HIV Risk Factors and HIV Prevalence Among Street Youth in Russia, Yulia Batluk, HealthRight International

Street Youth in million in Russia Homelessness Begging Alcohol and drug use, including IDU Poor health status – lice, STDs Inhalant use  poor mental health

HIV Prevalence Survey Cross-sectional assessment Street youth years old 41 locations mapped, 22 randomly selected 313 participants, 37.4% HIV-positive (Kissin, D., et. al. HIV seroprevalence in street youth, St. Petersburg, Russia. AIDS 2007, Vol 21 No 17, 2333–2340)

HIV Risk Factors Double orphans Have not attended school for > 3 years Ever lived in an institution No place to live Previously diagnosed STI Needle sharing Use of stadol, heroin or inhalants

HIV Risk Behavior Survey Among Street Youth Eight regions of Russia Design similar to the 2006 survey, but no HIV testing ~100 youth per region Total sample 794

SURVEY MAP

2011 Survey Method Interviewers trained Mapping of street youth locations in each city Random selection of sites Recruit participants and assess eligibility Secure informed consent Interview participants - 60 questions on demographics, behavior and HIV knowledge Psychosocial counseling and referral

Survey Results

Didn’t use condom at last sex

Pregnancy

Previously diagnosed STI

No access to medical care

Multiple Sex Partners & No Condom Used at Last Intercourse

Sex Risks & Drug Use

Risky group characteristics VariablesHigh risk Low risk p Number of drinks last time 6.084,65,000 Number s/he get drunk last month 3,782,64,001 Never or rare use condom with street youth, % 51,721,8,000 Have been pregnant, % 35,514,4,000

Risky group characteristics VariablesMean 1Mean 2p Live with both parents,% 15,326,0,031 Father alive,% 42,461,7,001 Condoms – bring partner,% 35,324,2,027 Family member - alcoholic 74,456,6,002 Phys/sex abuse in the family 59,540,6,001 No medical care access 28,215,7,004

Lifetime Experience of Drug Use, St. Petersburg,

Current Drug Use St. Petersburg,

Experience of Institutionalization,

Sex Risks and IDU St. Petersburg,

Ever Tested for HIV,

HIV Risks, St. Petersburg, Factors associated with HIV p Didn’t attend school for >3 years,% 44,54,00,00 Double orphan,% 13,44,00,00 Ever lived in a shelter or an orphanage,% 35,95,10,00 No place to live (lives in attic or basement),% 23,52,00,00 Ever used injecting drugs,% 50,74,00,00 Ever used stadol,% 44,22,00,00 Ever used heroin,% 34,45,00,00 Ever used inhalants,% 55,217,80,01 Previously diagnosed STI,% 33,715,80,01

HIV Knowledge In 2011, more likely to know that: HIV cannot be transmitted through mosquito bite Condoms can protect against HIV Same likelihood to know that: One can be infected with HIV through syringe or needle sharing One cannot be infected through sharing a meal Less likely to know that: A healthy-looking person may be infected with HIV

Conclusions All HIV risk factors defined in 2006 significantly reduced by 2011 Drug use in street youth population is significantly reduced except marijuana Sexual risk level remains almost the same as well as alcohol consumption (often associated with risky sexual behavior)

Why? (Educated Guesses) No sexual education in schools Street youth know that HIV is related to injecting drug use Govt and NGO social service spheres are stronger preventing family breakdown