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At least 19 recordsLinked to original sources
PubMed1985

Intravenous drug abusers and the acquired immunodeficiency syndrome (AIDS). Demographic, drug use, and needle-sharing patterns.

We studied the demographic characteristics, drug use patterns, and sexual habits of intravenous (IV) drug abusers to further define this population at risk for acquired immunodeficiency syndrome (AIDS). Sixteen IV drug abuser patients with AIDS, 24 IV drug abuser patients with AIDS-related complex (ARC), and 14 IV drug abuser controls without evidence of AIDS or ARC were evaluated. The subjects in each group were similar demographically, in drug use practice, and in sexual orientation and experience. Of the AIDS and ARC patients, 34 (88%) of 40, including all seven homosexual men, shared needles, as did all drug abusers without AIDS or ARC. Seventy-four percent of patients, including all homosexual men, attended "shooting galleries," where anonymous multiple-partner needle sharing took place. Needle sharing supports the hypothesis of AIDS transmission by a blood-borne route, can explain the spread of AIDS and the high rate of seropositivity to the putative AIDS agent among IV drug abusers, and is a logical link between IV drug abusers and male homosexuals, the two largest groups with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Risk factors for needle sharing among methadone-treated patients.

OBJECTIVE: This paper examines the sociodemographic and psychiatric characteristics of patients taking methadone who continue to share needles. METHOD: Three hundred twenty-three patients were recruited from four methadone programs. Data were collected by using questionnaires and interviews. Psychiatric symptoms were measured with the SCL-90, the Beck Depression Inventory, and the Addiction Severity Index. RESULTS: Twenty percent of these subjects reported sharing needles within the previous 6 months. Those who shared reported greater difficulty in acquiring new needles, more legal difficulties, more severe drug problems, and higher levels of psychiatric symptoms. CONCLUSIONS: These data suggest that patients who continue to share needles are a more disturbed subgroup of the methadone maintenance population. Efforts designed to reduce needle sharing may need to be more sharply focused on patients who are at greatest risk of infection, and these patients may require more intensive psychiatric services.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Reliability and construct validity of the needle sharing inventory.

The Needle Sharing Inventory (NSI) is a 59-item test developed to specify and assess behavior patterns associated with drug use and needle sharing. In order to determine its reliability and construct validity, the NSI was administered to 80 intravenous drug users (IVDUs) recruited from a methadone maintenance program in New York City. Patients were included in the study if they reported using intravenous drugs during the previous month. Factor analysis was performed indicating that 31 of the items loaded onto 6 factors similar to those hypothesized: four dealing with the social context of needle sharing - indiscriminate sharing, social sharing, intimate sharing, and use of shooting galleries; and two dealing with the emotional context of intravenous drug use negative affect states and positive affect states. These variables accounted for 71% of the total variance, suggesting internal consistency of these items. Factor scores significantly correlated to subjects' self-reported estimates of time using nonsterile needles and sharing needles. These data suggest that the NSI is both a reliable and a valid measure which may be used in future studies of intravenous drug use and needle sharing behavior patterns. The NSI may prove useful for the purpose of developing and evaluating interventions aimed at preventing or reducing the spread of HIV through needle sharing.

Adult↗
PubMed1990

Needle-sharing practices and risk for AIDS transmission among intravenous drug users in Seattle.

Sharing of needles by intravenous drug users is known to be one of the major means for the transmission of the HIV virus into the general population. In Seattle, where liberal laws make acquisition of needles relatively easy, it has been assumed that needle sharing is not a significant problem. Results of a survey of 212 methadone maintenance clients demonstrated that needle sharing is quite prevalent among intravenous drug users in this area and that addicts fail to sterilize their needles between uses. Because the rate of HIV infection among Seattle's intravenous drug users is relatively low, immediate intervention efforts by public health authorities can prevent a rapid acceleration of the infection rate.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Needle sharing behaviour among injection drug users (IDUs) in treatment in Montreal and Toronto, 1988-1989.

Injection drug users (IDUs) entering treatment programs in Montreal and Toronto were recruited for a study of drug using behaviour and risk of HIV infection. Only those who had injected within 6 months of entering their treatment program were eligible for participation. 183 subjects were recruited in Montreal and 167 in Toronto between November, 1988 and October, 1989. Each participant completed a standardized interviewer-administered questionnaire which focussed on, among other things, drug history and needle sharing behaviour. Approximately three-quarters of respondents in both cities reported sharing needles and syringes within the 6-month period prior to their entry into treatment. Our analysis, which focussed on variables associated with needle sharing revealed that having a sexual partner who injected, trouble obtaining sterile needles and syringes and cocaine injection were significantly and independently associated with needle sharing in a logistic regression model which also controlled for city of recruitment.

AIDS Serodiagnosis↗
PubMed1991

Needle sharing in The Netherlands: an ethnographic analysis.

BACKGROUND: Needle sharing has been reported to be the main cause of the rapid spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk behaviors such as needle sharing are, however, the end result of complicated interaction patterns in drug user networks, which have their specific rules and rituals, and larger social structures and official drug policy. METHODS: To study these interaction patterns we examined the drug administration rituals of heroin addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were collected by participant observation. RESULTS: In less than 10% of the observed self-injections unsafe syringes were used. In 68% of the self-injections new, sterile syringes were used. Needle sharing as a planned sequence was not observed. Sharing was determined primarily by the availability of syringes, experience with the injecting ritual, and drug craving. In all observed needle-sharing events, subjects were aware of the risks involved and undertook efforts to clean the injection equipment. CONCLUSIONS: In contrast to psychological approaches aimed at reducing individual "risk behavior," these findings suggest that HIV prevention can be made more effective if active drug injectors are organized to help themselves and their peers prevent high-risk exchange situations.

Adult↗
PubMed1991

Needle-sharing among intravenous drug users in New Orleans.

We studied needle sharing among intravenous drug users in New Orleans, where needles are not controlled by prescription. Three hundred and eighty self-identified intravenous drug users were interviewed regarding needle-sharing practices, frequency of drug use, and drug(s) of choice. Overall, 65.8% admitted they regularly used needles which had been used by others. No significant differences in needle sharing were found by sex, race, frequency of injection, or drug of choice. A survey of pharmacies found that 85.5% have self-imposed restrictions on the sale of needles and syringes. Legal availability of injection equipment may not be equivalent to actual availability to the consumer.

Adult↗
PubMedDate not supplied

Reduction in needle sharing among community wide samples of injecting drug users.

Evidence of reduced levels of needle sharing among injecting drug users (IDUs) has largely been confined to IDUs attending needle exchanges or receiving treatment. In this paper we present the results of a serial cross-sectional study of needle sharing conducted in Glasgow using a multisite sampling strategy. Of the estimated 9400 IDUs in the city, 503 were interviewed in 1990 and 535 in 1991. The proportion of IDUs reporting injecting with, or passing on used needles and syringes in the last 6 months fell significantly as did the number of individuals from whom equipment was received or passed on to. The impact of this level of sharing has been limited in terms of HIV transmission; the prevalence of HIV among the 1990 sample was 2.0% and 1.1% for the 1991 sample. However, the fact that third of IDUs in Glasgow continue to inject, even occasionally, with used equipment gives cause for concern in view of the other pathologies known to be associated with poor injecting hygiene.

Adolescent↗
PubMed1990

Changes in needle sharing behavior among intravenous drug users: San Francisco, 1986-88.

We analyzed data for San Francisco intravenous drug users entering treatment, April 1986-September 1988 (N = 7,660). The proportion of cases reporting any needle sharing in the month preceding treatment decreased from 50 percent in 1986 to 28 percent in 1988. Similar decreases were reported by two longitudinal cohorts (needle sharing by the same individuals) admitted in 1986 and 1987 (n = 303), and in 1986 and 1988 (n = 205). In a multiple logistic regression model four variables predicted needle sharing: earlier time of admission, cocaine use, younger age, and being White rather than Black.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A model-based estimate of HIV infectivity via needle sharing.

Critical to understanding the spread of the human immunodeficiency virus via needle sharing among drug users is the infectivity, i.e., the conditional probability of infection given injection with a shared, contaminated syringe. A simple mathematical model was constructed that relates infectivity to the prevalence of infection in needles used by drug users, the mean shared injection frequency among drug users, the probability that a needle is disinfected prior to use, and the mean AIDS incubation time. Three of these parameters have been estimated using data from the New Haven, Connecticut legal needle exchange program. Using the polymerase chain reaction to test for the presence of HIV proviral DNA in a sample of returned needles, we determined that 67.5% were HIV positive. We were able to estimate shared injection rates and disinfection rates from surveys of drug users enrolled in the needle exchange and our syringe tracking system. Current estimates of the mean AIDS incubation time are available in the literature. Our model implies that the probability of infection per injection with a contaminated syringe equals 0.0067, which is slightly higher than the transmission probabilities of 1/300 to 1/200 estimated from needlestick studies, and a factor of 3 higher than estimates of the probability of HIV transmission per vaginal sex act from a infected man to an uninfected woman.

HIV Infections↗
PubMed1989

Determinants of needle sharing among intravenous drug users.

Data from 110 IV-drug abusing persons in methadone maintenance were analyzed to determine the correlates of needle sharing. Sharing was directly related to peer group behavior, attitudes conducive to sharing, economic motivation to share, not owning injection equipment, and fatalism about developing AIDS. Sharers were aware of their AIDS risk. Indicated measures to reduce needle sharing would be positive peer support groups to help resist pressures to share, legal and free access to fresh injection equipment, education on the utility of risk reduction, and increased treatment options for IV cocaine users.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Needle sharing among intravenous drug abusers: future directions.

In summary, the conference focused on one means of HIV transmission among intravenous drug abusers: exposure through the sharing of drug injection equipment. The participants emphasized the urgency of the AIDS epidemic among intravenous drug abusers. A massive effort is needed now to prevent further spread of the disease. The prevention of AIDS requires a multipronged approach to reach intravenous drug abusers, with various motivations for behavior change: Communities across the United States should quickly implement programs to educate addicts regarding their risk for AIDS and how they may reduce their risk. Aggressive outreach is a key educational tool. Drug abuse treatment is an important means of combating the AIDS epidemic among intravenous drug abusers who wish to quit using drugs and are willing to enter treatment. Resources need to be expanded so that drug abuse treatment is readily available. Since a substantial number of intravenous drug abusers will continue to inject drugs, an effective AIDS prevention strategy must encourage these individuals not to share injection equipment and must provide clear and explicit information on how they can clean their injection equipment to decrease the likelihood of HIV transmission if they continue to share. Public policies that restrict the availability of needles and thereby encourage needle sharing should be reexamined. As part of this reexamination, research should be conducted to determine the effectiveness of needle exchange programs that provide intravenous drug abusers with sterile needles in exchange for used needles.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Notification of the sex and needle-sharing partners of individuals with human immunodeficiency virus in rural South Carolina: 30-month experience.

The authors conducted a confidential and voluntary partner notification program to identify and educate the sex and needle-sharing partners of individuals with the human immunodeficiency virus (HIV) in a rural health district in South Carolina. During the first 30 months, of 485 named contacts, 290 (60%) were residents of the health district and were contacted and offered testing. Of the 290 contacted, 280 (97%)--53 women and 227 men; age range 14-74 years--accepted counseling and testing and 49 (18%) were HIV-antibody positive. Only 3 of the 49 (6%) had been previously tested. All HIV-infected individuals received appropriate physician, laboratory, and public health referrals. During the study, the mean number of sex partners per 6-month period decreased from 5.6 to 1.1 (80% reduction) for HIV-antibody positive persons and from 4.0 to 2.0 (50% reduction) for HIV-antibody negative persons. The authors conclude that in a rural setting, partner notification of HIV exposure can accurately target education and testing and can produce positive behavior change.

Adolescent↗
PubMed1990

Hepatitis B: transmission by sexual contact and needle sharing.

In the Western world most cases of hepatitis B virus (HBV) infection are acquired through sexual intercourse and through needle sharing by intravenous drug users (IVDU). The major risk factors for HBV infection in homosexual men include the number of sex partners and receptive anal intercourse. In heterosexuals, this risk also rises with an increasing number of sex partners. IVDU consistently show the highest HBV infection rates in Europe and North America, presently accounting for 25 to 50% of all hepatitis B cases. Infection with the human immunodeficiency virus affects the course of HBV infection as well as the immunological response to hepatitis B vaccines. Thus, in the industrialized world, interventions against HBV infection should primarily be targeted to homosexual men, heterosexuals with multiple partners, and IVDU.

HIV Infections↗
PubMedDate not supplied

Needle sharing and participation in the Amsterdam Syringe Exchange program among HIV-seronegative injecting drug users.

To enhance the prevention of human immunodeficiency virus infection, factors related to regular participation in the Amsterdam Syringe Exchange and the borrowing of syringes were studied in 131 HIV-seronegative injecting drug users in a 1989-90 survey. A total of 29 percent of the users reported borrowing syringes, that is injecting drugs at least once in the past 4-6 months with a needle or syringe previously used by someone else. Users at increased risk of borrowing are previous borrowers, long term moderate-to-heavy alcohol users, current cocaine injectors, and drug users without permanent housing. Regular clients of the syringe exchange, when compared with other injecting drug users, were found more often to be frequent, long term injectors. They borrowed slightly less often than other users, but this was not statistically significant, even after controlling for frequency of injecting or other potential confounders. The results suggest that, 5 years after the start of the Amsterdam Syringe Exchange, drug use characteristics govern an individual injecting drug user's choice of exchanging or not exchanging syringes. The conclusion is that it seems more important to direct additional preventive measures at injecting drug users with an increased risk of borrowing rather than at users who do not participate in the syringe exchange or who do so irregularly.

Adult↗