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PubMed1997

Risk contexts and risk behaviors in the Euregion Maas-Rhein: the Boule de Neige intervention for AIDS prevention among drug users.

Using targeted sampling, self-reported data of 1,767 drug users in the Euregion Maas-Rhein were collected over 3 years. Forty-two percent of the injection drug users shared syringes with sexual partners and 47.8% with friends. Eighty-one percent of the total sample had sexual contact in the last 6 months, half of whom with one person and half with two or more. Significant predictors of high-risk drug use were injecting in the presence of others, injection onset before the age of 20, female gender, and not living in The Netherlands. Participation in needle exchange or methadone programs and sufficient knowledge of risk factors was not significantly related to a reduction of high-risk drug use behavior. High-risk sexual behavior was found to be related to male gender, under the age of 30 and to multiple sexual partners. We conclude that in a social context where needle exchange, methadone programs, and sufficient knowledge of risk factors among the drug user population exist, AIDS prevention can be improved through behavioral skills training and developing specific interventions that target the peer group environments, rituals, partner relationships, and lifestyles of drug users.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Update: syringe-exchange programs--United States, 1996.

As of December 1996, approximately one third (36%) of the 573,000 cases of acquired immunodeficiency syndrome (AIDS) among adults reported to CDC were directly or indirectly associated with injecting-drug use. Syringe-exchange programs (SEPs) are one of the strategies for preventing infection with human immunodeficiency virus (HIV) among injecting-drug users (IDUs). The goal of SEPs is to reduce the transmission of HIV and other bloodborne infections associated with drug injection by providing sterile syringes in exchange for used, potentially contaminated syringes. This report summarizes a survey of U.S. SEPs regarding their activities during 1995 and 1996 and compares the findings with those during 1994 and early 1995. The findings indicate continued expansion in the number and activities of SEPs in the United States.

Adult↗
PubMed1997

Injecting-related harm and treatment-seeking behaviour among injecting drug users.

AIMS: This study aims to identify the physical harm associated with injecting drug use and examine the treatment-seeking behaviour of injecting drug users (IDUs). Specific attention is given to the factors associated with presentation and non-presentation of injecting-related problems. DESIGN: Participants were interviewed by research staff using a semi-structured questionnaire, then physically examined by a medical team. SETTING: Needles exchanges in Glasgow. PARTICIPANTS: One hundred and twelve injecting drug users. FINDINGS: Respondents' accounts of their current injecting-related problems were found to be consistent with the clinician's findings, suggesting that IDUs are able to self-diagnose injecting-related harm. However, almost three-quarters had not sought help for these problems. Qualitative data suggest the main reasons for non-presentation, or delayed presentation, of injecting-related problems are normalization of injecting-related harm and a reluctance to attend available services. Almost half of those seeking treatment for injecting-related problems did so during an emergency or crisis. CONCLUSIONS: Low threshold services, such as needle exchanges, may have to take a more proactive stance to encourage injectors to present with injecting-related problems. This may help reduce injecting-related harms, especially the resulting medical complications, which would in turn relieve the pressure on other services such as hospital Accident and Emergency Departments.

Abscess↗
PubMed1998

Hepatitis C virus antibody prevalence among injecting drug users in Glasgow has fallen but remains high.

Few data have been published on the prevalence of hepatitis C virus (HCV) among injecting drug users (IDUs) in the United Kingdom. This study compares the prevalence of antibody against HCV (anti-HCV) among IDUs in Glasgow in 1990 (when Glasgow's needle/syringe exchange programme had become established) with that in 1995. Serum left over from specimens taken for named HIV antibody testing was tested anonymously for anti-HCV. The prevalence of anti-HCV fell significantly between 1990 and 1995 among IDUs of all ages (90% to 77%), IDUs aged 15 to 19 years (92% to 29%), and IDUs aged 20 to 24 years (91% to 65%). This study suggests that the incidence of HCV infection among young IDUs fell in the early to mid 1990s, after the establishment of Glasgow's needle/syringe exchange scheme between 1988 and 1990. Since almost a third of injectors under 20 years of age when tested in 1995 had been infected with HCV, however, other interventions may be needed to prevent the spread of HCV in this high risk group.

Adolescent↗