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Injecting drug users' utilization of public space in Belgrade: Places, risk-management, and habitual life  [PDF]
?iki? Bojan
Glasnik Etnografskog Instituta SANU , 2007, DOI: 10.2298/gei0701103z
Abstract: Results from the case-study in Belgrade injecting drug users are presented here featuring the discussion on injecting occurring within the versatility of places belong to the public space. The attention is paid mostly to the certain type of physical risk environment which is specific to Belgrade injecting scene, called "shtek", but risk production and risk management are reviewed also taking into consideration other types of physical environments.
Continued high prevalence of HIV, HBV and HCV among injecting and noninjecting drug users in Italy
Camoni,Laura; Regine,Vincenza; Salfa,Maria Cristina; Nicoletti,Giovanni; Canuzzi,Pietro; Magliocchetti,Natalia; Rezza,Giovanni; Suligoi,Barbara; ,;
Annali dell'Istituto Superiore di Sanità , 2010, DOI: 10.4415/ANN_10_01_08
Abstract: we estimated the prevalence of hiv, hbv and hcv infections among injecting and non-injecting drug users treated within public drug-treatment centres in italy to determine the correlates of infection. in the sample of 1330 drug users, the prevalence of hiv was 14.4% among drug injectors and 1.6% among non-injectors; the prevalence of hbv was 70.4% among injecting drug users and 22.8% among non-injectors and of hcv was 83.2% among injecting drug users and 22.0% among non-injectors. old age, unemployment, and intravenous drug use were significantly correlated with each of the infections, as well as a longer history of injecting drug use. the results indicate that these infections continue to circulate among drug users, highlighting the need for monitoring of this group in italy.
The acceptability and feasibility of peer worker support role in community based HCV treatment for injecting drug users
Josephine Norman, Nick M Walsh, Janette Mugavin, Mark A Stoové, Jenny Kelsall, Kirk Austin, Nick Lintzeris
Harm Reduction Journal , 2008, DOI: 10.1186/1477-7517-5-8
Abstract: Hepatitis C (HCV) affects over 200 000 Australians [1]. IDU is the most common mode of transmission of HCV in Australia – accounting for approximately 80% of all HCV cases [2], and over 90% of newly acquired HCV infections [3]. The prevalence of HCV in the injecting drug user population in Australia has been consistently estimated at between 50 and 70% since the 1970's [4-8]Antiviral therapy for chronic HCV infection has improved considerably in recent years, with sustained virological response – equating to a probable cure – increasing from 15–20% with interferon monotherapy to 50–80% with pegylated interferon and ribavirin therapy [9]. Despite these advances in HCV antiviral treatment, the number of people accessing therapy remains small – in excess of 2000 people undergo treatment per year, representing only 1% of Australians with chronic HCV infection [1], Anecdotal evidence suggests that limited numbers of injecting drug users receive HCV treatment in Australia, even though current IDU was removed as an exclusion criterion for government-funded HCV antiviral treatment in Australia in May 2001.There is international recognition of the need for a more inclusive approach to HCV treatment to increase the availability of treatment for patients who have previously been ineligible or difficult to engage in treatment [10]. Indeed, increasing international evidence suggests that HCV positive substance dependent injecting drug users can achieve favourable antiviral treatment outcomes when engaged in comprehensive substance use treatment and supportive HCV treatment programs [11-15].Recently there has been an effort to reduce the barriers to HCV treatment in Australia (e.g., removing IDU as an exclusion criterion for treatment, removal of the requirement for a liver biopsy prior to commencing treatment). Despite this, limited numbers of injecting drug users have received treatment in Australia and IDU has been identified as a major barrier to receiving referrals to specia
HCV and HIV infection and co-infection: injecting drug use and sexual behavior, AjUDE-Brasil I Project
Zocratto, Keli Bahia Felicíssimo;Caiaffa, Waleska Teixeira;Proietti, Fernando Augusto;Carneiro-Proietti, Anna Bárbara;Mingoti, Sueli Aparecida;Ribeiro, Geraldo José Coelho;,;
Cadernos de Saúde Pública , 2006, DOI: 10.1590/S0102-311X2006000400022
Abstract: this study aimed to characterize sexual and drug-use behaviors in injecting drug users (idus) in relation to single hepatitis c virus (hcv) and human immunodeficiency virus (hiv) infection and hcv/hiv co-infection. the sample consisted of 272 idus enrolled in the ajude-brasil i project, a cross-sectional multi-center study conducted in five brazilian cities in 1998. data were collected with a structured questionnaire using self-reported risk behavior, and hcv and hiv serological status used elisa on filter paper. idus were clustered in four distinct groups: hcv/hiv seronegative; hcv mono-infected; hiv mono-infected; and hcv/hiv co-infected. active sharing of injecting equipment was associated with hcv infection (p = 0.001). sexual behavior variables, especially male same-sex sexual relations, were consistently associated with hiv infection. hcv/hiv co-infection was associated with both sexual and drug use variables. it was possible to distinguish different behavioral indicators for hcv and hiv infection and co-infection in this population.
HCV and HIV infection and co-infection: injecting drug use and sexual behavior, AjUDE-Brasil I Project  [cached]
Zocratto Keli Bahia Felicíssimo,Caiaffa Waleska Teixeira,Proietti Fernando Augusto,Carneiro-Proietti Anna Bárbara
Cadernos de Saúde Pública , 2006,
Abstract: This study aimed to characterize sexual and drug-use behaviors in injecting drug users (IDUs) in relation to single hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection and HCV/HIV co-infection. The sample consisted of 272 IDUs enrolled in the AjUDE-Brasil I Project, a cross-sectional multi-center study conducted in five Brazilian cities in 1998. Data were collected with a structured questionnaire using self-reported risk behavior, and HCV and HIV serological status used ELISA on filter paper. IDUs were clustered in four distinct groups: HCV/HIV seronegative; HCV mono-infected; HIV mono-infected; and HCV/HIV co-infected. Active sharing of injecting equipment was associated with HCV infection (p = 0.001). Sexual behavior variables, especially male same-sex sexual relations, were consistently associated with HIV infection. HCV/HIV co-infection was associated with both sexual and drug use variables. It was possible to distinguish different behavioral indicators for HCV and HIV infection and co-infection in this population.
The provision of non-needle/syringe drug injecting paraphernalia in the primary prevention of HCV among IDU: a systematic review
Michelle Gillies, Norah Palmateer, Sharon Hutchinson, Syed Ahmed, Avril Taylor, David Goldberg
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-721
Abstract: A systematic search of seven databases and the grey literature for articles published January 1989-February 2010 was undertaken. Thirteen studies (twelve observational and one non-randomized uncontrolled pilot intervention) were identified and appraised for study design and quality by two investigators.No studies examined the association between the provision of non-N/S injecting paraphernalia and incident HCV infection. One cross-sectional study found that individuals who frequently, compared to those who infrequently, used sterile cookers and water, were less likely to report prevalent HCV infection. Another found no association between the uptake of sterile non-N/S injecting paraphernalia and self-reported sharing of this paraphernalia. The remaining observational studies used attendance at needle and syringe exchange programmes (NSP) or safer injection facilities (SIF) that provided non-N/S injecting paraphernalia as a proxy measure. Eight studies presented adjusted odds ratios, ranging from 0.3 to 0.9, suggesting a reduced likelihood of self-reported sharing of non-N/S injecting paraphernalia associated with use of NSP or SIF. There was substantial uncertainty associated with these estimates however. Three unadjusted studies reported a reduction in the prevalence of sharing of non-N/S injecting paraphernalia over time among NSP users. Only one study reported an adjusted temporal trend in the prevalence of sharing non-N/S injecting paraphernalia, finding higher rates among non-NSP users than NSP users at each time point, and a greater reduction in sharing among non-NSP than NSP users over time. Study limitations included the use of convenience samples, self-reported exposure and outcome measures, flawed classification of the exposed and unexposed groups, and inadequate adjustment for potential confounding variables.The evidence to demonstrate that the provision of sterile non-N/S injecting paraphernalia reduces HCV transmission or modifies injecting risk behavio
High Prevalence of HIV, HCV, HBV and Co-Infection and Associated Risk Factors among Injecting Drug Users in Yunnan Province, China  [PDF]
Yan-Heng Zhou,Zhi-Hong Yao,Feng-Liang Liu,Hong Li,Li Jiang,Jia-Wu Zhu,Yong-Tang Zheng
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0042937
Abstract: To estimate the prevalence of HIV, HCV, HBV and co-infection with 2 or 3 viruses and evaluate risk factors among injecting drug users (IDUs) in Yunnan province, China.
A Practical Approach to Managing Patients with HCV Infection
Huang Richard H.,Hu Ke-Qin
International Journal of Medical Sciences , 2006,
Abstract: Hepatitis C virus (HCV) infection is a major worldwide public health concern. It is a common cause of chronic liver disease and hepatocellular carcinoma. HCV antibody and HCV RNA testing are available diagnostic studies that offer high degree of accuracy. Current standard therapy includes a combination of pegylated interferon and ribavirin. Response rate is approximately 40% for genotype 1 and 80% for genotypes 2 and 3, respectively. Successful treatment can stop the progression of chronic liver disease, reduce the need for liver transplantation, and possibly decrease the risk for Hepatocellular carcinoma (HCC). Evaluating for potential treatment candidacy is an important initial step in the management of chronic HCV infection as not all individuals may need or qualify for the treatment. Understanding the natural history, the different diagnostic modalities, the current therapeutic options and, the treatment response and adverse effect profiles can help the practitioners better manage chronic HCV infection.
Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil
Oliveira, M.L.A.;Bastos, F.I.;Telles, P.R.;Yoshida, C.F.T.;Schatzmayr, H.G.;Paetzold, U.;Pauli, G.;Schreier, E.;
Brazilian Journal of Medical and Biological Research , 1999, DOI: 10.1590/S0100-879X1999000900009
Abstract: viral hepatitis constitutes a major health issue, with high prevalence among injecting drug users (idus). the present study assessed the prevalence and risk determinants for hepatitis b, c and d viruses (hbv, hcv and hdv) infections among 102 idus from rio de janeiro, brazil. serological markers and hcv-rna were detected by enzyme immunoassay and nested pcr, respectively. hcv genotyping was determined by restriction fragment length polymorphism analysis (rflp). hbsag, anti-hbc and anti-hbs were found in 7.8, 55.8 and 24.7% of idus, respectively. in the final logistic regression, hbv infection was independently associated with male homosexual intercourse within the last 5 years (odds ratio (or) 3.1; 95% confidence interval (ci) 1.1-8.8). no subject presented anti-delta (anti-hd). anti-hcv was detected in 69.6% of subjects, and was found to be independently associated with needle sharing in the last 6 months (or 3.4; 95% ci 1.3-9.2) and with longer duration of iv drug use (or 3.1; 95% ci 1.1-8.7). these data demonstrate that this population is at high risk for both hbv and hcv infection. among idus from rio de janeiro, unprotected sexual intercourse seems to be more closely associated with hbv infection, whereas hcv is positively correlated with high risk injecting behavior. comprehensive public health interventions targeting this population and their sexual partners must be encouraged.
Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil  [cached]
Oliveira M.L.A.,Bastos F.I.,Telles P.R.,Yoshida C.F.T.
Brazilian Journal of Medical and Biological Research , 1999,
Abstract: Viral hepatitis constitutes a major health issue, with high prevalence among injecting drug users (IDUs). The present study assessed the prevalence and risk determinants for hepatitis B, C and D viruses (HBV, HCV and HDV) infections among 102 IDUs from Rio de Janeiro, Brazil. Serological markers and HCV-RNA were detected by enzyme immunoassay and nested PCR, respectively. HCV genotyping was determined by restriction fragment length polymorphism analysis (RFLP). HBsAg, anti-HBc and anti-HBs were found in 7.8, 55.8 and 24.7% of IDUs, respectively. In the final logistic regression, HBV infection was independently associated with male homosexual intercourse within the last 5 years (odds ratio (OR) 3.1; 95% confidence interval (CI) 1.1-8.8). No subject presented anti-delta (anti-HD). Anti-HCV was detected in 69.6% of subjects, and was found to be independently associated with needle sharing in the last 6 months (OR 3.4; 95% CI 1.3-9.2) and with longer duration of iv drug use (OR 3.1; 95% CI 1.1-8.7). These data demonstrate that this population is at high risk for both HBV and HCV infection. Among IDUs from Rio de Janeiro, unprotected sexual intercourse seems to be more closely associated with HBV infection, whereas HCV is positively correlated with high risk injecting behavior. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged.
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