Barriers to accessing drug treatment in Russia: a qualitative study among injecting drug users in two cities

Bobrova, Natalia; Rhodes, Tim; Power, Robert; Alcorn, Ron; Neifeld, Elena; Krasiukov, Nikolai; Латышевская, Н И; Maximova, Svetlana G.

doi:10.1016/s0376-8716(06)80010-4

Cited by 86 publications

(81 citation statements)

References 17 publications

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“…However, a positive finding was that 70% of drug users agreed to be tested for HIV. The difficulties noted with regard to accessing drug and HIV services, including stigmatisation, are likewise in agreement with research conducted elsewhere (Bobrova, Rhodes, Power, Alcorn, Neifeld, Krasiukov, et al, 2006;Downing, Knight, Reiss Vernon, Mulia, Ferreboeuf, et al, 2001). …”

Section: Discussionsupporting

confidence: 64%

Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drugusing populations in Cape Town, Durban and Pretoria, South Africa

Parry

Petersen²,

Carney³

et al. 2008

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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This exploratory study examines the links between drug use and high-risk sexual practices and HIV in vulnerable drug-using populations in South Africa, including commercial sex workers (CSWs), men who have sex with men (MSM), injecting drug users (IDUs) and non-injecting drug users who are not CSWs or MSM (NIDUs). A rapid assessment ethnographic study was undertaken using observation, mapping, key informant interviews and focus groups in known 'hotspots' for drug use and sexual risk in Cape Town, Durban and Pretoria. Key informant (KI) and focus group interviews involved drug users and service providers. Purposeful snowball sampling and street intercepts were used to recruit drug users. Outcome measures included drug-related sexual HIV risk behaviour, and risk behaviour related to injection drug use, as well as issues related to service use. HIV testing of drug-using KIs was conducted using the SmartCheck Rapid HIV-1 Antibody Test. Non-injection drug use (mainly cannabis, methaqualone, crack cocaine and crystal methamphetamine) and injection drug use (mainly heroin) was occurring in these cities. Drug users report selling sex for money to buy drugs, and CSWs used drugs before, during and after sex. Most (70%) of the drug-using KIs offered HIV testing accepted and 28% were positive, with rates highest among CSWs and MSM. IDUs reported engaging in needle sharing and needle disposal practices that put them and others at risk for contracting HIV. There was a widespread lack of awareness about where to access HIV treatment and preventive services, and numerous barriers to accessing appropriate HIV and drug-intervention services were reported. Multiple risk behaviours of vulnerable populations and lack of access to HIV prevention services could accelerate the diffusion of HIV. Targeted interventions could play an important role in limiting the spread of HIV in and through these under-reached and vulnerable populations.

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Section: Discussionsupporting

confidence: 64%

Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drugusing populations in Cape Town, Durban and Pretoria, South Africa

Parry

Petersen²,

Carney³

et al. 2008

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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“…35 Research suggests that a strong emphasis on the registration of persons seeking help for their drug use acts as a disincentive among IDUs to access drug treatment or pharmacies and syringe exchange projects for clean injecting equipment, as well as contributes to their marginalization through loss of employment opportunity once certified an addict. 22,48 Studies have found association between registration at drug treatment services and HIV or HCV infection, 36 arrest and syphilis, 50 and drug-related arrest and elevated odds of syringe sharing. 37 Our findings capture a strong emphasis on street policing as a mechanism of pervasive surveillance in the lives of IDUs.…”

Section: Discussionmentioning

confidence: 97%

Street Policing, Injecting Drug Use and Harm Reduction in a Russian City: A Qualitative Study of Police Perspectives

Rhodes

Platt

Sarang³

et al. 2006

J Urban Health

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We undertook a qualitative exploration of police perspectives on injecting drug use and needle and syringe access among injecting drug users (IDUs) in a Russian city which has witnessed explosive spread of HIV associated with drug injecting. Twenty-seven in-depth qualitative interviews were conducted in May 2002 with police officers of varying rank who reported having regular contact with IDUs. All interviews were tape-recorded, transcribed, translated and coded thematically. Accounts upheld an approach to policing which emphasised high street-based visibility and close surveillance of IDUs. IDUs were depicted as 'potential criminals' warranting a 'pre-emptive' approach to the prevention of drug-related crime. Street policing was described as a means of maintaining close surveillance leading to the official registration of persons suspected or proven to be users of illicit drugs. Such registration enabled further ongoing surveillance, including through stop and search procedures. While aware of drug users' reluctance to carry injecting equipment linked to their fears of detention or arrest, accounts suggested that the confiscation of previously used injecting equipment can constitute evidence in relation to drugs possession charges and that discovery of clean injecting equipment may be sufficient to raise suspicion and/or further investigation, including through stop and search or questioning. Our findings suggest an uneasy relationship between street policing and needle and syringe access, whereby policing strategies can undermine an HIV prevention ethos promoting needle and syringe accessibility among IDUs. We conclude that facilitating partnerships between policing agencies and HIV prevention initiatives are a critical feature of creating environments conducive for risk reduction.

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“…It may be difficult, though, to provide an exact number, as being registered as a drug user has been stipulated as a definite barrier to enter treatment in Russian clinics [7,16]. Law enforcement agencies routinely check the lists, and the only way of being assured of confidentiality is by paying for anonymity [7].…”

Section: Discussionmentioning

confidence: 99%

Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study

Dahl

Rezvyy

Bogdanov³

et al. 2017

International Journal of Circumpolar Health

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Both in Norway and Russia a considerable portion of the population have substance use disorders. However, the knowledge about outpatient services treating substance use disorders in Norway and Russia is limited. This study will describe and compare outpatient clinics treating substance use disorders in Arkhangelsk in Northwest Russia and in Bodø and Tromsø in Northern Norway on availability, accessibility and treated prevalence (patients treated in one year). The managers (N=3) of the outpatient clinics (N=3) were interviewed with the European Service Mapping Schedule (ESMS) and the International Classification of Mental Health Care (ICMHC). The interviews were supplemented by e-mail and phone calls. The treatment in Arkhangelsk was mainly biologically oriented (medical), while a greater variety of methods was available in Bodø and Tromsø. The clinic in Russia was a drop-in clinic, while in Norway patients needed a referral to get an appointment in the clinic. Patients treated in Arkhangelsk (treated prevalence) was 1662, while in Bodø it was 233 and in Tromsø 220. The present study revealed great differences between the clinics involved in accessibility, availability and treated prevalence. Cultural traditions and budgeting of the mental health care system could explain some of the findings.

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Barriers to accessing drug treatment in Russia: a qualitative study among injecting drug users in two cities

Cited by 86 publications

References 17 publications

Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drugusing populations in Cape Town, Durban and Pretoria, South Africa

Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drugusing populations in Cape Town, Durban and Pretoria, South Africa

Street Policing, Injecting Drug Use and Harm Reduction in a Russian City: A Qualitative Study of Police Perspectives

Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study

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