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Biomedical subjects

B F Lewis

Publications and source records attributed to B F Lewis.

17 recordsLinked to original sources
PubMed1995

Outcomes of a 21-day drug detoxification program: retention, transfer to further treatment, and HIV risk reduction.

We investigated the outcomes of a 21-day inpatient drug detoxification and rehabilitation program including length of stay, transfer to further treatment, and HIV risky behavior. Clients (n = 567) were predominantly White, male, currently unemployed, and their treatment was not covered by third party payment. 78% were detoxified with methadone. The median length of stay was 18 days. Higher education, not living with spouse or children, English as primary language, admission during fall or winter months, and greater knowledge of HIV transmission were independent predictors of greater length of stay. Among those with follow-up (n = 450), 19% were transferred to residential drug-free programs and 7% to outpatient programs. Taking into account loss to follow-up, the overall rate of treatment transfer could be as low as 21%. Greater length of stay was associated with higher rates of transfer to residential treatment. Relapse rates to either any drug use or injection drug use were lower among subjects transferred to residential treatment than either clients transferred to outpatient programs or those with no further treatment. Among subjects who continued to inject drugs at follow-up, no reduction in HIV risky behaviors was found regardless of further treatment. We conclude that detoxification programs have the potential for reducing relapse to drug use when followed by residential drug-free treatment.

Adolescent↗
PubMed1994

HIV-1 antibody testing among drug users participating in AIDS education.

This study aimed to identify factors which predict participation of drug users in HIV-1 antibody testing. The study was part of a randomized controlled trial of three small group AIDS educational programs, in a 21-day in-patient drug detoxification and rehabilitation program. Subjects (n = 497) were clients admitted to the program who consented to participate in the evaluation and who completed baseline data collection. All subjects received pre-test counseling. Testing was offered after 1 week in treatment; 52% decided to be tested. Factors which predicted participation in testing included: no previously reported positive result, a longer stay in treatment, a greater frequency of injection, a greater perceived probability of being infected, and the type of AIDS education. Both actual and perceived level of risk, and the type of AIDS education provided can affect participation in testing programs.

AIDS Serodiagnosis↗
PubMed1993

Behavioral outcomes of AIDS educational interventions for drug users in short-term treatment.

This paper reports the behavioral outcomes of informational vs enhanced small-group educational interventions for drug users among 407 subjects in a short-term drug treatment program. Logistic regression was used to analyze drug use and sexual behaviors at the final follow-up visit. Among lower risk subjects, the enhanced intervention was more effective in reducing injection practices that produced risks in terms of human immunodeficiency virus infection; among those at highest risk, the informational interventions were more effective. The enhanced intervention was more effective than the informational interventions in reducing cocaine use at follow-up. No differential intervention effect on sexual risk behaviors was found.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS education for drug abusers: evaluation of short-term effectiveness.

BACKGROUND: Interventions are needed to assist drug abusers in reducing risky drug and sexual behavior. METHODS: A randomized controlled trial compared three small-group AIDS educational interventions among 567 clients of a 21-day inpatient drug detoxification program: a two-session informational intervention, given either during the first (early) or second (late) week of treatment; and a six-session enhanced intervention. Changes in knowledge, attitudes, and psychomotor skills were assessed before and after each intervention, and behavioral outcomes were assessed at follow-up 10 to 18 weeks after admission. RESULTS: Immediately after the interventions, enhanced group members reported significantly greater self-efficacy to talk themselves out of AIDS-risky behavior; other knowledge and attitude scales did not differ by intervention. At follow-up, significant reductions in risky drug use were reported by all groups. Enhanced group members reported significantly greater reduction in injection frequency than did late informational subjects. CONCLUSIONS: No beneficial effect was detected of delaying AIDS education for clients entering detoxification. At this early stage of follow-up, there is only weak evidence that an enhanced intervention improved outcomes.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Time trends in high-risk injection practices in a multi-site study in Massachusetts: effects of enrollment site and residence.

Time trends in needle sharing and bleach use were examined among needle users enrolled at drug abuse treatment and nontreatment sites in greater Worcester, MA, from 1987 through 1989. Substantial declines in high-risk behavior were found, with different trends at drug treatment versus nontreatment sites. The percentage of individuals sharing needles declined at treatment facilities but not at nontreatment sites. Among those sharing, the proportion using bleach increased at both drug treatment and nontreatment sites. The bleach distribution program in Worcester appears to be associated with increased bleach use among residents. Bleach use was associated with residence in Worcester, after controlling for age, gender, race, enrollment site, time period, and frequency of sharing. Risk reduction in the subpopulation of needle users entering treatment was greater than that among those not in treatment. As avoidance of sharing is likely to be more effective than bleaching for the prevention of human immunodeficiency virus (HIV) transmission, the subpopulation not in treatment should be targeted for prevention programs.

Adolescent↗
PubMed1991

Drug treatment staff attitudes toward AIDS and workplace transmission of HIV: a survey and follow-up--Spectrum House, Inc.

A growing number of cases of HIV infection and AIDS in the U.S. have been reported among intravenous drug users and their sexual partners. This increase in cases has begun to have a significant impact on substance abuse treatment programs; in addition to the complexities of HIV education and counseling, the staff of such programs must deal with their own fears regarding HIV infection, since many experientially trained staff are, themselves, former IV drug users. Other staff members may experience irrational anxiety about working HIV-infected clients, due to the fear of workplace exposure to the virus. In order to assess the extent and nature of such anxieties among its staff, Spectrum House, Inc., a comprehensive substance abuse treatment program, administered a Staff AIDS Survey in 1986 and again in 1987. Responses reflected a marked decrease in staff anxieties relating to workplace transmission of HIV during the 14-month period between surveys, seemingly related to both the implementation of AIDS education and an increase in contact with HIV positive clients. Those staff members whose contact with HIV positive clients remained infrequent between surveys, however, continued to show higher levels of fear about casual contact and workplace exposure to HIV. These results indicate that increased staff-client interaction may be an effective addition to other forms of staff AIDS education in substance abuse treatment programs.

Acquired Immunodeficiency Syndrome↗
PubMed1991

First single lung transplant in Virginia.

Lung transplantation is now established as a clinical reality for patients with irreversible, lethal pulmonary conditions. We report the first successful application of this treatment modality in Virginia.

Humans↗
PubMed1990

Racial/ethnic differences in HIV-1 seroprevalence and risky behaviors among intravenous drug users in a multisite study.

Differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence and patterns of drug-use and sexual behaviors were examined among Hispanic, black, and white intravenous drug users recruited at multiple sites in Worcester, Massachusetts. A total of 1,092 (786 males, 306 females) intravenous drug users were interviewed, and HIV-1 antibody test results were available for 874 (80.0%). After adjustment for demographic differences, black males were significantly less likely to report risky drug-use behaviors (ever sharing needles and recently visiting shooting galleries) compared with white males. In contrast, Hispanic males were significantly more likely to report recent risky drug-use behaviors (sharing needles in New York City, daily needle-sharing, and visiting shooting galleries). Both groups were less likely to report risky sexual behaviors compared with whites. The odds ratios for HIV-1 seropositivity remained significantly greater than 1 for Hispanics compared with whites (odds ratio = 4.5) and maintained marginal significance for blacks compared with whites (odds ratio = 2.1) when adjusted for risky behaviors and demographic variables. The different patterns of drug-use and sexual behaviors by race/ethnicity indicate the need for interventions targeted to specific populations.

AIDS Serodiagnosis↗
PubMed1990

Demographic characteristics, risk behaviors, and HIV seroprevalence among intravenous drug users by site of contact: results from a community-wide HIV surveillance project.

We investigated differences in behaviors important for human immunodeficiency virus (HIV) transmission and HIV antibody status among 927 recent needle users enrolled in a multi-site HIV surveillance project in Worcester, Massachusetts. Subjects were enrolled at drug abuse treatment centers reported less risky injection practices unexplained by demographic variables. Risky sexual practices were in general reported more frequently by men at the jail than men at other sites. However, HIV status showed little relation to enrollment site. These results have implications both for targeting of acquired immunodeficiency syndrome (AIDS) prevention programs to needle users not in drug abuse treatment and for potential selection bias in studies of intravenous drug users.

Adult↗
PubMed1975

Psychotropic drugs on general medical and surgical wards of a teaching hospital.

We examined the prescribing habits for psychotropic drugs of internists, surgeons, and gynecologists on their inpatient wards in a teaching hospital. Data were gathered from patients' charts and pharmacy records. In a six-week period, 9% of all admissions received such a drug. The male:female ratio and black:white ratios were studied; the maximum incidence of receiving these medications was in the 50- to 60-year age group. Minor tranquilizers were prescribed most frequently, followed, respectively, by major tranquilizers, barbiturates, and antidepressants. Less than half the available drugs were used, but drugs of differernt groups were often used interchangeably in an unsystematic fashion, and there was little evidence as to how effective a drug had been. It also seemed that depression was often overlooked or insufficiently treated.

Adult↗
PubMed1975

Inpatient and outpatient patterns of psychotropic drug prescribing by nonpsychiatrist physicians.

The authors found that among 228 general hospital patients, minor tranquilizers were prescribed most often and with the least justification and that major tranquilizers were prescribed sparingly and by and large judiciously. Antidepressants were given less often than would be justified by the incidence of depressive illness among these patients. Nonrecognition of depression in patients with somatic complaints and autonomic signs of depression contributed to this lack of treatment.

Anti-Anxiety Agents↗
PubMedDate not supplied

Admissions of injection drug users to drug abuse treatment following HIV counseling and testing.

The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public health importance is attaining admission to drug abuse treatment by those IDUs who are either infected or who are at high risk of becoming infected. The authors investigated factors related to admission to drug abuse treatment among 519 IDUs who received HIV counseling and testing from September 1987 through December 1990 at a men's prison and at community-based testing sites in Worcester, MA. By June 1991, 123 of the 519 IDUs (24 percent) had been admitted to treatment. Variables associated with their admission included a long history of drug injection, frequent recent drug injection, cleaning injection equipment using bleach, prior drug treatment, and a positive HIV test result. Logistic regression analyses, controlling for effects of recruitment site, year, sex, and area of residence, generally confirmed the associations. IDUs in the study population who were HIV-infected sought treatment or were admitted to treatment more frequently than those who were not infected. The results indicate that access to drug abuse treatment should be facilitated for high-risk IDUs and for those who have begun to inject drugs recently.

Adolescent↗