The social production of substance abuse and HIV/HCV risk: an exploratory study of opioid-using immigrants from the former Soviet Union living in New York City

Abstract

BackgroundSeveral former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection.MethodsIn-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes.ResultsThe "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services.ConclusionSeveral behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities.

Youth, violence and non-injection drug use: nexus of vulnerabilities among lesbian and bisexual sex workers

“…The stigma faced by lesbian/bisexual SWs may result in internalized homophobia, which has been suggested as a possible explanation of increased rates of substance use among lesbian and bisexual women (Rosario, Schrimshaw, & Hunter, 2008; Young, Friedman, & Case, 2005). Finally, research suggests that social networks may play an important role in HIV risk pathways (Guarino, Moore, Marsch, & Florio, 2012; Rhodes, Singer, Bourgois, Friedman, & Strathdee, 2005), and it is possible that lesbian/bisexual SWs work in specific social networks where there is overlap between non-injection stimulant use and sex work.…”

Injection and sexual HIV/HCV risk behaviors associated with nonmedical use of prescription opioids among young adults in New York City

“…Recent research documents similar patterns among injecting PO misusers (Surratt, Kurtz and Cicero, 2011; Lankenau et al, 2012; Johnson et al, 2013). Behaviors such as sharing syringes and other drug-injection equipment, use of shooting galleries and communal sharing of drug solution in group-injection situations have been well-documented among young heroin injection initiates and may place them at high risk for HIV and/or HCV transmission (Fuller et al, 2003; Goldsamt, Harocopos, Kobrak, Jost & Clatts, 2010; Harocopos, Goldsamt, Kobrak, Jost & Clatts, 2009; Guarino, Moore, Marsch & Florio, 2012). …”

Substance Use Disorders Among First- and Second-Generation Immigrant Adults in the United States: Evidence of an Immigrant Paradox?

“…The vast majority of these studies are limited in generalizability inasmuch as they use samples of youth from particular national/ethnic groups or specifi c regions of the United States (Turner and Gil, 2002). Investigations from adult samples focused on emigrants from Mexico (Borges et al, 2009(Borges et al, , 2012, the former Soviet Union (Guarino et al, 2012), Asia (Moloney et al, 2008;Wong et al, 2007), and Latin America (Alegría et al, 2008;Ojeda et al, 2008) have found trends similar to those identifi ed in younger samples. Studies of adults in the United States have been hampered by their inability to examine the stability of the relationship between substance use and immigration across multiple immigrant generations or among emigrants from various regions of the world (Johnson et al, 2002;Li and Wen, 2013;Salas-Wright and Vaughn, 2014).…”