Multi-Methods Approaches to UdUnders tan ding thAthe Assoc itiiation between Methamphetamine Injection and HIV Risk in the FSU IiKGdJIrwin, K., Grund, J-PAbdlNP., Abdala, N., Borodkina, O. & Heimer, R. Three domains of multi -methods approach:

(1) conducting ethnographic observations of home production of stimulants and extensive discussions with IDUs and HIV preventiiidion service providers

(2) manufacturing stimulants in the laboratory , replicating field observations of ingredients and modes of preparation to explore their influence on the survival of HIV;

(3) conducting a structured survey of IDUs Cities Participants

„ Tomsk – Sibirsky Federal District „ Irkutsk – Sibirsky Federal District „ Kazan - Privolzhsky Federal District „ Chapaevsk -Privolzhsky Federal District „ Novorossiysk - Southern Federal District „ Saint Petersburg –North– North--WesternWestern Federal District „ Yaroslavl - Centralny Federal District „ Rybinsk - Centralny Federal District „ Moscow - Centralny Federal District „ Khabarovsk –Far Eastern Federal District „ Ekaterinburg – Ural District „ Total number of respondents: 826 Demographics GlSlIftiGeneral Sample Information

Sex: Males – 72,5% Females – 27,5% mean Age -26- 26,,55 Education Less than high school –1– 166,,88%% High school – 42,, 6% Technical school ( college) –27– 27,,55% Unfinished university – 8,, 7% University –6– 6,,22%% HiULtHeroin Use, Last 30 Days

дн 120 30 е ии 100

последн 80

за

60 героина

40 ие нн Пол

20 Мужской

0 Женский Употребле K T C S N Y R M Irk H E azan oms hap t. Petersburgov aroslav y o ab ka b sc u or in ts a ter k a os s ow k ro evs k v inb s l sk k iy ur sk g

Город HditLtHomemade opiates use, Last 30 Days е

дн 120 30 ее 100

80 последни

за " 60 ханки "

40 Пол

20 Мужской

0 Женский Употребление K Tomsk Cha St. Peter Novor Yaroslavl Rybi Moscow I Hab E a rk k z u a a p nsk tsk a te n ae o rov ri s n v sb s sk b s iy u k urg sk rg

Город Non-injecting “vint”

„ Kazan 6,,4 6 4%% „ Rybinsk 33,,00%% „ Tomsk 44,,66%% „ Moscow 12,,5 12 5%% „ Chapaevsk „ Irkutsk „ St.Petersburg 1,,21 2%% „ Habarovsk „ Novorossiysk „ Ekaterinburg 8,, 6% „ Yaroslavl 11,,77%% „ total 3,,5 3 5%% Injecting “vint”

„ Kazan 66 66,,44%% „ Rybinsk 7575,,88%% „ Tomsk 27,,627 6%% „ Moscow 88,,8 88 8%% „ Chapaevsk 11,,311 3%% „ Irkutsk 15,,9 15 9%% „ St.Petersburg 48,,848 8%% „ Habarovsk 8,,28 2%% „ Novorossiysk 13,, 1% „ Ekaterinburg 66,, 16% „ Yaroslavl 8080,,00%% „ total 43,,8 43 8%% Non-injecting “Jeff”

„ Kazan .. „ Rybinsk 33,,00%% „ Tomsk 33,,44%% „ Moscow „ Chapaevsk „ Irkutsk „ St.Petersburg 2,,32 3%% „ Habarovsk „ Novorossiysk 2,, 4% „ Ekaterinburg „ Yaroslavl „ total 1,,0 1 0%% Injecting “Jeff”

„ Kazan 33,,3 33 3%% „ Rybinsk 36,,4 36 4%% „ Tomsk 16,,1 16 1%% „ Moscow 8,,8 8 8%% „ Chapaevsk 33,,88%% „ Irkutsk 44,,99%% „ St.Petersburg 90,,7 90 7%% „ Habarovsk 32,,8 32 8%% „ Novorossiysk 31,, 0% „ Ekaterinburg 39,, 0% „ Yaroslavl 20,,0 20 0%% „ total 28,,7 28 7%% Age of starting use tobacco,,,gg alcohol, light drug.

18

17

16

15 Возраст начала 14 курения (tobacco)

13 Возраст начала возраст употребления алкогол 12 (alcohol) Возраст начала 11 употребления марихуа Средний K T C St N Y R M I H E a om h o aro y rkut ab k z a .P. v b os a (light drug) a pa P orossiy ins c a t n sk etersburg sl ow sk r e e a o ri vsk vl k vsk nburg sk

Город Illegal income

80

доход 75

йй 70 73 69

60 нелегальны

50 52 50 48 48 48

еющих 45 мм

и 40 40 %

30 29

20 Kazan Chapaevsk Novorossiysk Rybinsk Irkutsk Ekaterinburg Tomsk St. Petersburg Yaroslavl Moscow Habarovsk

Город HOftHYUdDAlHow Often Have You Used Drugs Alone During Last 30 Days?

50

40

30

20

10 Percent 0 DK s ometimes most of the times never half of the times alw ays People With Whom Drugs Were Used

100

80

60

40

20

Percent 0 husband, w ife, lover relative drug dealer other ther anosex par t tner fif r ien dd s s tranger Needle Exchange Clients (Ones Who Ever Used SEP)

60

50

40

30

20

10 ercent

PP 0 no yes DK Clients of SEP

80

76 74

ажды 70 нн 68

од 67 64 60 бы

55

хотя 53

50 PP

SE 40 38

вшихся 30

аа 30 28 24 20 пользов 10 % Kazan Chapaevsk Novorossiysk Rybinsk Irkutsk Ekaterinburg Tomsk St. Petersburg Yaroslavl Moscow Habarovsk

Город Needle Exchange for Others

„ General –36– 36..99 % „ Tomsk –35– 35..00%% „ Novorossiysk ––2020..33%% „ Saint Petersburg –25– 25..00%% „ YllYaroslavl – 21.. 9% „ Rybinsk –50– 50..00%% „ Chapaevsk –65– 65..55%% „ Kazan ––4747..44%% „ Moscow ––4545..55%% „ Khabarovsk – 41.. 2% „ Irkutsk ––2828..99%% „ Ekaterinburg –45– 45%% The reasons not to use SEP

40

37

30

20 21

10 11 11 8

4 4 0 3 % слиш не др мн боюс н у др е нас хочу угие ог привык угое о ь ком нет , и тру милиции да чтобы ст SEP о дностей л чник еко

кто и -т Number of injections made by one syringe during last 30 days

3,5 ицом

рр 3,0 3,0 шп

2,5 2,5 одним 2,3 хх 2,0 1,9 2,0 1,8 1,7 1,5 1,6 сделанны 1,5 ,

йй 1,4 1,2 1,0 инъекци

,5 K T C S N Y R M I H E во r az om ha tPt ov ar y o k ab ka тт . u P os b s t an s p eter oro ins c s a terinburg k a l ow k rov evs s avl k s siysk s k burg k Количес Город Thank you for your attention