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Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study

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ABSTRACT Background 

Evidence highlights the prison as a high risk environment in relation to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmsission associated with injecting drug use. Methods 

We undertook qualitative studies among 209 injecting drug users (IDUs) in three Russian cities: Moscow (n = 56), Volgograd (n = 83) and Barnaul in western Siberia (n = 70). Results 

Over three-quarters (77%) reported experience of police arrest related to their drug use, and 35% (55% of men) a history of imprisonment or detention. Findings emphasize the critical role that penitentiary institutions may play as a structural factor in the diffusion of HIV associated with drug injection in the Russian Federation. While drugs were perceived to be generally available in penitentiary institutions, sterile injection equipment was scarce and as a consequence routinely shared, including within large groups. Attempts to clean borrowed needles or syringes were inadequate, and risk reduction was severely constrained by a combination of lack of injecting equipment availability and punishment for its possession. Perceptions of relative safety were also found to be associated with assumptions of HIV negativity, resulting from a perception that all prisoners are HIV tested upon entry with those found HIV positive segregated. Conclusion 

This study shows an urgent need for HIV prevention interventions in the Russian penitentiary system.

Keywords: Harm reduction; Russia; injection drug use; prisoners; prisons; risk environment

Document Type: Research Article


Affiliations: 1: Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, UK, 2: National Scientific Centre for Addictions Research, Moscow, Russia, 3: ‘Mothers Against Drugs’, Volgograd, Russia, 4: ‘Siberian Initiative’, Barnaul, Russia and 5: ‘Return to Life’, Moscow, Russia 6: Russian Harm Reduction Network, Moscow, Russia,

Publication date: 2006-12-01

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