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Biomedical subjects

A J Saxon

Publications and source records attributed to A J Saxon.

At least 37 records · Page 2Linked to original sources
PubMed1992

Longitudinal sexual behavior changes in injecting drug users.

OBJECTIVE: To determine whether injection drug users (IDU) maintained sexual behavior risk reduction over an 18-month period that had been noted previously over a 4-month period. DESIGN: A repeated measures design was utilized with IDU assessed initially at study enrollment and again 18 months later. METHODS: Sexual behaviors of a group of 220 IDU (148 men and 72 women) were assessed by a structured interview at the start of an AIDS prevention project and again 18 months later. RESULTS: Having multiple sex partners during the 12 months before initial assessment was reported by 42.6% of the men and 35.7% of the women. Significantly fewer had multiple sex partners during the 10 months before follow-up assessment (men, 20.9%; women, 14.3%). Condom use for vaginal intercourse increased from a mean of 11.9% initially to 27.8% at follow-up for men. The increase in condom use was greater for those with multiple sex partners. Women did not report significant increases in condom use. Continued involvement in unsafe sexual behaviors was associated with exchanging sex for money or drugs, using drugs to help meet sexual needs, alcohol use and drug use. CONCLUSIONS: Risk reductions noted previously were maintained over 18 months for the majority of the sample. Drug-use treatment and interventions that closely examine the interplay between drug use and sexuality for individual IDU are recommended as strategies to further reduce the sexual risk of HIV transmission among IDU.

Adult↗
PubMed1992

Alcohol use and high-risk behavior by intravenous drug users in an AIDS education paradigm.

The relationship between alcohol consumption and high-risk behavior for HIV infection was examined among 313 in-treatment intravenous drug users (IVDUs) by random assignment of these subjects to one of three interventions: (1) structured interview regarding risk behavior; (2) interview plus one group AIDS education session; (3) interview, AIDS education plus optional HIV testing. Alcohol users (n = 148) had more needle sharing and sexual partners than did nondrinkers. Follow-up interviews revealed no significant behavioral changes as a function of intervention condition or alcohol use. Better interventions, including more vigorous treatment of alcohol use, are needed to reduce risk behaviors among IVDUs.

AIDS Serodiagnosis↗
PubMed1992

Risk reduction in sexual behavior: a condom giveaway program in a drug abuse treatment clinic.

Just before and 4 months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men attending an outpatient drug abuse treatment clinic. Jars filled with a variety of condoms were placed in every clinic room. Condom taking varied as a function of room. Sixty percent of the subjects reported taking condoms. At follow-up, clients reported increases in condom possession and in use of condoms for vaginal intercourse.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Ineffectiveness of AIDS education and HIV antibody testing in reducing high-risk behaviors among injection drug users.

The effectiveness of education in reducing high-risk human immunodeficiency virus (HIV) transmission behaviors was examined in 313 injection drug users. Involvement in high-risk behaviors was assessed via structured interview at study entry and 4 months following the intervention. Subjects were randomly assigned to (1) AIDS education, (2) AIDS education with optional HIV antibody testing, or (3) a wait list. The sample as a whole decreased its involvement in high-risk behaviors, but there were no significant differences as a function of experimental group assignment.

AIDS Serodiagnosis↗
PubMed1991

Needle-use practices among intravenous drug users in an area where needle purchase is legal.

Needle-use practices of intravenous drug users (IVDUs) were examined in a region (Seattle, King Country, Washington State, USA) where needle purchase is legal. IVDUs in treatment (n = 313) were administered extensive structured interviews concerning drug and injection equipment-use practices. Of the 80.2% reporting intravenous drug use in the previous year, 78.3% reported sharing needles. Of the 47.7% reporting intravenous use in the previous 30 days, only 40.5% shared needles, with 59.3% sharing with only one other person. Most needle-sharing partners were very well known (63%) or well known (17%) to the subjects. The most frequent method for obtaining needles was 'buying in a drug store', ranked first by 65% of the sample. Subjects whose primary source was 'buying in a drug store' shared equipment less frequently during drug-use events in the previous year (mean: 16.2%) than those with other primary sources (mean: 28.5%). Compared with findings from other regions where needle purchase and possession are illegal without a prescription, fewer subjects in the current investigation shared needles, and those who did shared with a smaller number of people. The apparent association between legalized injection equipment and reduced sharing of equipment among IVDUs should be further examined in longitudinal studies of needle-sharing before and after legalization is instituted.

Adult↗
PubMed1991

Urine screening practices in methadone maintenance clinics. A survey of how the results are used.

The urinalysis practices of 324 methadone maintenance clinics were surveyed using a brief self-report questionnaire. Results indicate that there is wide variability in collection practices and clinic responses to positive findings. Virtually all clinics provide counseling and revocation of take-home methadone doses as a response to positive urinalysis results. However, increase in urine screening frequency, methadone dose adjustments, contingency contracting, group therapy, and eventual discharge are interventions also used. The implementation of different interventions varied as a function of clinic size, city size, region of the country, and program funding source.

Community Mental Health Centers↗
PubMed1991

Validity of the MCMI Drug Abuse Scale varies as a function of drug choice, race, and axis II subtypes.

The validity of the Drug Abuse Scale (T) from the Million Clinical Multiaxial Inventory (MCMI) was studied by administering the MCMI to 110 male veterans seeking treatment for opioid or cocaine dependence. Only 26 and 23% of the sample obtained base rate (BR) scores above the clinical relevant cutoffs of 84 and 74, respectively. Covariables associated with elevated scores on the T Scale were Black race, presence of narcissistic/antisocial personality features, and more severe psychopathology in general. The authors urge caution in using the Drug Abuse Scale for the purpose of identifying drug abusers.

Adult↗
PubMed1991

Sexual behaviors of intravenous drug users in treatment.

Sexual behaviors of a group of 313 intravenous drug users (IVDUs) (225 men, 88 women) were assessed by a structured interview at the start of an AIDS prevention project. Although the majority were celibate or monogamous during the prior year (men 52.5%, women 64.3%), many IVDUs had multiple sexual partners in that time, including 19.6% of men and 7.2% of women reporting five or more. Married male and female IVDUs were more likely to have multiple sexual partners than married people in general population samples. Only 38.5% of male and 35.4% of female IVDUs ever used condoms during the previous 5 years. Percentage of sexual encounters in which condoms were used correlated significantly with the number of partners for women (r = 0.37, p less than 0.01), but not for men (r = 0.03, ns). Use of intravenous drugs in the prior year, sharing of needles, use of stimulants, exchange of sex for money or drugs, and combining sexual events with drug use were all associated with greater numbers of sexual partners. A subset of male IVDUs engages in the dual-risk behaviors of needle sharing and unprotected intercourse with multiple partners. This group could act as a highly efficient vector for human immunodeficiency virus transmission and should become a focus of intensive preventive intervention.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Validity of the MCMI Drug Abuse Scale with drug abusing and psychiatric samples.

The validity of the Drug Abuse Scale (T) from the Millon Clinical Multiaxial Inventory (MCMI) was studied by administering the MCMI to 75 White male veterans who were seeking treatment for opioid or cocaine dependence and 60 White male veterans without diagnoses of drug dependence who were receiving psychiatric care. Only (39.4%) of the drug-abusing sample was classified correctly by obtaining base rate (BR) scores above the clinical relevant cut-off of 74, whereas, only 12% of the psychiatric sample was misclassified by having obtained a BR above 74. The results suggest that the MCMI T Scale is limited in its ability to identify drug users, but is also unlikely to misclassify psychiatric patients as drug abusers when they are not. The authors urge caution in using the Drug Abuse Scale for the purpose of identifying drug abusers.

Adult↗
PubMed1990

Staffing patterns of American methadone maintenance programs.

Methadone maintenance is the most frequently utilized treatment for heroin addiction and also represents one of the best AIDS-prevention tools for the IV drug using population. Despite these important roles, very little has been reported about how methadone maintenance clinics are staffed. Surveys covering various aspects of program operations, including staffing, were sent to all clinics (N = 557) listed in the 1984 National Directory of Drug Abuse and Alcohol Treatment Programs. Using ANOVA, staffing patterns were compared across programs as a function of clinic size, city size, region of the country, and funding resources. While few differences were found based on city or clinic size, staffing patterns varied as a function of regional location as well as the sources of a clinic's funding.

Community Mental Health Centers↗
PubMed1990

Personality disorder subtypes among cocaine and opioid addicts using the Millon Clinical Multiaxial Inventory.

Individuals with psychoactive substance dependence suffer from high rates of non-substance use psychiatric disorders. These disorders sometimes prove difficult to distinguish in clinical practice. The Millon Clinical Multiaxial Inventory (MCMI) is a relatively new assessment tool which purports to evaluate DSM-III Axis I and Axis II disorders. In the present study, the MCMI was administered to 73 opioid addicts and 37 cocaine addicts entering treatment. MCMI protocols were then sorted four times to identify: (1) subjects with psychotic disturbances, (2) subjects with affective disturbances, (3) subjects with severe personality disorders, and (4) basic personality disorder subtypes. The covariabilities of all four categories with drug of choice are presented and discussed. The covariabilites of the first three categories with the fourth are also presented and discussed. The MCMI appears to be a useful instrument for psychiatric diagnosis of opioid and cocaine addicts.

Adult↗
PubMed1990

A nationwide survey of urinalysis practices of methadone maintenance clinics. Utilization of laboratory services.

The urinalysis practices of 324 methadone maintenance clinics were surveyed by using a brief self-report questionnaire. Results indicated that there was a wide variability in collection practices and utilization of laboratory techniques. The most frequent collection schedules were monthly (40%) and weekly (32%). The most frequent laboratory techniques used for initial screening were thin-layer chromatography and enzyme immunoassay. Confirmatory testing by a second technique was used by 69% of the laboratories. The most popular confirmatory techniques used were thin-layer chromatography, enzyme immunoassay, and gas chromatography-mass spectrometry. The geographic differences in urinalysis practices also were noted. The implications for drug abuse treatment were determined.

Community Health Centers↗
PubMed1989

Valproic acid, unlike other anticonvulsants, has no effect on methadone metabolism: two cases.

Two patients who were concomitantly undergoing methadone maintenance treatment and receiving phenytoin suffered continuing opioid withdrawal symptoms as a results of phenytoin's acceleration of methadone metabolism. When anticonvulsant therapy was discontinued, these patients had seizures. One patient was switched to carbamazepine as an alternative anticonvulsant, but this treatment resulted in a similar clinical problem. When both patients received valproic acid instead, the withdrawal symptoms disappeared and their conditions stabilized.

Adult↗
PubMed1988

Clinical evaluation and use of urine screening for drug abuse.

Urine drug screening is indicated to evaluate patients who show mental status or behavioral changes and to monitor the abstinence of drug abusers. The appropriate timing for collecting urine specimens may vary depending on the suspected drug of abuse and on laboratory factors. Laboratories use a variety of techniques to do urine screens, and these must be understood by clinicians ordering the screens to interpret results correctly. In treating drug-abusing patients, clinicians must apply structured reinforcement in conjunction with urine screen results to aid patients in achieving abstinence.

Humans↗