HERMITAGE Study

NIAAA: Maximizing Opportunity – HIV Prevention in  Hospitalized Russian Drinkers

HIV’s Evolution in Russia – Mitigating Infection Transmission and Alcoholism in a Growing Epidemic (HERMITAGE)

Funding source: NIAAA     

Grant number: R01 AA016059

Principal Investigator: Jeffrey Samet, MD, MA, MPH

Key personnel:

Elena Blokhina, MD, PhD, Co-Investigator

Debbie Cheng, ScD, Biostatistician

Christine Chaisson, MPH, Data Manager

Evgeny Krupitsky, MD, PhD, DMSci, Co-Investigator & Russian PI

Dmitry Lioznov, MD, PhD, Co-Investigator

Anita Raj, PhD, Co-Investigator

Alexander Walley, MD, MSc, Co-Investigator

Edwin Zvartau, MD, PhD, DMSci, Co-Investigator, & Russian Project Director

Funding dates: 09/30/06-08/31/12   

Grant Abstract:

The HIV epidemic in Russia has occurred within the past  10 years and now includes an estimated 1 million people. Russia also has one of the highest levels of per capita alcohol consumption. Thus far, the HIV epidemic in Russia has been primarily propelled by injection drug users (IDUs). However, the risk for viral transmission beyond drug users, as previously observed in other countries when this epidemic progresses, looms large. Many HIV-infected persons with alcohol problems take part in risky sex and drug related behaviors. Thus alcohol use may accelerate HIV transmission to the general population in Russia. The objective of this proposal, HERMITAGE, HIV’s Evolution in Russia – Mitigating Infection Transmission and Alcoholism in a Growing Epidemic, is to test in a randomized controlled trial the effectiveness of a USHIV secondary prevention program, Healthy Relationships Intervention, among HIV-infected patients with risky drinking in a Russian infectious disease hospital. The intervention will be culturally adapted and modified to address substance use and associated risk behaviors. The study will randomize 300 HIV-infected patients with risky alcohol consumption to an adapted Healthy Relationships Intervention (HRI) or attention-control support groups. Subjects participating in the HRI will attend 5, 2-hour structured group sessions in addition to 2, 1-hour individualized sessions. Subjects participating in the attention-control group will be exposed to support groups during the same timeframe. All patients will be assessed at baseline, 6, and 12-months post- randomization. Primary outcomes are HIV sex- and drug risk behaviors, sexually transmitted diseases, and alcohol consumption. Additionally, subjects will be assessed regarding secondary outcomes including addiction severity and disclosure of HIV serostatus. We hypothesize that relative to controls, participants receiving the Healthy Relationships Intervention will reduce HIV sex- and drug risk behaviors, STDs and alcohol consumption. If the intervention is effective among HIV-infected hospitalized patients, it could be used to address other HIV infected persons in a variety of Russian settings potentially reducing the transmission of HIV by decreasing risky sex- and drug-use behaviors.

Project Manager:

Carly Bridden, MA, MPH

617-414-5768

Carly.Bridden@bmc.org

Staff:

Sharon Coleman, Statistical Analyst

Emily Quinn, Statistical Analyst

Publications:

Krupitsky E, Raj A, Egorova V, Lioznov D, Bridden C, Kalichman S, Cheng D, Chaisson C, Palfai T, Verbitskaya E, Zvartau E, Samet J. An HIV Prevention Intervention for Use with HIV-Infected Russian Drinkers: The HERMITAGE Study. Presented at 2008 RSA/ISBRA.

Samet JH, Krupitsky E, Raj A, Bridden C, Cheng D, Chaisson C, Walley A. Sexually Transmitted Diseases in HIV-Infected Russian Drinkers.  Alc Clin Exp Res. 2009: 33(suppl):306A.

Pace CA, Lioznov D, Cheng DM, Wakeman SE, Raj A, Walley AY, Coleman SM, Bridden C, Krupitsky E, Samet JH. Sexually transmitted infections among HIV-infected heavy drinkers in St. Petersburg, Russia. International Journal of STD and AIDS. In Press.

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May 14, 2012
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