Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Robert Heimer

Abstract

Russia and the other countries that comprised the Soviet Union constitute the one region in which the HIV epidemic continues to expand. Unlike most other regions, more than a quarter of HIV cases in Russia resulted from unsafe injection among people who inject drugs (PWID), and St. Petersburg is among the cities with the highest rates and case counts of HIV. Our study sought to identify actionable psychosocial characteristics influencing receipt of antiretroviral therapy (ART) in PWID. This study assessed survey results from 225 HIV-positive individuals recruited from a Russian NGO that provides PWID with harm reduction services. Individuals were categorized into two groups: those taking antiretroviral medication (ARV+) and those not taking antiretrovirals (ARV-). Participants were administered a biobehavioral survey focusing on psychosocial measures. Analyses included descriptive statistics, correlation matrices, and linear regressions. ARV+ participants (n = 113) had a significantly higher level of PTSD than did ARV- participants (n = 112). Greater internalized stigmas and coping skills were associated with more PTSD attributes, while fewer PTSD attributes were associated with higher anticipated stigmas. Women were more likely than men to have greater PTSD attributes and better coping skills. Coping and resilience were positively correlated (r = 0.172). In this study, ARV+ participants did not differ from ARV- participants in either anticipated or internalized stigma or in coping skills or resilience. However, ARV+ participants exhibited higher levels of PTSD, which was associated with greater internalized stigma and coping. These findings suggest the importance of understanding the association of psychological problems, such as PTSD, that could interfere with the receipt of ARVs and could be remediated by psychosocial interventions, such as resilience and coping.

Comments

This is an Open Access Thesis.

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