Background The majority of early cases of HIV in Russia were among men who have sex with men (MSM). Despite this and the current resurgence of HIV among MSM globally, little systematic work has been done to assess current HIV risks. We conducted a rapid assessment of HIV and associated risk behaviors among MSM in Russia. Methods An anonymous, cross-sectional study was performed among MSM in Moscow and St. Petersburg (January 2008). Participants were enrolled by local NGO partners via peer-recruitment, underwent a brief behavioral survey, and were offered rapid, oral HIV screening. Factors associated with HIV infection were assessed using logistic regression. Results A total of 401 participants were enrolled. HIV prevalence was comparable in the two cities (6.0% in Moscow, 5.5% in St. Petersburg). Approximately half (49.3%) were under age 25, 75.1% of all men reported unprotected anal intercourse (UAI) and 21.5% reported engaging in unprotected exchange sex in the prior 12 months. HIV infection was the highest (7.7%) among the youngest MSM, those aged 18-22 years. Never having tested for HIV (AOR=6.2; 95% C.I.: 1.8, 21.9) and ever injecting drugs (AOR=11.3; 95% C.I.: 2.6, 50.4) were independently associated with HIV infection. Conclusions We found significant overall HIV prevalence among MSM in Moscow and St. Petersburg, particularly among the youngest men. The majority of men reported ongoing high risk behaviors, indicating the potential for further spread. HIV prevention efforts need to specifically focus on urban MSM in Russia, encourage testing, and target injection risks to address this epidemic.
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