Syndrome of substance abuse, violence and HIV-infection/AIDS (SAVA) and some related factors among sex workers in 4 cities in Russian Federation

Introduction. Social determinants of health are often a major topic for syndemic research. This is consistent with the fundamental idea of syndemic conditions that share common social factors and bio-social interactions. One of the earliest syndemies was the reported abuse of psychoactive substances in the United States, the experience of victimization from interpersonal violence and HIV infection (SAVA).The objective of this study was to assess the prevalence of SAVA syndrome and its relationship with risk factors for HIV infection in key groups — female sex workers (SW). Materials and methods. The analysis is based on data from a biobehavioral study carried out in 4 cities of the Russian Federation and involving 817 SWs (time-place sampling). The study included a questionnaire survey and determination of HIV status.Results and discussion. The prevalence of SAVA syndemics in the groups of SWs and MSM was relatively low because of relatively low (in comparison with IDUs) prevalence of HIV infection. Full syndemics occurred in 1.27%, [95% CI=0.30–2.24%] female sex workers. Incomplete syndemics (excluding HIV infection from definition) was detected in 7.31%, [95% CI=4.59–10.02%] of SW.SWs who were physically and sexually abused had HIV infection in 16.7% of cases, only physically abused — in 10% of cases, while among those who denied violence against them — only 6.5%.