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Half of HIV-positive persons in Russia are on antiretroviral therapy (ART), and only 27% are virally suppressed. A feasibility pilot intervention to mobilize social capital resources for HIV care support was conducted in St. Petersburg. Out-of-care or ART-nonadherent HIV-positive persons (n = 24) attended a five-session intervention to increase access social capital resources (i.e., family, friends, or providers) to mobilize supports for entering care, initiating care, and adhering to ART. HIV care indicators were assessed at baseline, an immediate followup (FU-1), and 6-month followup (FU-2) points. At FU-1, participants more frequently discussed their care experiences with others, verifying the intervention's mechanism of action. Participants increased in scales of medication taking adherence (p = 0.002, FU-1; p = 0.011, FU-2), self-efficacy (p = 0.042; FU-1), and outcome expectancies (p = 0.016, FU-2). Among persons not on ART, HIV Medication Readiness scale scores increased at FU-1 (p = 0.032) but became attenuated at FU-2. Participants tended to more frequently keep care appointments (79%, baseline to 90%, FU-1, p = 0.077); to have undetectable viral load (54%, baseline to 74%, FU-2; p = 0.063); and to have fewer past-month days with delayed or incomplete medication doses (7.8, baseline to 4.2, FU-1; p = 0.084). This novel social capital intervention is promising for improving HIV care-related outcomes and warrants a full-scale evaluation. [ABSTRACT FROM AUTHOR]

Russia has over 1.2 million HIV infections and Europe's highest HIV incidence. Although its HIV epidemic is intertwined with high alcohol consumption rates, the interaction between alcohol use and HIV care in Russia is understudied. Five hundred eighty-six HIV-positive persons were recruited using social network methods in St. Petersburg. Fifty-nine percent of males, and 45% of females, drank regularly. Thirty percent of alcohol users reported binge drinking (males: ≥ 5 drinks; females ≥ 4 drinks) in the past week. Alcohol use was associated with lower HIV care engagement and having a detectable viral load. Multivariate analyses showed that any alcohol consumption, number of alcohol drinks consumed, and having a binge drinking day in the past week were associated with male gender, use of illicit drugs, drug injection, smaller social network size, lower social supports, being unmarried, and reporting condomless intercourse with non-main partners. Interventions to improve HIV care in Russia must comprehensively address the use of alcohol and substances that interfere with care engagement. [ABSTRACT FROM AUTHOR]

Introduction The proportion of people living with HIV (PLH) in care and on antiretroviral therapy (ART) in Russia is lower than in Sub-Saharan Africa []. This is undoubtedly due to a variety of systems and structural issues related to poor treatment access, linkage and care delivery models. However, little research has explored the reasons that PLH are not in care from their own perspectives. This information can help to guide the development of approaches for improving HIV care engagement in the country. Materials and Methods In-depth interviews were undertaken with 80 PLH in St. Petersburg who had never been in HIV medical care, had previously been out of care, or had always been in care. Participants were recruited through online PLH forums and Websites, outreach needle exchange and non-government organisation (NGO) programs, and chain referral. The interviews elicited detailed information about participants' experiences and circumstances responsible for being out of care, and factors contributing to nonretention in HIV treatment. Verbatim transcriptions of the interviews were coded and analyzed using MAXQDA software to identify emerging themes. Results Two types of care engagement barriers most often emerged. Some related to medical services, and others to the family and social environment. The most frequent medical service barriers were poor treatment infrastructure conditions and access; dissatisfaction with quality of services and medical staff; and concerns over confidentiality and HIV status disclosure. Social barriers were fears of potential harm to family relationships, negative consequences if status became known at work, and public stigmatization and myths associated having an HIV+ status. Social support from the PLH community and from family and close friends facilitated care engagement, as did motivation to take care of oneself and one's family. Most participants also described circumstances in which engaging into HIV care was brought about by an urgent issue (opportunistic infections) or was enforced through hospitalization or imprisonment. Trust in one's doctor and simply not wanting to die were also common motives. Conclusions Stigma was a major barrier to care engagement, including fear that others would learn of one's HIV+ status, whether at work, in one's family, or in the general community. By contrast, support from family, friends and the PLH community contributed to care engagement. [ABSTRACT FROM AUTHOR]