International Journal of Behavioral Medicine

, Volume 24, Issue 2, pp 180–190 | Cite as

Prevalence of Alcohol Use, Sexual Risk Behavior, and HIV Among Russians in High-Risk Settings: a Systematic Review and Meta-Analysis

  • Chiao-Wen Lan
  • Lori A. J. Scott-Sheldon
  • Kate B. Carey
  • Blair T. Johnson
  • Michael P. Carey



The purpose of this study was to examine the (a) prevalence of and (b) association between alcohol, risky sex, and HIV among Russians at risk for primary or secondary HIV transmission.


Electronic databases were searched to locate studies that sampled Russians, assessed alcohol use, and included either a behavioral measure of risk or a biological measure of HIV. Weighted mean (logit) effect sizes were calculated using random-effects assumptions. Moderator analyses were conducted using meta-regression.


Studies (19) sampled 12,916 Russians (M age = 29; 36 % women). Participants were recruited from clinical (52 %; e.g., sexually transmitted infection (STI) clinic, drug treatment), other high-risk community settings (32 %; e.g., sexual/drug networks), or both (16 %). Findings indicate that a substantial proportion of the participants used alcohol (77 %; 55 % heavy drinking). One half of participants reported using condoms (52 %), but only 29 % used condoms consistently. Most participants reported drinking before sex (64 %). Of the studies testing for HIV, 10 % of participants tested positive. Meta-regression analyses indicated that hazardous/harmful alcohol use was associated with increased risky behaviors (i.e., multiple partners, inconsistent condom use).


These findings support the need for and potential benefit of addressing alcohol use in HIV prevention programming in Russia.


Alcohol use Sexual risk behaviors HIV Russia Meta-analysis 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


Research reported in this paper was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under award number R01 AA021355 to Lori A. J. Scott-Sheldon, PhD. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Supplementary material

12529_2016_9596_MOESM1_ESM.docx (31 kb)
ESM 1 (DOCX 31.3 kb)
12529_2016_9596_MOESM2_ESM.docx (26 kb)
ESM 2 (DOCX 25.8 kb)


  1. 1.
    UNAIDS. The Gap Report. 2014.Google Scholar
  2. 2.
    Piot P, Abdool Karim SS, Hecht R, et al. Defeating AIDS—advancing global health. Lancet. 2015;386(9989):171–218. doi: 10.1016/s0140-6736(15)60658-4.CrossRefPubMedGoogle Scholar
  3. 3.
    Pokrovsky V, Ladnaya NN, Buravtsova EV. HIV Infection: information bulletin #34. Russian Federal AIDS Center. 2010.Google Scholar
  4. 4.
    Centers for Disease Control and Prevention. Rapid increase in HIV rates—Orel Oblast, Russian Federation, 1999-2001. Morb Mortal Wkly Rep. 2003;52(28):657–60.Google Scholar
  5. 5.
    Rakhmanova A, Vinogradova E, Yakovev A. The characteristics of HIV-infection in St. Petersburg. St. Petersburg, Russian Federation 2007.Google Scholar
  6. 6.
    Balachova TN, Batluk JV, Bryant KJ, Shaboltas AV. International collaboration in HIV prevention research: evidence from a research seminar in Russia. AIDS Res Hum Retrovir. 2015;31(2):163–72. doi: 10.1089/aid.2014.0078.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    World Health Organization. Global Status Report on Alcohol and Health. 2014.Google Scholar
  8. 8.
    Chenet L, McKee M, Leon D, Shkolnikov V, Vassin S. Alcohol and cardiovascular mortality in Moscow; new evidence of a causal association. J Epidemiol Community Health. 1998;52(12):772–4.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009;373(9682):2223–33. doi: 10.1016/s0140-6736(09)60746-7.CrossRefPubMedGoogle Scholar
  10. 10.
    World Health Organization. WHO country profile: the Russian Federation. 2011. Accessed June 22, 2014.
  11. 11.
    Fortenberry JD, Orr DP, Katz BP, Brizendine EJ, Blythe MJ. Sex under the influence. A diary self-report study of substance use and sexual behavior among adolescent women. Sex Transm Dis. 1997;24(6):313–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Irwin TW, Morgenstern J, Parsons JT, Wainberg M, Labouvie E. Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: an event level analysis of timeline followback data. AIDS Behav. 2006;10(3):299–307. doi: 10.1007/s10461-005-9045-7.CrossRefPubMedGoogle Scholar
  13. 13.
    Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci. 2007;8(2):141–51. doi: 10.1007/s11121-006-0061-2.CrossRefPubMedGoogle Scholar
  14. 14.
    Morojele NK, Kachieng’a MA, Mokoko E, et al. Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province. South Africa Social Science & Medicine. 2006;62(1):217–27. doi: 10.1016/j.socscimed.2005.05.031.CrossRefGoogle Scholar
  15. 15.
    Scott-Sheldon LAJ, Walstrom P, Carey KB, Johnson BT, Carey MP. Alcohol use and sexual risk behaviors among individuals infected with HIV: a systematic review and meta-analysis 2012 to early 2013. Current HIV/AIDS reports. 2013;10(4):314–23. doi: 10.1007/s11904-013-0177-5.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bryant KJ. Expanding research on the role of alcohol consumption and related risks in the prevention and treatment of HIV/AIDS. Subst Use Misuse. 2006;41(10–12):1465–507. doi: 10.1080/10826080600846250.CrossRefPubMedGoogle Scholar
  17. 17.
    Shuper PA, Neuman M, Kanteres F, Baliunas D, Joharchi N, Rehm J. Causal considerations on alcohol and HIV/AIDS—a systematic review. Alcohol & Alcoholism. 2010;45(2):159–66. doi: 10.1093/alcalc/agp091.CrossRefGoogle Scholar
  18. 18.
    Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3–17.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Cook RL, Clark DBI. There an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sex Transm Dis. 2005;32(3):156–64.CrossRefPubMedGoogle Scholar
  20. 20.
    Baliunas D, Rehm J, Irving H, Shuper P. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. International journal of public health. 2010;55(3):159–66. doi: 10.1007/s00038-009-0095-x.CrossRefPubMedGoogle Scholar
  21. 21.
    Baum MK, Rafie C, Lai S, Sales S, Page JB, Campa A. Alcohol use accelerates HIV disease progression. AIDS Res Hum Retrovir. 2010;26(5):511–8. doi: 10.1089/aid.2009.0211.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2014. = 1&ua = 1.
  23. 23.
    Wilsnack RW, Wilsnack SC, Kristjanson AF, Vogeltanz-Holm ND, Gmel G. Gender and alcohol consumption: patterns from the multinational GENACIS project. Addiction. 2009;104(9):1487–500. doi: 10.1111/j.1360-0443.2009.02696.x.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Beyrer C, Baral SD, Walker D, Wirtz AL, Johns B, Sifakis F. The expanding epidemics of HIV type 1 among men who have sex with men in low- and middle-income countries: diversity and consistency. Epidemiol Rev. 2010;32:137–51. doi: 10.1093/epirev/mxq011.CrossRefPubMedGoogle Scholar
  25. 25.
    Shannon K, Strathdee SA, Goldenberg SM, et al. Global epidemiology of HIV among female sex workers: influence of structural determinants. Lancet. 2015. doi: 10.1016/s0140-6736(14)60931-4.Google Scholar
  26. 26.
    UNAIDS. 2015 Epidemiological slides—How AIDS Changed Everything report. 2015.Google Scholar
  27. 27.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41. doi: 10.1016/j.ijsu.2010.02.007.CrossRefPubMedGoogle Scholar
  28. 28.
    Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.CrossRefPubMedGoogle Scholar
  29. 29.
    Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–84.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Fowkes FG, Fulton PM. Critical appraisal of published research: introductory guidelines. BMJ (Clinical research ed). 1991;302(6785):1136–40.CrossRefGoogle Scholar
  31. 31.
    Baral S, Kizub D, Masenior NF, et al. Male sex workers in Moscow, Russia: a pilot study of demographics, substance use patterns, and prevalence of HIV-1 and sexually transmitted infections. AIDS Care. 2010;22(1):112–8. doi: 10.1080/09540120903012585.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Abdala N, Zhan WH, Shaboltas AV, Skochilov RV, Kozlov AP, Krasnoselskikh TV. Efficacy of a brief HIV prevention counseling intervention among STI clinic patients in Russia: a randomized controlled trial. AIDS Behav. 2013;17(3):1016–24. doi: 10.1007/s10461-012-0311-1.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Hoffman IF, Latkin CA, Kukhareva PV, et al. A peer-educator network HIV prevention intervention among injection drug users: results of a randomized controlled trial in St. Petersburg, Russia. AIDS Behav. 2013;17(7):2510–20. doi: 10.1007/s10461-013-0563-4.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Samet JH, Krupitsky EM, Cheng DM, et al. Mitigating risky sexual behaviors among Russian narcology hospital patients: the PREVENT (Partnership to Reduce the Epidemic Via Engagement in Narcology Treatment) randomized controlled trial. Addiction. 2008;103(9):1474–83.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Samet JH, Raj A, Cheng DM, et al. HERMITAGE-a randomized controlled trial to reduce sexually transmitted infections and HIV risk behaviors among HIV-infected Russian drinkers. Addiction. 2015;110(1):80–90. doi: 10.1111/add.12716.CrossRefPubMedGoogle Scholar
  36. 36.
    Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks, CA: Sage.Google Scholar
  37. 37.
    Stata Corp. Stata Statistical Software: Release 12. College Station, TX: Stata Corp 2011.Google Scholar
  38. 38.
    Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.CrossRefPubMedGoogle Scholar
  39. 39.
    World Health Organization. AUDIT: The Alcohol Use Disorders Identification Test, guidelines for use in primary care.. 2nd ed. Geneva, Switzerland: World Health Organization,; 2001.Google Scholar
  40. 40.
    Wirtz AL, Zelaya CE, Latkin C, et al. Alcohol use and associated sexual and substance use behaviors among men who have sex with men in Moscow, Russia. AIDS Behav. 2015:1–14. doi: 10.1007/s10461-015-1066-2.
  41. 41.
    Cook RL, Comer DM, Wiesenfeld HC, et al. Alcohol and drug use and related disorders: an underrecognized health issue among adolescents and young adults attending sexually transmitted disease clinics. Sex Transm Dis. 2006;33(9):565–70. doi: 10.1097/01.olq.0000206422.40319.54.CrossRefPubMedGoogle Scholar
  42. 42.
    Howards PP, Thomas JC, Earp JA. Do clinic-based STD data reflect community patterns? Int J STD AIDS. 2002;13(11):775–80. doi: 10.1258/095646202320753745.CrossRefPubMedGoogle Scholar
  43. 43.
    Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med. 2003;26(2):104–23.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Niccolai LM, Shcherbakova IS, Toussova OV, Kozlov AP, Heimer R. The potential for bridging of HIV transmission in the Russian Federation: sex risk behaviors and HIV prevalence among drug users (DUs) and their non-DU sex partners. Journal of Urban Health. 2009;86(Suppl 1):131–43. doi: 10.1007/s11524-009-9369-0.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Higgins JPT. Commentary: heterogeneity in meta-analysis should be expected and appropriately quantified. Int J Epidemiol. 2008;37(5):1158–60. doi: 10.1093/ije/dyn204.CrossRefPubMedGoogle Scholar
  46. 46.
    Higgins JPT, Thompson SG, Spiegelhalter DJA. Re-evaluation of random-effects meta-analysis. Journal of the Royal Statistical Society: Series A (Statistics in Society). 2009;172(1):137–59. doi: 10.1111/j.1467-985X.2008.00552.x.CrossRefGoogle Scholar
  47. 47.
    IOGT International. HIV and Alcohol. Sweeden. 2009. Accessed March 10 2016.
  48. 48.
    Amirkhanian YA, Kelly JA, Takacs J, et al. HIV/STD prevalence, risk behavior, and substance use patterns and predictors in Russian and Hungarian sociocentric social networks of men who have sex with men. AIDS Educ Prev. 2009;21(3):266–79.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Eritsyan KU, Levina OS, White E, Smolskaya TT, Heimer R. HIV prevalence and risk behavior among injection drug users and their sex partners in two Russian cities. AIDS Res Hum Retrovir. 2013;29(4):687–90. doi: 10.1089/aid.2012.0161.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Fleming MF, Krupitsky EM, Tsoy M, et al. Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients. International Journal of Tuberculosis and Lung Disease. 2006;10(5):565–70.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Iguchi MY, Ober AJ, Berry SH, et al. Simultaneous recruitment of drug users and men who have sex with men in the United States and Russia using respondent-driven sampling: sampling methods and implications. Journal of Urban Health. 2009;86(Suppl 1):5–31. doi: 10.1007/s11524-009-9365-4.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Krupitsky EM, Zvartau E, Karandashova G, et al. The onset of HIV infection in the Leningrad region of Russia: a focus on drug and alcohol dependence. HIV medicine. 2004;5(1):30–3.CrossRefPubMedGoogle Scholar
  53. 53.
    Krupitsky EM, Horton NJ, Williams EC, et al. Alcohol use and HIV risk behaviors among HIV-infected hospitalized patients in St. Petersburg, Russia. Drug Alcohol Depend. 2005;79(2):251–6. doi: 10.1016/j.drugalcdep.2005.01.015.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Niccolai LM, Odinokova VA, Safiullina LZ, et al. Clients of street-based female sex workers and potential bridging of HIV/STI in Russia: results of a pilot study. AIDS Care. 2012;24(5):665–72. doi: 10.1080/09540121.2011.630356.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Odinokova V, Rusakova M, Urada LA, Silverman JG, Raj A. Police sexual coercion and its association with risky sex work and substance use behaviors among female sex workers in St. Petersburg and Orenburg, Russia. International Journal of Drug Policy. 2014;25(1):96–104. doi: 10.1016/j.drugpo.2013.06.008.CrossRefPubMedGoogle Scholar
  56. 56.
    Shipitsyna E, Krasnoselskikh T, Zolotoverkhaya E, et al. Sexual behaviours, knowledge and attitudes regarding safe sex, and prevalence of non-viral sexually transmitted infections among attendees of youth clinics in St. Petersburg, Russia. Journal of the European Academy of Dermatology and Venereology : JEADV. 2013;27(1):e75–84. doi: 10.1111/j.1468-3083.2012.04512.x.CrossRefPubMedGoogle Scholar
  57. 57.
    Vasquez C, Lioznov D, Nikolaenko S, et al. Gender disparities in HIV risk behavior and access to health care in St. Petersburg, Russia. AIDS Patient Care STDs. 2013;27(5):304–10. doi: 10.1089/apc.2013.0019.CrossRefPubMedGoogle Scholar
  58. 58.
    Zhan WH, Krasnoselskikh TV, Niccolai LM, Golovanov S, Kozlov AP, Abdala N. Concurrent sexual partnerships and sexually transmitted diseases in Russia. Sex Transm Dis. 2011;38(6):543–7. doi: 10.1097/OLQ.0b013e318205e449.PubMedPubMedCentralGoogle Scholar
  59. 59.
    Zhan WH, Shaboltas AV, Skochilov RV, Kozlov AP, Krasnoselskikh TV, Abdala N. Alcohol misuse, drinking contexts and intimate partner violence in St. Petersburg, Russia: results from a cross-sectional study. BMC Public Health. 2011;11:629. doi: 10.1186/1471-2458-11-629.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Zhan WH, Shaboltas AV, Skochilov RV, Krasnoselskikh TV, Abdala N. History of childhood abuse, sensation seeking, and intimate partner violence under/not under the influence of a substance: a cross-sectional study in Russia. PLoS One. 2013;8(7):e68027. doi: 10.1371/journal.pone.0068027.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2016

Authors and Affiliations

  • Chiao-Wen Lan
    • 1
  • Lori A. J. Scott-Sheldon
    • 1
    • 2
    • 3
  • Kate B. Carey
    • 3
  • Blair T. Johnson
    • 4
  • Michael P. Carey
    • 1
    • 2
    • 3
  1. 1.Centers for Behavioral and Preventive MedicineThe Miriam HospitalProvidenceUSA
  2. 2.Department of Psychiatry and Human Behavior, Alpert School of MedicineBrown UniversityProvidenceUSA
  3. 3.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  4. 4.Department of PsychologyUniversity of ConnecticutStorrsUSA

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