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At least 19 recordsLinked to original sources
PubMed1986

AIDS health education for intravenous drug users.

Intravenous (IV) drug users are the second largest risk group for AIDS and the main source of infection for heterosexual partner and pediatric AIDS cases. IV drug users have an addiction and a subculture that make risk reduction difficult; for example, to refuse to share needles can endanger personal relationships, and carrying clean works (rather than renting them in a shooting gallery) risks arrest. In New York City, at least, knowledge about AIDS transmission is widespread among IV drug users, and most drug injectors report having changed their drug use practices to reduce their risks. The main functions of health education in areas where IV drug users have this level of knowledge are to disseminate news of new discoveries; reach those drug users who have not yet learned AIDS basics; reinforce what is already known; and provide information about new programs to help drug users deal with AIDS-related problems. To encourage behavior change requires going beyond simple education, however; it entails trying to change IV drug user subculture. Drug user groups in the Netherlands and in New York City are attempting to do this from within the subculture. Outside intervention requires repeated messages from multiple sources; face-to-face, interactive communication; and perhaps the use of ex-addicts as health educators.

Acquired Immunodeficiency Syndrome↗
PubMed1994

IV drug users: changes in risk behaviour according to HIV status in a national survey in Spain.

STUDY OBJECTIVE: To determine whether HIV positive intravenous drug users (IVDUs) who were receiving outpatient treatment for opiate and cocaine abuse or dependence used practices aimed at reducing the spread of HIV. DESIGN: Cross sectional study of behaviour and HIV serostatus in IVDUs. SETTING: A nationwide sample, from 83 health centres for outpatient treatment, stratified by autonomous regions. PARTICIPANTS: Altogether 1074 IVDUs were recruited. HIV serostatus could be verified in 738 (68.7%) of these. MEASUREMENTS AND MAIN RESULTS: Crude and adjusted odds ratios and their 95% confidence intervals were estimated to assess the association between HIV serostatus and behavioural changes. In their daily interactions with other members of the same household, seropositive subjects more frequently used preventive methods aimed at avoiding transmission than seronegative patients. Treatment for abuse or dependency before the current regimen had a greater impact in HIV positive than HIV negative subjects in terms of abstaining from risk behaviours. There was a significant trend toward lower drug consumption in HIV positive subjects, and the number of seropositive and seronegative IVDUs who stopped injecting their drugs was significantly higher among the former. Seropositive subjects were also more likely to stop sharing drug injecting equipment and to change their sexual habits; they reported an increased consistent use of condoms. CONCLUSIONS: HIV positive IVDUs were more likely to change their risk behaviours than their HIV negative counterparts.

Adolescent↗
PubMed1990

AIDS risk behavior patterns among intravenous drug users in Puerto Rico and the United States.

We interviewed 385 IV drug users recruited in the streets of the San Juan metropolitan area and compared our findings with comparable results from projects in the United States. As expected, intravenous (IV) drug users, irrespectively of the race or ethnic group they belong to or the geographical setting in which they live, are still practicing HIV risk behaviors. Overall, IV drug users in this analysis are young, however, both Puerto Rican and Hispanic groups have completed less years of school than Blacks and Whites in the United States. The fact that almost half of Puerto Rican IV drug users in the United States reported illegal activities as a source of income surprised investigators. However, as hypothesized by investigators, almost half of the Island's IV drug users reported to live with parents. Puerto Rican IV drug users are still practicing HIV risk behaviors, they inject drugs and use shooting galleries to inject drugs more frequently, and are less likely to clean needles and use condoms than Puerto Ricans in the U.S., Blacks and Whites. It is a well known fact that intravenous drug users are the largest group at risk for the acquired immunodeficiency syndrome (AIDS) in Puerto Rico and among Puerto Ricans in the United States. IV drug users are also the major risk for heterosexual transmission and main source of perinatal transmission of the disease. Thus, resources for preventing AIDS in Puerto Rico are needed most among IV drug users, where 44.5 of the subjects in this study are HIV positive.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Human immunodeficiency virus infection in diabetic intravenous drug users.

OBJECTIVE: --To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. DESIGN: --Cross-sectional survey in a cohort of IV drug users. SETTING: --Community-based study clinic. SUBJECTS: --The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. OUTCOME MEASURES: --The HIV seroprevalence among IV drug users with and without a history of diabetes. RESULTS: --Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P = .03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. CONCLUSION: --Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.

Adult↗
PubMed1991

Trends in sociodemographic and behavioral characteristics of HIV antibody-positive blood donors.

This paper describes the sociodemographic characteristics of people who donated blood to the New York Blood Center between April 1985 and February 1988 and tested positive for antibodies to HIV. Information on HIV-related risk factors and knowledge of blood screening is presented for seropositive donors who participated in an evaluation study. The most commonly reported risk factor among men was sexual contact with another man, and many of the male seropositive donors reported sex with an intravenous (IV) drug user or use of IV drugs. The proportion of men reporting sexual contact with another man decreased over the period of the study, and the proportion reporting use of IV drugs or sex with an IV drug user increased. Awareness of blood screening for HIV antibodies increased over the study period. The greatest increase was among those donating for transfusion, but only about a quarter of seropositive donors used the confidential unit exclusion (CUE) process.

Adolescent↗
PubMedDate not supplied

HIV infection and intravenous drug use: critical issues in transmission dynamics, infection outcomes, and prevention.

As the second largest group of persons to have been infected with human immunodeficiency virus (HIV), and the most likely to transmit HIV to heterosexual partners in the United States and Europe, iv drug users will play an increasingly important role in the future of the AIDS epidemic. This paper reviews five emerging critical issues regarding HIV infection among iv drug users. In epidemiology, rates of drug injection and anonymous sharing of injection equipment appear related to rapid spread of HIV among iv drug users, while heterosexual transmission from iv drug users appears to have been occurring at a relatively slow but constant rate. Data exist that support a gender-related cofactor and a continuing drug injection cofactor, but mechanisms for these potential cofactors have not been determined. Besides frank AIDS, HIV infection also appears to lead to epidemic-level increases in a variety of fatal infections among iv drug users. Several studies of prevention show active risk reduction among iv drug users, but new methods are urgently needed to increase amount of risk reduction.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Development of AIDS, HIV seroconversion, and potential co-factors for T4 cell loss in a cohort of intravenous drug users.

A cohort of 334 intravenous (IV) drug users from New York City drug treatment programs were followed over a mean 9-month period. Among the 165 who were seropositive at enlistment, four developed clinical AIDS, for an annual rate of 3%. Elevated IgA was a significant predictor of developing AIDS. Among 72 subjects who were initially seronegative and who were re-interviewed, four were seropositive at follow-up, for a seroconversion rate of 7% per year among seronegatives. Among seropositive subjects who did not develop AIDS or fatal AIDS related complex (ARC), continued drug injection was associated with rate of T4 cell loss, and there was a non-significant trend for males to lose T4 cells more rapidly than females. While it was not possible to distinguish the mechanism underlying the relationship between continued drug injection and T4 cell loss, seropositive IV drug users should be warned that continued injection may lead to increased HIV-related immunosuppression as well as, if injection equipment is shared, risking viral transmission to others.

Acquired Immunodeficiency Syndrome↗
PubMed1987

HIV infection among intravenous drug users: epidemiology and risk reduction.

Research on the epidemiology of HIV infection among IV drug users is still at a relatively early stage. Multilocation studies that would permit better geographic comparisons are greatly needed. Multi-method studies within single geographic areas are also needed to assess possible biases with respect to sample recruitment and data collection procedures. The continuation of the epidemic provides a changing historical context that complicates any comparisons. Despite these problems, there are some consistencies that can be seen across studies. Studies of HIV seroprevalence among IV drug users show wide variation among cities in the United States and Europe. The time that the virus was introduced into the IV drug using group within the city is one factor in explaining these differences; other cross-city factors have yet to be identified. Once HIV has been introduced into the IV drug use group within a particular geographic area, there is the possibility of rapid spread up to seroprevalence levels of 50% or greater. Thus, a currently low seroprevalence rate should not be seen as a stable situation. Frequency of injection and sharing of equipment with multiple other drug users (particularly at shooting galleries) have been frequently associated with HIV exposure. Being female, ethnicity (in the USA) and engaging in prostitution also may be associated with increased risk for HIV exposure, suggesting that prevention programs should include special consideration of sex and ethnic differences. Studies of AIDS risk reduction show that substantial proportions of IV drug users are changing their behavior to avoid exposure to HIV. This risk reduction is probably more advanced in New York, with its high seroprevalence and incidence of cases, but is also occurring in cities with lower seroprevalence and limited numbers of cases. The primary forms of risk reduction are increasing the use of sterile equipment, reducing the number of needle sharing partners, and reducing the frequency of injection. These behavior changes are very similar to the frequently identified behavioral risk factors associated with HIV exposure, suggesting that they should be effective in at least slowing the spread of HIV among IV drug users. No linkage of risk reduction to decreases in seroconversion has yet been shown, however, and greater risk reduction is clearly required. A variety of prevention strategies will probably be needed to reduce the spread of HIV among IV drug users. Prevention of initiation into drug injection is an undeniable long-term goal for the control of HIV infection, but there is very little research being conducted in this area.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Human immunodeficiency virus seropositivity in intravenous drug users in Ohio.

A seroprevalence survey of 508 intravenous (IV) drug users enrolled in methadone treatment programs in Ohio for evidence of infection with the human immunodeficiency virus (HIV) demonstrated a positivity prevalence of 1.4%. This seropositivity prevalence is low compared with 10% to 72% positive from surveys conducted in the IV drug-using populations of New York, New Jersey, Detroit and San Francisco. Although needle sharing was common (71% since 1983), the number of sharing partners was usually limited and regular. A potential for cross-infection from urban centers with higher seropositivity prevalence was indicated by patterns of travel and needle sharing while traveling to higher risk metropolitan centers such as New York. Hispanics appeared to be at greater risk for HIV infection (OR 17.7, 95% CI 2.4-133.0), as were male IV drug users with gay/bisexual lifestyles (OR 14.1, 95% CI 1.3-153.0). HIV positive individuals were identified in Cleveland (1.6%), Dayton (3.1%), and Columbus (0.8%), but not in the four other Ohio metropolitan areas participating in the survey. Study participants indicated that knowledge of AIDS had changed their IV drug-using habits with 60% reporting that fear of AIDS had caused them to give up IV drugs or needle sharing. Sampling from methadone clinics may underestimate the HIV seropositivity in Ohio's IV drug-using community; however, it appears that relatively few IV drug users in Ohio are currently infected with HIV. The low prevalence of HIV infection in the Ohio IV drug-using community provides the opportunity to intervene in limiting the spread of the virus by educating individuals to reduce or eliminate risk factors for the transmission of the disease.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Effects of group membership on perception of risk for AIDS.

The role of social identity as a moderator for perception of risk for AIDS has not been examined. The purpose of this study was to examine perception of risk for AIDS as a function of membership in an identified risk group. 34 subjects who were homosexual, 58 intravenous drug users (IV), and 34 college students rated a 21-item list of behaviors for perception of AIDS risk. The findings indicate that the IV drug-use group significantly underestimated five risk behaviors, four of which are high probability behaviors of IV drug-users and two of which are exclusively IV drug-use behaviors. The homosexual group significantly underestimated four risk behaviors, all of which are primarily characteristic of that group. The college group was generally more accurate in assessing risk than either of the other two groups. These findings support the hypothesis that membership in a perceived risk group is related to differential perceptual bias associated with the need for positive social identity for one's group.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS in the black community: public health implications.

As of the end of September 1988, 16,600 cases of acquired immunodeficiency syndrome (AIDS) have been reported in New York City, including 5,248 cases among blacks, 32 percent of the total. Of these, 4,220 (80 percent of adults) are men, 1,028 (19 percent of adults) are women, and 195 are children.The major source of the spread of human immunodeficiency virus (HIV) infection within the black community is the intravenous (IV) drug user. Half of New York City's 200,000 IV drug users are estimated to be black; almost half of the women infected with AIDS through sexual contact with IV drug users are black. Every option for breaking the AIDS-IV drug abuser connection must be explored.AIDS among blacks is especially charged with the potential for discrimination or widespread backlash. AIDS education efforts must be increased, and legislation to protect against unauthorized disclosures of confidential health records must be supported. Comprehensive education programs must destigmatize AIDS among health care workers.To keep up with the epidemic, a national prevention strategy must consist of a massive national public health education program; voluntary, confidential counseling and HIV antibody testing expanded into every public and private clinical facility; and major efforts to curtail AIDS transmission by the IV drug user.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Exposure of intravenous drug users to AIDS retrovirus, Sydney, 1985.

A survey of a cohort of 200 intravenous (IV) drug users drawn from five drug referral agencies was conducted in Sydney in 1985 and revealed only one heterosexual male with antibodies to AIDS retrovirus (ARV). Contact tracing of sexual and needle-sharing partners resulted in the referral of a further four out of six at-risk individuals seropositive for ARV. This study indicates that ARV has now reached the IV drug-using population and could be spread further among IV drug users by sexual contact and by needle-sharing. We conclude that exposure to ARV among IV drug users is in its earliest stages in Australia. There is an urgent need to introduce measures such as contact tracing and screening of IV drug users to prevent further spread of ARV in this risk group.

Adult↗
PubMed2002

[Causes of death in HIV-infected French drug users, 1995-2000].

Since the decline in mortality among HIV-infected persons after introduction of highly active antiretroviral therapy, concerns related to co-morbidities have increased as they may impair vital prognosis, particularly in intravenous (IV) drug users. We describe firstly the changes in the distribution of the causes of death between 1995 and 2000 among IV drug users in the "Aquitaine Cohort" based on hospital information system, and secondly the distribution of the causes of death among IV drug users in the French national survey "Mortalité 2000" specifically set up in 2000 for optimal exhaustiveness. The total number of deaths declined between 1995 and 2000 and 1/3 were IV drug users. Deceased IV drug users were younger than other deceased patients, had longer median time from diagnosis of HIV infection and higher median CD4 cell count. Poor socio-economic conditions were notified in 55%. Among IV drug users, the proportion of AIDS-related deaths was above 75% in 1995 and below 30% in 2000. In 2000, 25% of deaths were HCV-related, 12% of deaths were due to accident, overdose or suicide, and 8% were due to non-AIDS non-HCV related cancer. Among IV drug users, improvement in vital prognosis requires to improve management of HCV infection and to take into account socio-economic conditions and other addictive behaviours like alcohol consumption and smoking.

Adult↗
PubMed1985

The incidence rate of acquired immunodeficiency syndrome in selected populations.

Population figures were obtained, and incidence rates of acquired immunodeficiency syndrome (AIDS) for the 12 months from June 1, 1983, to May 31, 1984, were estimated for single (never-married) men aged 15 years or older, intravenous (IV) drug users, Haitians living in the United States, persons with hemophilia A and B, female sexual contacts of male IV drug users, and blood transfusion recipients. Single men in San Francisco and Manhattan, IV drug users in New York City and New Jersey, hemophilia A patients, and recent Haitian entrants had the highest rates of disease (82.0 to 268.9 per 100,000). Male IV drug users and male Haitians were two to four times as likely to experience development of AIDS as were females in each group. Persons with hemophilia A had six times the incidence rate of AIDS as did those with hemophilia B. Persons with severe hemophilia A had three times the rate of those with moderate and seven times the rate of those with mild clotting factor deficiency. Although blood transfusion recipients and female sexual contacts of male IV drug users had much lower average yearly rates than did persons in the four other groups (0.4 to 9.4 per 100,000), they still had a higher incidence rate of AIDS than did persons not belonging to any of these groups (0.1 per 100,000).

Acquired Immunodeficiency Syndrome↗
PubMed1987

Knowledge about AIDS and high-risk behavior among intravenous drug users in New York City.

Two hundred and sixty-one intravenous (IV) drug users, distributed between a methadone maintenance program and a large detention facility in New York City, were interviewed about knowledge of AIDS, needle use practices, and risk-reduction efforts. Ninety-seven per cent of subjects recognized needle-sharing as an AIDS risk factor; subjects showed less awareness about the effectiveness of certain risk-reduction techniques and tended to over-estimate the risk of casual contact. Of those still sharing needles at the time of first becoming aware of AIDS, 63% reported having subsequently either stopped needle-sharing or ceased IV drug use entirely. Logistic regression analysis indicated that continued needle-sharing behavior was associated with the detention facility site and lower scores on an AIDS knowledge questionnaire; reduced needle-sharing was more evident among methadone program patients and among subjects with greater knowledge about AIDS. The most common reasons for continued needle-sharing among those who continued to share needles despite knowledge of risk were: 'need to inject drugs, with no clean needle available' and 'only share with close friend or relative', offered by 46 and 45% of subjects, respectively. Results suggest that certain subgroups of IV drug users have adopted risk-reduction measures in response to AIDS. Expanded educational programs, increased drug treatment capacity, and additional strategies addressing drug users' access to sterile injection equipment and the social context of needle-sharing may be necessary to curb the further spread of AIDS among IV drug users.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A larger spectrum of severe HIV-1--related disease in intravenous drug users in New York City.

Increasing mortality in intravenous (IV) drug users not reported to surveillance as acquired immunodeficiency syndrome (AIDS) has occurred in New York City coincident with the AIDS epidemic. From 1981 to 1986, narcotics-related deaths increased on average 32% per year from 492 in 1981 to 1996 in 1986. This increase included deaths from AIDS increasing from 0 to 905 and deaths from other causes, many of which were infectious diseases, increasing from 492 to 1091. Investigations of these deaths suggest a causal association with human immunodeficiency virus (HIV) infection. These deaths may represent a spectrum of HIV-related disease that has not been identified through AIDS surveillance and has resulted in a large underestimation of the impact of AIDS on IV drug users and blacks and Hispanics.

Acquired Immunodeficiency Syndrome↗