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Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

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Abstract

The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18 and 44 years, who were at risk for an alcohol-exposed pregnancy were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner’s risk associated with partner’s drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner’s risk that included partner’s imprisonment and partner’s sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners’ risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥ 8 than those who had lower scores, and were 3.9 (95% CI [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.

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Acknowledgements

Sources of support: Research Grant R01AA016234 from the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Fogarty International Center (Brain Disorders in the Developing World: Research Across the Lifespan) to T. Balachova at OUHSC; and the U.S.-Russia Collaborative HIV/AIDS Research Initiative, the National Institutes of Health (NIH), USA and the Russian Foundation for Basic Research (RFBR), Russia, Administrative Supplement 3R01AA016234-05S1 and Research Grant R21AA022596 from NIAAA to T. Balachova at OUHSC and Research Grant 12-06-91444 from RFBR to A. Shaboltas at SPSU. The authors would like to thank Theresa Exner, PhD, of Columbia University, for her invaluable consultation on the study procedures and development of the study survey measure. The authors wish to acknowledge the contributions of Karen Beckman, MD, and Kathy Kyler, MS, of OUHSC, Sangeeta Agrawal, MS, of Gallup Consulting, and Nicholas Knowlton, MS, of NSK Statistical Solutions. Many thanks also go to Mary Asal, Ekaterina Burina, Elena Kosih, and other graduate students from St. Petersburg State University, Nizhny Novgorod State Pedagogical University, and the University of Oklahoma Health Sciences Center for their assistance with the study. Special thanks go to the participants who volunteered to participate in the study.

Funding

Tatiana Balachova, Som Bohora, Mark Chaffin, Alla Shaboltas, Barbara Bonner, Galina Isurina, Larissa Tsvetkova, Larissa Skitnevskaya, and Elena Volkova, had NIH Grants funding. Alla Shaboltas and Julia Batluk had RFBR Grant funding.

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Authors and Affiliations

  1. Department of Pediatrics, The University of Oklahoma Health Sciences Center (OUHSC), 940 N.E. 13th Street, Nicholson Tower, Suite 4900, Oklahoma City, 73104, OK, USA

    Som Bohora, Mark Chaffin, Barbara Bonner, David Bard & Tatiana Balachova

  2. Psychology Department, St. Petersburg State University (SPSU), Saint Petersburg, Russia

    Alla Shaboltas, Galina Isurina, Julia Batluk, Larissa Tsvetkova & Elena Volkova

  3. Nizhniy Novgorod State Pedagogical University, Nizhniy Novgorod, Russia

    Larissa Skitnevskaya & Elena Volkova

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  1. Som Bohora
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  2. Mark Chaffin
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  3. Alla Shaboltas
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  4. Barbara Bonner
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  8. Larissa Tsvetkova
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  9. Larissa Skitnevskaya
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  10. Elena Volkova
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  11. Tatiana Balachova
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Correspondence to Tatiana Balachova.

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Author Contributions

All authors have made substantual contribution to the study design, data gathering, analysis, and/or interpretation of data and have contributed to the intellectual content and preparation of the manuscript. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, NIAAA, FIC, or RFBR.

Conflict of interest

The authors declare that they have no other conflicts of interest.

Ethical Approval

The study approval was obtained from the Institutional Review Boards (IRBs) of both participating universities, the St. Petersburg State University and the University of Oklahoma Health Sciences Center. All procedures performed in the study were in accordance with the ethical standards of the IRBs and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bohora, S., Chaffin, M., Shaboltas, A. et al. Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies. AIDS Behav 21 (Suppl 2), 243–252 (2017). https://doi.org/10.1007/s10461-017-1929-9

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