfaction with care was strongly and positively associated with the decentralized model of care and Patient-Doctor Relationship Score. Patient experience elements such as waiting time, travel time, and number of services used were not significant factors related to satisfaction. Given the positive association of satisfaction with decentralized service delivery, it is worth exploring decentralization as one way of improving health care services for people living with HIV/AIDS.

Mechanisms of HIV transportation through blood-brain barrier, vascular plexus and interaction with cerebral cells having CD-4-receptors, ССR-5- and CXCR-4-coreceptors were studied. Cerebral damage developed through latent and acute periods also known as HIV-encephalopathy, HIV-associated neurocognitive dysfunction etc. Cerebral lesions are caused by a variety of chemical agents from pro-inflammatory cytokines to toxic HIV-proteins resulting in development of HIV-dementia through several years. Even early stage of this process revealed significant disturbances of glucose metabolism and evoked potentials EEG alterations which can serve as a marker of HIV-infection. Genetic differences of HIV in blood and spinal liquor with different drug resistance were revealed implying a new approach to therapy development.

The proportion of people living with HIV (PLWH) in need of antiretroviral therapy (ART) is growing rapidly in Russia. Successful treatment outcomes reduces disease progression and contributes to HIV epidemic control. We conducted a pilot study following 100 PLWH newly found eligible for ART in St. Petersburg, Russia. We determined the proportion of PLWH who initiated ART, remained in treatment, and achieved an undetectable VL during 6-month follow up. Semi-structured interviews were conducted prior the initiation of ART and progress along the cascade was assessed through medical chart review. Individual characteristics associated with successful ART outcomes were assessed as part of efforts to generate hypotheses. Almost all (96%) participants initiated ART, full retention was demonstrated by 80%, among whom 71% achieved undetectable VL. Optimal retention was associated with older age and higher education (p < 0.05). There was no significant difference in ART outcomes between those who used illicit drugs and those had not. Interventions to improve treatment effectiveness should emphasize that initiation, optimal retention and achieving an undetectable VL are independent of drug abuse status. However, our pilot study highlights the need for the further research in the examining links between individual and structural factors and ART effectiveness.

In this number, we begin publication of case series devoted to epidemiology, clinical picture, diagnosis, treatment, prevention, medical and social consequences of COVID-19. Taking into account the situation anxiety, infection scope and spread rate, involvement of the whole nation into the problem irrespective of gender, age, social affiliations along with comprehensive observing social and medical prevention measures, preemptive training and continuing education of medical specialists are essential considering that novel coronavirus is new not only viewed from its molecular biological features perspective but also from the perspective of possible difficulties of diagnosis and treatment, clinical features, high risk of development of critical con- ditions and complications, high mortality rate that has been shown by an example of China, USA, and European Countries.In the first report, we tried to highlight the experience gained in the study of novel coronavirus nature, epidemiology, pathogenesis and clinical manifestations, give information from literature sources based on the experience of our colleagues in coping with serious disease and its consequences.