Prevalence of Alcohol Use, Sexual Risk Behavior, and HIV Among Russians in High-Risk Settings: a Systematic Review and Meta-Analysis

Abstract

Objective To examine the (a) prevalence of and (b) association between alcohol, risky sex, and HIV among Russians at-risk for primary or secondary HIV transmission. Method Electronic databases were searched to locate studies that sampled Russians, assessed alcohol, and included either a behavioral measure of risk or a biological measure of HIV. Weighted mean (logit) effect sizes were calculated using random-effects assumptions. Moderator analyses were conducted using meta-regression. Results Studies (19) sampled 12,916 Russians (Mage = 29; 36% women). Participants were recruited from clinical (52%; e.g., STI clinic, drug treatment), other high-risk community settings (32%; e.g., sexual/drug networks), or both (16%). Findings indicate that a substantial proportion of the participants used alcohol (77%; 55% heavy drinking). One-half of participants reported using condoms (52%) but only 29% used condoms consistently. Most participants reported drinking before sex (64%). Of the studies testing for HIV, 10% of participants tested positive. Meta-regression analyses indicated that hazardous/harmful alcohol use was associated with increased risky behaviors (i.e., multiple partners, inconsistent condom use). Conclusions These findings support the need for and potential benefit of addressing alcohol use in HIV prevention programming in Russia.

The relationship between different dimensions of alcohol use and the burden of disease—an update

“…In the following, we try to summarize recent developments (following closely [98]; see also [99]), and suggest an operationalization to quantify the causal impact of alcohol use on HIV/AIDS. Alcohol use was found to be associated with HIV incidence and prevalence in systematic reviews and metaanalyses [100][101][102][103][104][105][106]. This association may have resulted, in part, from the causal impact of acute alcohol use on sexual decision-making [107], resulting in condomless sex [105,[108][109][110][111][112][113][114].…”

“I Wasn’t in My Right Mind”: Qualitative Findings on the Impact of Alcohol on Condom Use in Patients Living with HIV/AIDS in Brazil, Thailand, and Zambia (HPTN 063)

“…Condom use was 67% and 25% of the sample reported multiple, concurrent partners [16]. Finally, a recent meta-analysis of alcohol and sexual transmission risk in Russia [17] found that individuals with high levels of alcohol use or "hazardous/harmful alcohol use" reported significantly more sexual partners and less consistent condom use than those who used alcohol recreationally. For a comprehensive review of alcohol and sexual behavior that can lead to HIV transmission, see Freeman [18].…”

Personal and Lifestyle Determinants of HIV Transmission Risk in Spanish University Students

“…Regarding lifestyle, although diet characteristics have not been previously analyzed in this sense, similar results have been obtained when food insecurity has been related to sexual behavior in adolescents and young adults [ 32 , 33 , 34 ]. Similarly, in the case of alcohol, various previous studies have found a significant positive association between alcohol consumption and HIV risk in young and adult populations [ 56 , 57 , 58 ]. Although smoking was associated, in classical research, with HIV risk [ 23 , 24 , 25 , 26 , 27 ], few studies have been conducted recently.…”