Female partners of opioid-injecting men in the Republic of Georgia: an initial characterization

Ingunn O Lund, Irma Kirtadze, David Otiashvili, Kevin E O'Grady, Hendrée E Jones, Ingunn O Lund, Irma Kirtadze, David Otiashvili, Kevin E O'Grady, Hendrée E Jones

Abstract

Background: HIV and Hepatitis C virus (HCV) infections are strongly related to injection drug use in the Republic of Georgia. Little information is available about HIV and HCV status, sexual risk, support for their partner, and risk for physical violence among the female partners of opioid-injecting men in the Republic of Georgia, many of whom may not be using drugs, yet may be at high risk of being infected with HIV and HCV from their drug-using partners.

Methods: In order to better understand the risks for females whose partners are injecting drugs, the present study conducted an initial investigation of the non-substance-using female partners of 40 opioid-injecting men who were participating in a clinical trial examining the feasibility and efficacy of a 22-week comprehensive intervention that paired behavioral treatment with naltrexone. The 40 female partners were assessed at their male partners' study intake.

Results: The female sample was 32.3 years old (SD=6.7), 37 (93%) were married, with 15.5 years of education. A majority reported at least partial employment the majority of the time during the past 3 years, with only one woman reported being unemployed most of the time during the past 3 years. They self-reported they were 3% HIV-positive and 8% HCV-positive. Their HIV sex risk scores indicated a relatively low risk. However, only 4 (10%) women reported using a condom most of the time while having sex and 15 (38%) report not having had sex during the last 30 days. Experiences of interpersonal violence were common, with 42% reporting physical abuse by their partner during the last year and 48% reporting feeling unsafe in their current relationship.

Conclusions: The alarmingly high rate of failure to use barrier protection methods, together with the high percentage who did not know their HIV and HCV status, suggest that it may be beneficial to include non-substance-using female partners in prevention programs along with their partners to reduce the risk of HIV and HCV spreading from the population of injection-drug-using males into the general population. [This secondary analysis study was funded by an international supplement to the parent randomized clinical trial "Treating the Partners of Drug Using Pregnant Women: Stage II (HOPE)". ]

Trial registration: ClinicalTrials.gov NCT00496990.

References

    1. Government of Georgia. UNGASS Country Progress Report, Reporting Period 2008 – 2009 calendar years. Tbilisi: BioMed Central; 2010.
    1. Georgian AIDS and Clinical Immunology Centre. HIV/AIDS Epidemiology in Georgia. 2012. accessed September 10, 2012, from .
    1. Sirbiladze T. Estimating the prevalence of injecting drug use in Georgia: Consensus report. Tbilsi: Bemoni Public Union; 2010.
    1. EMCDDA Statistical Bulletin. Annual report 2006: the state of the drugs problem in Europe. 2006. . (accessed 13 November 2012)
    1. Javakhishvili D, Sturua L, Otiashvili D, Kirtadze I, Zabransky T. Overview of the Drug Situation in Georgia, 2011. Addictologie. 2011;11(1):52–51.
    1. Stvilia K, Meparidze M, Tsertsvadze T, Sharvadze L, Dzigua L. Prevalence of HBV and HCV infections and high risk behavior for blood born infections among general population of Tbilisi, Georgia. Ann Biomed Research and Education. 2005;5(4):289–298.
    1. Buckley C. The Socio-Cultural Correlates of HIV/AIDS in the Southern Caucasus. HIV and AIDS in the Caucasus: A Socio-Cultural Approach. Paris: UNESCO; 2005. pp. 11–33.
    1. STI/HIV SHIP Project. Characteristics, high risk behaviors and knowledge of STI/HIV/AIDS, and prevalence of HIV, Syphilis and Hepatitis Among Injecting Drug Users in Tbilisi, Georgia: 2002–2006. Tbilisi: USAID; 2007.
    1. Chkhartishvili N, McNutt LA, Smith PF, Tsertsvadze T. Characteristics of HIV-infected women and factors associated with HCV seropositivity in the Republic of Georgia. AIDS Res And Therapy. 2011;8(1):25. doi: 10.1186/1742-6405-8-25.
    1. Shapatava E, Nelson KE, Tsertsvadze T, Rio C. Risk behaviors and HIV, hepatitis B, and hepatitis C seroprevalence among injection drug users in Georgia. Drug Alcohol Depend. 2006;82:S35–S38.
    1. Javakhishvili DJ, Balanchivadze N, Kirtadze I, Sturua L, Otiashvili D, Zabransky T. Overview of the Drug Situation in Georgia, 2012. Tbilisi: Global Initiative on Psychiatry/Alternative Georgia; 2012.
    1. Fals-Stewart W, Golden J, Schumacher JA. Intimate partner violence and substance use: a longitudinal day-to-day examination. Addict Behav. 2003;28(9):1555–1574. doi: 10.1016/j.addbeh.2003.08.035.
    1. Stuart GL, Temple JR, Follansbee KW, Bucossi MM, Hellmuth JC, Moore TM. The role of drug use in a conceptual model of intimate partner violence in men and women arrested for domestic violence. Psychol Addict Behav. 2008;22(1):12.
    1. Nizharadze G, Stvilia K, Todadze K. HIV and AIDS in Georgia: A Socio-Cultural Approach. Tbilisi: UNESCO; 2005.
    1. Chitashvili M, Javakhishvili N, Arutiunov L, Tsuladze L, Chachanidze S. National research on domestic violence against women in Georgia. Tbilisi; 2010.
    1. Fals-Stewart W, Kashdan TB, O’Farrell TJ, Birchler GR. Behavioral couples therapy for drug-abusing patients: Effects on partner violence. J Subst Abuse Treat. 2002;22(2):87–96. doi: 10.1016/S0740-5472(01)00218-5.
    1. Gossop M. A web of dependence. Addiction. 2001;96(5):677–678. doi: 10.1046/j.1360-0443.2001.9656771.x.
    1. Otiashvili D, Zabransky T, Kirtadze I, Piralishvili G, Chavchanidze M, Miovsky M. Why Do the Clients of Georgian Needle Exchange Programmes Inject Buprenorphine? Eur Addict Res. 2010;16(1):1–8. doi: 10.1159/000253858.
    1. Otiashvili D, Kirtadze I, O’Grady KE, Jones HE. Drug use and HIV risk outcomes in opioid-injecting men in the Republic of Georgia: Behavioral treatment+ naltrexone compared to usual care. Drug Alcohol Depend. 2012;120(1–3):14–21.
    1. Kirtadze I, Otiashvili D, O’Grady KE, Jones HE. Behavioral treatment+ naltrexone reduces drug use and legal problems in the Republic of Georgia. Am J Drug Alcohol Abuse. 2012;38:171–175. doi: 10.3109/00952990.2011.643996.
    1. Chaudhury R, Jones H, Wechsberg W, O’Grady K, Tuten M, Chisolm M. Addiction severity index composite scores as predictors for sexual-risk behaviors and drug-use behaviors in drug-using pregnant patients. Am J Drug Alcohol Abuse. 2010;36(1):25–30. doi: 10.3109/00952990903544810.
    1. Metzger D, Woody G, Navaline H, McLellan A, Meyers K, Boney T, O’Brien C. The risk assessment battery (RAB): Validity and reliability. Paper presented at the Sixt Annual Meeting of the National Cooperative Vaccine Development Group for AIDS. Alexandria; October 30 - November 4, 1993.
    1. Norbeck JS, Lindsey AM, Carrieri VL. The development of an instrument to measure social support. Nurs Res. 1981;30(5):264–269.
    1. Stvilia K, Todadze K, Nizharadze G. HIV and AIDS in the Caucasus: A Socio-Cultural Approach. Tbilisi: UNESCO; 2005. HIV and AIDS in Georgia: a socio-cultural approach; pp. 68–80.
    1. Kirtadze I, Otiashvili D, O’Grady KE, Zule W, Krupitsky E, Wechsberg WM, Jones HE. Twice stigmatized: Provider’s perspectives on drug-using women in the Republic of Georgia. J Psychoactive Drugs. in press.
    1. Kuniholm MH, Aladashvili M, Rio CD, Stvilia K, Gabelia N, Chitale RA, Nelson KE. Not all injection drug users are created equal: heterogeneity of HIV, hepatitis C virus, and hepatitis B virus infection in Georgia. Subst Use Misuse. 2008;43(10):1424–1437. doi: 10.1080/10826080802108293.
    1. Serbanescu F, Imnadze P, Bokhua Z, Nutsubidze N, Jackson D, Morris L. Preliminary Report. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta; 2005. Georgia Reproductive Health Survey 2005.
    1. Yodanis CL. Gender Inequality, Violence Against Women, and Fear. J Interpers Violence. 2004;19(6):655–675. doi: 10.1177/0886260504263868.
    1. Hser Y, Anglin MD, McGlothlin W. Sex differences in addict careers. 1. Initiation of use. Am J Drug Alcohol Abuse. 1987;13(1–2):33–57.
    1. IHRD. Key findings from Azerbaijan, Georgia, Kyrgyzstan, Russia and Ukraine. New York: Open Society Institute; 2009. International Harm Reduction Development Program: Women, Harm Reduction, and HIV.
    1. Ashery RS, Wild J, Zhao Z, Rosenshine N, Young P. The Wheel Project: Women helping to empower and enhance lives. J Subst Abuse Treat. 1997;14(2):113–121. doi: 10.1016/S0740-5472(96)00129-8.

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