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Biomedical subjects

N McKeganey

Publications and source records attributed to N McKeganey.

At least 19 recordsLinked to original sources
PubMed2001

The attendance pattern of clients at a Scottish needle exchange.

AIMS: To examine the pattern of attendance at a Scottish needle exchange. DESIGN: Semi-structured interviews and retrospective analysis of attendance patterns. SETTING: A needle exchange in a Scottish city which covers the whole of the city. PARTICIPANTS: Clients and staff of the needle exchange. MEASUREMENTS: The attendance pattern of 1556 clients of the needle exchange over a 4-year period 1995-1998. FINDINGS: The average frequency of attendance over the 4-year period was 12.7. In 1998, 23% had only visited the needle exchange once and 11% had only visited twice. CONCLUSIONS: A significant minority of clients only attend the needle exchange once or twice a year. There is a need to include information on client retention in future evaluations of needle and syringe exchange clinics and to specify the kind of relationships needle and syringe exchange clinic staff are expected to develop with clients and what level of client retention they should be aiming towards in a well-run clinic.

Adult↗
PubMed2000

Association between illegal drugs and weapon carrying in young people in Scotland: schools' survey.

OBJECTIVES: To identify the type and extent of weapons being carried among young people in Scotland, and to determine the relation between use of illegal drugs and weapon carrying. DESIGN: Questionnaire school survey. SETTING: Independent schools in central Scotland and schools in Lanarkshire and Perth and Kinross. PARTICIPANTS: 3121 students aged 11 to 16 in 20 schools. MAIN OUTCOME MEASURES: Self completion questionnaire reporting history of drug use and weapon carrying. RESULTS: Overall, 34.1% of males and 8. 6% of females reported having carried a weapon (P<0.0001), ranging from 29.2% of boys aged 11-13 (classes S1 to S2) to 39.3% of boys aged 13-15 (S3 to S4). These values are higher than those in a recent survey of young people in England. Weapon carrying in Lanarkshire was 70% higher for males than in the rural area of Perth and Kinross. Both males and females who had taken drugs were more likely to carry weapons (63.5% of male drug users versus 20.5% of non-users and 22.8% of female drug users versus 3.7% of non-users; both P<0.0001). The proportions of males carrying weapons who used none, one, two, three or four, or five or more illegal drugs were 21%, 52%, 68%, 74%, and 92% respectively. A similar trend was found among females. CONCLUSIONS: Better information is needed on the nature and extent of weapon carrying by young people in the United Kingdom, and better educational campaigns are needed warning of the dangers of carrying weapons.

Adolescent↗
PubMed2000

Addicts' narratives of recovery from drug use: constructing a non-addict identity.

Sociological accounts of the process of recovery from dependent drug use have emphasised the importance of the individual constructing a non-addict identity for themselves. Following Giddens we identify the process of providing a narrative of their recovery as one of the mechanisms by which addicts may seek to achieve this. The narratives of recovery which are the subject of this paper were elicited in the course of semi-structured interviews with a sample of 70 recovering addicts. There were three key areas in which the addicts' narratives of recovery could be seen to be constructing a non-addict identity for the individual; firstly, in relation to the reinterpretation of aspects of their drug using lifestyle; secondly, in relation to the reconstruction of their sense of self and thirdly, in relation to the provision of convincing explanations for their recovery. In certain respects, the addicts' narratives of recovery are similar to the accounts of recovery provided by drug workers and addictions researchers. The paper argues that the correspondence between addicts' own accounts of their recovery and those of professional drug workers may be not so much the result of the intrinsic nature of the recovery process as a product of the socially constructed nature of the narratives and the fact that the latter may have been developed in conjunction with those working in the drug treatment industry.

Adult↗
PubMed1996

Contrasting methods of collecting data on injectors' risk behaviour.

In this paper two contrasting methods of collecting data on drug injectors' needle and syringe sharing practices are considered, namely: direct questions about any previous sharing in the last 6 months, and vignettes in which injectors are asked to indicate whether they would be prepared to share injecting equipment in a range of situations. Injectors' statements of their preparedness to share are far in excess of their reports of actual sharing. The possible reasons for this discrepancy are considered, including that injectors may have under-reported the level of their actual sharing. It is suggested that in future studies aiming to collect risk behaviour data should seek to combine methods rather than to rely solely upon direct questioning of any past sharing.

Adolescent↗
PubMed1996

Estimating the prevalence of drug misuse in Dundee, Scotland: an application of capture-recapture methods.

STUDY OBJECTIVES: To apply capture-recapture methods to provide an estimate of the prevalence of opiate and benzodiazepine misuse in Dundee, Scotland. DESIGN: A four sample capture-recapture method using data from both statutory and non-statutory data sources to estimate drug misuse prevalence in Dundee between January 1990 and December 1994. PARTICIPANTS: Users of benzodiazepines or opiates residing within Dundee. RESULTS: Altogether 855 drug misusers were identified from various sources within Dundee; many were identified from more than one source. Using this data, the estimated unknown population was 1702, giving a total population of 2557 (95% confidence interval (CI) 1974, 3458) who misuse benzodiazepines or opiates. This represents a prevalence of 28.8 (95% CI 22.3, 39.0) per thousand. CONCLUSIONS: Capture-recapture techniques can be applied to statutory and non-statutory agency data to produce an estimate of at least certain sections of the drug misusing population. However, it is important to recognise the limitations of this methodology and in future to seek to combine a range of approaches to the problem of estimating prevalence rather than sticking rigidly to any single approach.

Adolescent↗
PubMed1995

The preparedness to share injecting equipment: an analysis using vignettes.

This paper reports on the use of vignettes to study drug injectors' preparedness to share injecting equipment. Separate vignettes referring to borrowing and passing on injecting equipment have been submitted to 505 injecting drug users in Glasgow. Injectors were asked to identify their own likely response in each of the situations described within the vignettes. It was shown that even among those injectors not reporting any actual sharing in the last 6 months a significant proportion would still be prepared to share injecting equipment within certain situations. The preparedness to share injecting equipment was seen to be influenced by such factors as social distance, sex and length of time injecting. It is suggested that even in situations where drug injectors may have modified their behaviour in the direction of lower levels of reported sharing, a propensity to share may remain. This suggests the continuing need to provide injectors with easy access to sterile injecting equipment; in addition, services working with injecting drug users may need to focus not only upon actual sharing behaviour but also upon what we have described here as the preparedness to share. Indeed, the latter dimension should stand as a warning to services of the potential for sharing injecting equipment to increase in the future.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Mobility of Scottish injecting drug users and risk of HIV infection.

Nine hundred and nineteen injecting drug users (IDUs) were interviewed in Glasgow, Scotland during 1990 and 1991, as part of a wider study of HIV risk behaviour, about their injecting and sexual behaviour outside the city in the previous two years. Forty-five percent of respondents injected outside Glasgow, 6% shared needles and syringes (n/s) and 20% had sexual intercourse. Much activity occurred outside Scotland but mainly within the UK, particularly London. Predictors of n/s sharing outside Glasgow during the previous two years included current injecting with and passing on of used n/s and sexual intercourse with casual partners. Predictors of sexual behaviour outside Glasgow included passing on used n/s, having sexual intercourse with casual partners and, for females, engaging in prostitution. Glasgow IDUs are a highly mobile group and although HIV prevalence remains low within this population, considerable potential for importation/exportation of HIV and other bloodborne and sexually transmitted infections exists. Further work is required to establish why IDUs travel to, and engage in high-risk activities in locations outside their home environment, and detailed data about activities such as frequency of condom usage and n/s cleaning practices need to obtained. While there is a widespread network of services for IDUs in the UK, information provided usually relates to local services and may not fully address the needs of this mobile population. Therefore, we recommend that IDUs be provided with details of facilities such as n/s exchange schemes and drug-treatment establishments in centres to where they most commonly travel.

Blood-Borne Pathogens↗
PubMed1994

Why do men buy sex and what are their assessments of the HIV-related risks when they do?

The belief that female prostitution might play a key role in the heterosexual spread of HIV infection has led to a great deal of attention being focused on the activities of women who sell sex. By contrast, the activities of men who buy sex has been largely ignored. One of the reasons for this has undoubtedly been the difficulties of contacting such men. In this paper data from telephone interviews with 70 men who had recently purchased sex are presented. It is shown that there was a wide range of factors that the men cited in explaining the appeal of commercial sex. The paper also reports on the males' views as to the risks of HIV associated with commercial sex. Although the men believed HIV to be very widespread amongst women selling sex, hardly any of them felt at risk themselves as a result of their commercial sexual encounters. The basis for the men's optimism about avoiding HIV and their preparedness to inform other sexual partners about their prostitute contacts are also described.

Adult↗
PubMed1993

Estimating the population prevalence of injection drug use and infection with human immunodeficiency virus among injection drug users in Glasgow, Scotland.

Although data on the prevalence of injection drug use are an essential prerequisite for estimating the number of individuals infected with the human immunodeficiency virus (HIV), there have been few attempts to utilize statistical methods of population estimation based on multiple data sources. Data on 3,670 cases (2,866 individuals) were obtained from the HIV test register, drug treatment agencies, police records, and needle and syringe exchanges in Glasgow, Scotland, in 1990. Log-linear analysis was used to model the number of individuals in each of the sources. The model incorporating dependency among the three health care agencies (HIV test, drug treatment, and needle exchange) and independence of the police sample fitted the data well, with a residual chi 2 value of 2.9 (6 df). The expected value of the missing cell corresponding to absence from all four samples was 5,628, yielding an overall estimate of 8,494 injectors (95% confidence interval (CI) 7,491-9,721), for a prevalence rate of 1.35% for people aged 15-55 years in Glasgow during 1990. The high ratio of known to unknown injectors (1:2) resulted from the extensive coverage of known injectors and the relatively high level of overlap between the combined health care agency sample and the police sample. While further analysis demonstrated that the probability of appearing in the four samples varied by age and sex, heterogeneity in the population did not affect the choice of model or substantially alter the estimates for the total number of unknown injectors. A concurrent study of a community-wide sample of 503 injectors resulted in an HIV prevalence rate of 1.1% (95% CI 0.4-2.5%). The results of these studies were combined to produce a further estimate of 93 HIV-infected current injectors in Glasgow (95% CI 33-214).

Adolescent↗
PubMed1993

HIV testing among injecting drug users in Glasgow.

The use of saliva rather than blood for epidemiological studies of HIV prevalence, especially among injecting drug users, has several practical advantages. In a cross-sectional, behavioural and prevalence study among drug users in Glasgow during 1990, salivary samples were therefore obtained by the use of salivettes. Such samples were requested for anonymous anti-HIV testing from 498 persons in locations varying from residential rehabilitation centres to the open streets. Of this number, 35 refused to give a sample, resulting in a compliance rate of 93%. Of the 463 salivettes received by the laboratory, eight were found to be dry. Of the remaining 455 specimens, eight were found to be positive for HIV-1 antibody by means of an IgG antibody capture ELISA, so giving a prevalence rate of 1.8%. The results of testing saliva and blood spot samples collected at the same time on filter paper from 98 persons for HIV-1 antibody were 100% concordant. The study confirms the experience of others that specimens of saliva are easy to collect under variable conditions by non-medical staff and demonstrates that the salivette can provide an HIV antibody test result the same as that obtained from a blood spot. The prevalence of HIV antibody determined in this study is similar to that of other studies taking place in the city during the same period of time.

Cross-Sectional Studies↗
PubMed1993

Prison experience of injecting drug users in Glasgow.

Five hundred three injecting drug users in Glasgow recruited by a multisite and citywide sampling strategy were questioned regarding their drug-taking behaviour during episodes of custody over the six months prior to interview. Fifty-two percent had been in custody during the past 6 months, 16% of these had injected while in custody. Of these 73% borrowed injecting equipment and 78% handed on used equipment to others. All those who shared, cleaned their injecting sets before use. Over half of those who injected had a source of new sets. While the potential exists for spread of HIV among drug users while in custody there is clear understanding among them of the route by which the virus is spread and also the will to prevent it.

Cross-Sectional Studies↗