HIV knowledge, self-perception of HIV risk, and sexual risk behaviors among male Tajik labor migrants who inject drugs in Moscow

Casey Morgan Luc, Judith Levy, Mahbat Bahromov, Jonbek Jonbekov, Mary E Mackesy-Amiti, Casey Morgan Luc, Judith Levy, Mahbat Bahromov, Jonbek Jonbekov, Mary E Mackesy-Amiti

Abstract

Background: The interplay of human immunodeficiency virus (HIV) knowledge and self-perception of risk for HIV among people who inject drugs is complex and understudied, especially among temporary migrant workers who inject drugs (MWID) while in a host country. In Russia, Tajik migrants make up the largest proportion of Moscow's foreign labor. Yet, HIV knowledge and self-perceived risk in association with sexual risk behavior among male Tajik MWID in Moscow remains unknown.

Objective: This research examines knowledge about HIV transmission, self-perception of HIV risk, and key psychosocial factors that possibly contribute to sexual risk behaviors among male Tajik labor MWID living in Moscow.

Methods: Structured interviews were conducted with 420 male Tajik labor MWID. Modified Poisson regression models investigated possible associations between major risk factors and HIV sexual risk behavior.

Results: Of the 420 MWID, 255 men (61%) reported sexual activity in the last 30 days. Level of HIV knowledge was not associated in either direction with condom use or risky sexual partnering, as measured by sex with multiple partners or female sex workers (FSW). Lower self-perceived HIV risk was associated with a greater likelihood of sex with multiple partners (aPR: 1.79, 95% CI: 1.34, 2.40) and FSW (aPR: 1.28, 95% CI: 1.04, 1.59), but was not associated with condom use. Police-enacted stigma was associated with sex with multiple partners (aPR: 1.22, 95% CI: 1.01, 1.49) and FSW (aPR: 1.32, 95% CI: 1.13, 1.54). While depression and lower levels of loneliness were associated with condomless sex (aPR: 1.14, 95% CI: 1.05, 1.24; aPR: 0.79, 95% CI: 0.68, 0.92, respectively), only depression was associated with condomless sex with FSW (aPR: 1.26, 95% CI: 1.03, 1.54).

Conclusions: HIV prevention programing for male Tajik MWID must go beyond solely educating about factors associated with HIV transmission to include increased awareness of personal risk based on engaging in these behaviors. Additionally, psychological services to counter depression and police-enacted stigma are needed.

Keywords: HIV Risk Self-Perception, HIV Knowledge, Psychosocial Factors; Injection drug use; Sexual risk behavior; Tajik migrant worker.

Conflict of interest statement

The authors declare no competing interests.

© 2024. The Author(s).

References

    1. Iom U. Migration and AIDS. Int Migr. 2004;445–468(4):36.
    1. Aibekova L, Foley B, Hortelano G, et al. Molecular epidemiology of HIV-1 subtype A in former Soviet Union countries. PLoS ONE. 2018;13(2):e0191891. doi: 10.1371/journal.pone.0191891.
    1. Bakhromov M, Levy JA. Double jeopardy through social marginalization: HIV risk among Tajik male labor migrants in Moscow. Drug Alcohol Depend. 2013;132(Suppl 1):S53–55. doi: 10.1016/j.drugalcdep.2013.06.029.
    1. UNAIDS. AIDSinfo.
    1. Weine S, Bahromov M, Mirzoev A. Unprotected Tajik male migrant workers in Moscow at risk for HIV/AIDS. J Immigr Minor Health. 2008;10(5):461–468. doi: 10.1007/s10903-007-9103-5.
    1. Bahromov M, Weine S. HIV prevention for migrants in transit: developing and testing TRAIN. AIDS Educ Prev. 2011;23(3):267–280. doi: 10.1521/aeap.2011.23.3.267.
    1. Gokengin D, Oprea C, Begovac J, et al. HIV care in Central and Eastern Europe: How close are we to the target? Int J Infect Dis. 2018;70:121–130. doi: 10.1016/j.ijid.2018.03.007.
    1. Heimer R. The Policy-Driven HIV Epidemic Among Opioid Users in the Russian Federation. Curr HIV/AIDS Rep. 2018;15(3):259–265. doi: 10.1007/s11904-018-0395-y.
    1. Baker P, Beletsky L, Avalos L, et al. Policing Practices and Risk of HIV Infection Among People Who Inject Drugs. Epidemiol Rev. 2020;42(1):27–40. doi: 10.1093/epirev/mxaa010.
    1. Levy JA, Mackesy-Amiti ME, Bakhromov M, Jonbekov J, Latkin CA. A Network-Based HIV Prevention Intervention for Tajik Migrant Workers Who Inject Drugs. AIDS Behav. 2022;26(3):719–727. doi: 10.1007/s10461-021-03431-5.
    1. Sawitri AA, Hartawan AA, Craine N, Sari AK, Septarini NW, Wirawan DN. Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali. Indonesia Int J Prison Health. 2016;12(1):27–38. doi: 10.1108/IJPH-05-2014-0011.
    1. Chen B, Zhu Y, Guo R, et al. HIV/AIDS-related knowledge awareness and risk behaviors among injection drug users in Maanshan, China: a cross-sectional study. BMC Public Health 2016;16:97.
    1. Steven Ndugwa Kabwama GB-B The association between HIV/AIDS-related knowledge and perception of risk for infection: a systematic review. Perspect Public Health. 2015;135(6):299–308. doi: 10.1177/1757913915595831.
    1. Noroozinejad G, Yarmohmmadi Vasel M, Bazrafkan F, Sehat M, Rezazadeh M, Ahmadi K. Perceived Risk Modifies the Effect of HIV Knowledge on Sexual Risk Behaviors. Front Public Health. 2013;1:33. doi: 10.3389/fpubh.2013.00033.
    1. Khajehkazemi R, Haghdoost A, Navadeh S, et al. Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs. Sex Health. 2014;11(6):568–574. doi: 10.1071/SH14165.
    1. Nyblade L, Mingkwan P, Stockton MA. Stigma reduction: an essential ingredient to ending AIDS by 2030. Lancet HIV. 2021;8(2):e106–e113. doi: 10.1016/S2352-3018(20)30309-X.
    1. Marotta P, El-Bassel N, Terlikbayeva A, et al. Sexual Risks and Policing among Male Migrant and Non-migrant Market Vendors in Central Asia. J Urban Health. 2018;95(1):116–128. doi: 10.1007/s11524-017-0171-0.
    1. Goldenberg SM, Krusi A, Zhang E, Chettiar J, Shannon K. Structural Determinants of Health among Im/Migrants in the Indoor Sex Industry: Experiences of Workers and Managers/Owners in Metropolitan Vancouver. PLoS ONE. 2017;12(1):e0170642. doi: 10.1371/journal.pone.0170642.
    1. Zeng H, Zhang L, Zhao Y, et al. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers. Health Soc Care Community. 2016;24(6):e173–e180. doi: 10.1111/hsc.12266.
    1. Munoz-Laboy M, Hirsch JS, Quispe-Lazaro A. Loneliness as a sexual risk factor for male Mexican migrant workers. Am J Public Health. 2009;99(5):802–810. doi: 10.2105/AJPH.2007.122283.
    1. Michalopoulos LM, Ncube N, Simona SJ, Kansankala B, Sinkala E, Raidoo J. A qualitative study of migrant-related stressors, psychosocial outcomes and HIV risk behaviour among truck drivers in Zambia. Afr J AIDS Res. 2016;15(3):219–226. doi: 10.2989/16085906.2016.1179653.
    1. Organista KC, Kubo A. Pilot survey of HIV risk and contextual problems and issues in Mexican/Latino migrant day laborers. J Immigr Health. 2005;7(4):269–281. doi: 10.1007/s10903-005-5124-0.
    1. King EJ, Maksymenko KM, Almodovar-Diaz Y, Johnson S. 'If she is a good woman …' and 'to be a real man …': gender, risk and access to HIV services among key populations in Tajikistan. Cult Health Sex. 2016;18(4):422–434. doi: 10.1080/13691058.2015.1089603.
    1. van Dam NT, Earleywine M. Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiat Res. 2011;186(1):128–132. doi: 10.1016/j.psychres.2010.08.018.
    1. Eaton WW SC, Ybarra M, Muntaner C, Tien A. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 2004:363-377.363.
    1. Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20–40. doi: 10.1207/s15327752jpa6601_2.
    1. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–706. doi: 10.1093/aje/kwh090.
    1. StataCorp, Stata Statistical Software: Release 182023.
    1. Davlidova S, Haley-Johnson Z, Nyhan K, Farooq A, Vermund SH, Ali S. Prevalence of HIV, HCV and HBV in Central Asia and the Caucasus: A systematic review. Int J Infect Dis. 2021;104:510–525. doi: 10.1016/j.ijid.2020.12.068.
    1. Weine S, Bahromov M, Loue S, Owens L. HIV sexual risk behaviors and multilevel determinants among male labor migrants from Tajikistan. J Immigr Minor Health. 2013;15(4):700–710. doi: 10.1007/s10903-012-9718-z.
    1. Amirkhanian YA, Kuznetsova AV, Kelly JA, et al. Male labor migrants in Russia: HIV risk behavior levels, contextual factors, and prevention needs. J Immigr Minor Health. 2011;13(5):919–928. doi: 10.1007/s10903-010-9376-y.
    1. Faust L, Yaya S. The effect of HIV educational interventions on HIV-related knowledge, condom use, and HIV incidence in sub-Saharan Africa: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):1254. doi: 10.1186/s12889-018-6178-y.
    1. Weine SM, Kashuba AB. Labor migration and HIV risk: a systematic review of the literature. AIDS Behav. 2012;16(6):1605–1621. doi: 10.1007/s10461-012-0183-4.
    1. Balayan T, Begovac J, Skrzat-Klapaczynska A, et al. Where are we with pre-exposure prophylaxis use in Central and Eastern Europe? Data from the Euroguidelines in Central and Eastern Europe (ECEE) Network Group. HIV Med. 2021;22(1):67–72. doi: 10.1111/hiv.12960.
    1. Bromberg DJ, Tate MM, Alaei A, et al. "Who are You and What are You Doing Here?": Social Capital and Barriers to Movement along the HIV Care Cascade among Tajikistani Migrants with HIV to Russia. AIDS Behav. 2021;25(10):3115–3127. doi: 10.1007/s10461-021-03359-w.
    1. Weine S, Bahromov M, Loue S, Owens L. Trauma exposure, PTSD, and HIV sexual risk behaviors among labor migrants from Tajikistan. AIDS Behav. 2012;16(6):1659–1669. doi: 10.1007/s10461-011-0122-9.
    1. Zabrocki C, Polutnik C, Jonbekov J, Shoakova F, Bahromov M, Weine S. Condom use and intimacy among Tajik male migrants and their regular female partners in Moscow. Cult Health Sex. 2015;17(1):17–33. doi: 10.1080/13691058.2014.937748.
    1. Mergenova G, Shaw SA, Terlikbayeva A, et al. Social Support and HIV Risks Among Migrant and Non-Migrant Market Workers in Almaty Kazakhstan. J Immigr Minor Health. 2017;19(4):809–817. doi: 10.1007/s10903-016-0529-5.
    1. Mackesy-Amiti ME, Levy JA, Bahromov M, Jonbekov J, Luc CM. MASLIHAT Trial Data and Documentation. OSF; 2023. 10.17605/.

Source: PubMed

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