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[PMID]:28471336
[Au] Autor:Harris T; Rice E; Rhoades H; Winetrobe H; Wenzel S
[Ad] Endereço:a School of Social Work , University of Southern California , Los Angeles , California , USA.
[Ti] Título:Gender Differences in the Path From Sexual Victimization to HIV Risk Behavior Among Homeless Youth.
[So] Source:J Child Sex Abus;26(3):334-351, 2017 Apr.
[Is] ISSN:1547-0679
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Experiencing sexual victimization prior to becoming homeless is common among homeless youth and is associated with increased HIV risk behavior. This study examined mediating variables that underlie this association, adding to the understanding of gender differences in these paths. Participants were homeless youth in Los Angeles recruited through service access centers who completed a computerized self-administered interview in English or Spanish using an iPad. Findings indicate a high presence of sexual victimization across both genders. Female participants experienced posttraumatic stress disorder and subsequent engagement with exchange sex, whereas male participants were primarily involved in substance use risk pathways. Results indicate paths in the association between sexual victimization and HIV risk behavior differ between male and female homeless youth. Gender-specific, mental-health-informed interventions targeting sexual risk reduction are warranted.
[Mh] Termos MeSH primário: Abuso Sexual na Infância
Infecções por HIV/transmissão
Jovens em Situação de Rua/psicologia
Sexo sem Proteção/psicologia
[Mh] Termos MeSH secundário: Adolescente
Abuso Sexual na Infância/psicologia
Abuso Sexual na Infância/estatística & dados numéricos
Feminino
Infecções por HIV/psicologia
Jovens em Situação de Rua/estatística & dados numéricos
Seres Humanos
Masculino
Fatores Sexuais
Abuso de Substâncias por Via Intravenosa/epidemiologia
Abuso de Substâncias por Via Intravenosa/psicologia
Sexo sem Proteção/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1080/10538712.2017.1287146


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[PMID]:27771524
[Au] Autor:Panda S; Kumar MS
[Ad] Endereço:National Institute of Cholera & Enteric Diseases (Indian Council of Medical Research), P-33 CIT Road, Scheme-XM, Beliaghata, Kolkata 700010, West Bengal, India.
[Ti] Título:Injecting drug use in India and the need for policy and program change.
[So] Source:Int J Drug Policy;37:115-116, 2016 11.
[Is] ISSN:1873-4758
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Legislação de Medicamentos/tendências
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idade de Início
Analgésicos Opioides
Usuários de Drogas
Feminino
Infecções por HIV/epidemiologia
Infecções por HIV/etiologia
Infecções por HIV/prevenção & controle
Redução do Dano
Hepatite C/epidemiologia
Hepatite C/etiologia
Hepatite C/prevenção & controle
Seres Humanos
Índia/epidemiologia
Masculino
Uso Comum de Agulhas e Seringas
Programas de Troca de Agulhas
Abuso de Substâncias por Via Intravenosa/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28454556
[Au] Autor:Daw MA; El-Bouzedi A; Ahmed MO; Dau AA; In association with the Libyan Study Group of Hepatitis & HIV
[Ad] Endereço:Department of Medical Microbiology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya. mohamedadaw@gmail.com.
[Ti] Título:Molecular and epidemiological characterization of HIV-1 subtypes among Libyan patients.
[So] Source:BMC Res Notes;10(1):170, 2017 Apr 28.
[Is] ISSN:1756-0500
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The epidemiological and clinical aspects of human immunodeficiency virus subtypes are of great interest worldwide. These subtypes are rarely studied in North African countries. Libya is a large country with the longest coast on the Mediterranean Sea, facing the Southern European countries. Studies on the characterization of HIV-1 subtypes are limited in Libya. This study aimed to determine the magnitude of the HIV problem among the Libyan population and to better understand the genetic diversity and the epidemiologic dynamics of HIV 1, as well as to correlate that with the risk factors involved. METHODS: A total of 159 HIV-1 strains were collected from 814 HIV positive patients from the four Libyan regions during a 16-year period (1995-2010). To determine the HIV-1 subtypes, genetic analysis and molecular sequencing were carried out using provirus polygene. Epidemiologic and demographic information was obtained from each participant and correlated with HIV-1 subtypes using logistic regression. RESULTS: The overall prevalence of HIV among Libyans ranged from 5 to 10 per 100,000 during the study period. It was higher among intravenous drug users (IVDUs) (53.9%), blood recipients (25.9%) and heterosexuals (17.6%) than by vertical transmission (2.6%). Prevalence was higher among males aged 20-40 years (M:F 1:6, P > 0.001). Among the 159 strains of HIV-1 available for typing, 117 strains (73.6%) were subtype B, 29 (18.2%) were CRF02_AG, and 13 (8.2%) were subtype A. HIV-1 subtype B was the most prevalent all over the country, and it was more prevalent in the Northern region, particularly among IVDUs (P < 0.001). GRF02_AG was common in the Eastern region, particularly among blood recipients while subtype A emerged in the Western region, particularly among IVDUs. CONCLUSIONS: HIV-1 infection is emerging in Libya with a shifting prevalence of subtypes associated with the changing epidemiology of HIV-1 among risk groups. A genetic analysis of HIV-1 strains demonstrated low subtype heterogeneity with the evolution of subtype B, and CRF_20 AG, as well as HIV-1 subtype A. Our study highlights the importance of expanded surveillance programs to control HIV infection and the necessity of introducing public health strategies to target the risk groups, particularly IVDUs.
[Mh] Termos MeSH primário: Infecções por HIV/epidemiologia
Infecções por HIV/transmissão
HIV-1/genética
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos
Filogenia
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Transfusão de Sangue
Feminino
Infecções por HIV/complicações
Infecções por HIV/virologia
HIV-1/classificação
HIV-1/isolamento & purificação
Seres Humanos
Líbia/epidemiologia
Masculino
Meia-Idade
Epidemiologia Molecular
Tipagem Molecular
Prevalência
Vigilância em Saúde Pública
Fatores de Risco
Fatores Sexuais
Abuso de Substâncias por Via Intravenosa/complicações
Abuso de Substâncias por Via Intravenosa/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s13104-017-2491-2


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[PMID]:29381697
[Au] Autor:Safreed-Harmon K; Hetherington KL; Aleman S; Alho H; Dalgard O; Frisch T; Gottfredsson M; Weis N; Lazarus JV; Hep-Nordic Study Group
[Ad] Endereço:CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
[Ti] Título:Policy responses to hepatitis C in the Nordic countries: Gaps and discrepant reporting in the Hep-Nordic study.
[So] Source:PLoS One;13(1):e0190146, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: In the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden), the prevalence of chronic hepatitis C virus (HCV) infection is relatively low in the general population, but is much higher among people who inject drugs (PWID). We conducted an exploratory study to investigate the extent to which these countries have policies supporting key elements of the public health response that is necessary to achieve the global goal of eliminating HCV as a public health threat. METHODS: Fourteen stakeholders representing government agencies, medical societies, and civil society organisations (CSOs) in the Nordic countries completed a cross-sectional online survey that included 21 policy questions related to national coordination, prevention, testing, linkage to care, and treatment. We summarised the findings in a descriptive analysis, and noted discrepant responses from stakeholders within the same country. RESULTS: Stakeholders reported that three of the five study countries have national viral hepatitis strategies, while only Iceland has a national HCV elimination goal. The availability of harm reduction services varies, with opioid substitution therapy provided for the general population throughout all countries, but not needle and syringe programmes. No country has access to anonymous HCV testing in all parts of the country. National HCV treatment guidelines are available in all countries except Finland, and all countries provide publicly funded direct-acting antiviral treatment. Disagreement regarding policies was observed across countries, and CSOs were the stakeholder group that most frequently answered survey questions incorrectly. CONCLUSION: The Nordic region as a whole has not consistently expressed its commitment to tackling HCV, despite the existence of large HCV epidemics among PWID in these countries. Stakeholder alignment and an established elimination goal with an accompanying strategy and implementation plan should be recognised as the basis for coordinated national public health efforts to achieve HCV elimination in the Nordic region and elsewhere.
[Mh] Termos MeSH primário: Hepatite C/diagnóstico
Abuso de Substâncias por Via Intravenosa/complicações
[Mh] Termos MeSH secundário: Estudos Transversais
Hepatite C/epidemiologia
Hepatite C/etiologia
Seres Humanos
Prevalência
Prática de Saúde Pública
Países Escandinavos e Nórdicos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190146


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[PMID]:27776677
[Au] Autor:Jarlais DC; Arasteh K; Feelemyer J; McKnight C; Barnes DM; Tross S; Perlman DC; Campbell AN; Cooper HL; Hagan H
[Ad] Endereço:Icahn School of Medicine at Mount Sinai, New York, NY, United States. Electronic address: ddesjarlais@chpnet.org.
[Ti] Título:From Long-Term Injecting to Long-Term Non-Injecting Heroin and Cocaine Use: The Persistence of Changed Drug Habits.
[So] Source:J Subst Abuse Treat;71:48-53, 2016 12.
[Is] ISSN:1873-6483
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Transitioning from injecting to non-injecting routes of drug administration can provide important individual and community health benefits. We assessed characteristics of persons who had ceased injecting while continuing to use heroin and/or cocaine in New York City. METHODS: We recruited subjects entering Mount Sinai Beth Israel detoxification and methadone maintenance programs between 2011 and 2015. Demographic information, drug use histories, sexual behaviors, and "reverse transitions" from injecting to non-injecting drug use were assessed in structured face-to-face interviews. There were 303 "former injectors," operationally defined as persons who had injected at some time in their lives, but had not injected in at least the previous 6 months. Serum samples were collected for HIV and HCV testing. RESULTS: Former injectors were 81% male, 19% female, 17% White, 43% African-American, and 38% Latino/a, with a mean age of 50 (SD=9.2), and were currently using heroin and/or cocaine. They had injected drugs for a mean of 14 (SD=12.2) years before ceasing injection, and a mean of 13 (SD=12) years had elapsed since their last injection. HIV prevalence among the sample was 13% and HCV prevalence was 66%. The former injectors reported a wide variety of reasons for ceasing injecting. Half of the group appeared to have reached a point where relapse back to injecting was no longer problematic: they had not injected for three or more years, were not deliberately using specific techniques to avoid relapse to injecting, and were not worried about relapsing to injecting. CONCLUSIONS: Former injectors report very-long term behavior change toward reduced individual and societal harm while continuing to use heroin and cocaine. The behavior change appears to be self-sustaining, with full replacement of an injecting route of drug administration by a non-injecting route of administration. Additional research on the process of long-term cessation of injecting should be conducted within a "combined prevention and care" approach to HIV and HCV infection among persons who use drugs.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Dependência de Heroína/epidemiologia
Comportamento de Redução do Risco
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Cidade de Nova Iorque/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29253386
[Au] Autor:Uyei J; Fiellin DA; Buchelli M; Rodriguez-Santana R; Braithwaite RS
[Ad] Endereço:Department of Population Health, New York University School of Medicine, New York, NY, USA. Electronic address: jennifer.uyei@nyumc.org.
[Ti] Título:Effects of naloxone distribution alone or in combination with addiction treatment with or without pre-exposure prophylaxis for HIV prevention in people who inject drugs: a cost-effectiveness modelling study.
[So] Source:Lancet Public Health;2(3):e133-e140, 2017 Mar.
[Is] ISSN:2468-2667
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the USA, an epidemic of opioid overdose deaths is occurring, many of which are from heroin. Combining naloxone distribution with linkage to addiction treatment or pre-exposure prophylaxis (PrEP) for HIV prevention through syringe service programmes has the potential to save lives and be cost-effective. We estimated the outcomes and cost-effectiveness of five alternative strategies: no additional intervention, naloxone distribution, naloxone distribution plus linkage to addiction treatment, naloxone distribution plus PrEP, and naloxone distribution plus linkage to addiction treatment and PrEP. METHODS: We developed a decision analytical Markov model to simulate opioid overdose, HIV incidence, overdose-related deaths, and HIV-related deaths in people who inject drugs in Connecticut, USA. Model input parameters were derived from published sources. We compared each strategy with no intervention, as well as simultaneously considering all strategies. Sensitivity analysis was done for all variables. Linkage to addiction treatment was referral to an opioid treatment programme for methadone. Endpoints were survival, life expectancy, quality-adjusted life-years (QALYs), number and percentage of overdose deaths averted, number of HIV-related deaths averted, total costs (in 2015 US$) associated with each strategy, and incremental cost per QALY gained. FINDINGS: In the base-case analysis, compared with no additional intervention, the naloxone distribution strategy yielded an incremental cost-effectiveness ratio (ICER) of $323 per QALY, and naloxone distribution plus linkage to addiction treatment was cost saving compared with no additional intervention (greater effectiveness and less expensive). The most efficient strategies (ie, those conferring the greatest health benefit for a particular budget) were naloxone distribution combined with linkage to addiction treatment (cost saving), and naloxone distribution combined with PrEP and linkage to addiction treatment (ICER $95 337 per QALY) at a willingness-to-pay threshold of $100 000. In probabilistic sensitivity analysis, the combination of naloxone distribution, PrEP, and linkage to addiction treatment was the optimal strategy in 37% of iterations and the combination of naloxone distribution and linkage to addiction treatment was the optimal strategy in 34% of iterations. INTERPRETATION: Naloxone distribution through syringe service programmes is cost-effective compared with syringe distribution alone, but when combined with linkage to addiction treatment is cost saving compared with no additional services. A strategy that combines naloxone distribution, PrEP, and linkage to addiction treatment results in greater health benefits in people who inject drugs and is also cost-effective. FUNDING: State of Connecticut Department of Public Health and the National Institute of Mental Health.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Naloxona/provisão & distribuição
Profilaxia Pré-Exposição/utilização
Abuso de Substâncias por Via Intravenosa/terapia
[Mh] Termos MeSH secundário: Connecticut
Análise Custo-Benefício
Seres Humanos
Modelos Teóricos
Naloxona/economia
Programas de Troca de Agulhas/economia
Profilaxia Pré-Exposição/economia
Avaliação de Programas e Projetos de Saúde
Abuso de Substâncias por Via Intravenosa/economia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE


  7 / 13700 MEDLINE  
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[PMID]:29240757
[Au] Autor:Tobin K; Davey-Rothwell MA; Nonyane BAS; Knowlton A; Wissow L; Latkin CA
[Ad] Endereço:Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
[Ti] Título:RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.
[So] Source:PLoS One;12(12):e0187180, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and <40 on the Centers for Epidemiologic Studies-Depression (CES-D) scale were randomized using a two-block design, stratified by sex to ensure equivalent numbers, to a 10 session intervention arm (n = 162) or a single session control arm (n = 153). The outcomes of interest were decreases in CES-D score and injection risk behaviors and increases in condom use. The sample was majority African American (85%) and unemployed (94%). Nearly half (47%) reported injection in the prior 6 months and only 19% were taking medication for depression. Follow-up assessments were conducted at 6 and 12 months. Retention at 12 months was 94%. Intervention arm was associated with statistically significantly lower CES-D score at 12 month compared to control. No differences were observed between arms in injection risk. At 6 month, intervention was associated with greater odds of condom use with non-main partner. These findings suggest the potential role of the integrated intervention in reducing depressive symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.
[Mh] Termos MeSH primário: Terapia Cognitiva
Depressão/terapia
Infecções por HIV/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Preservativos
Feminino
Infecções por HIV/prevenção & controle
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
Comportamento Sexual
Abuso de Substâncias por Via Intravenosa
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187180


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[PMID]:29323855
[Au] Autor:Lebedev AV; Kazennova EV; Zverev SY; Nistratova YI; Laga VY; Tumanov AS; Glushchenko NV; Yarygina EI; Bobkova MR
[Ti] Título:Analysis of the env gene variability of the IDU-A HIV-1 variant in the outbreak of the HIV infection epidemic in Perm region of Russia (1996-2011).
[So] Source:Vopr Virusol;61(5):222-9, 2016.
[Is] ISSN:0507-4088
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:In the present work, a total of 132 HIV-1 env gene C2-V3-C3 sequences belonging to the IDU-A genetic variant were analyzed. The variants were obtained from the viruses circulating among IDUs and heterosexuals in the Perm region at different periods. It was shown that the rate of the divergence of the IDU-A HIV-1 viruses from a common ancestor increased 4.3 times (p < 0.001) in 2011 as compared with the onset of the epidemics. The rate of the HIV-1 evolution was different in the two risk groups of the infection. The mean genetic distance of HIV-1 variants circulating among heterosexuals was 1.3 times longer (p = 0.008) than that among IDUs. The accumulation rate of the nucleotide (including nonsynonymous) substitutions in the C2-V3-C3 HIV-1 env gene region among individuals infected by heterosexual contacts was 1.7 times higher than that among IDUs. The differences in the positions of the codons subjected to positive selection were demonstrated depending on the infection risk group tested.
[Mh] Termos MeSH primário: Surtos de Doenças
Variação Genética
Infecções por HIV/epidemiologia
HIV-1/genética
Abuso de Substâncias por Via Intravenosa/epidemiologia
Produtos do Gene env do Vírus da Imunodeficiência Humana/genética
[Mh] Termos MeSH secundário: Adulto
Códon
Feminino
Expressão Gênica
Infecções por HIV/transmissão
Infecções por HIV/virologia
HIV-1/classificação
Heterossexualidade
Seres Humanos
Masculino
Taxa de Mutação
Filogenia
Federação Russa/epidemiologia
Seleção Genética
Abuso de Substâncias por Via Intravenosa/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Codon); 0 (env Gene Products, Human Immunodeficiency Virus)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE


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[PMID]:27770694
[Au] Autor:Adamson K; Jackson L; Gahagan J
[Ad] Endereço:Dalhousie University School of Health and Human Performance, Halifax, Nova Scotia, Canada. Electronic address: kelly.adamson@dal.ca.
[Ti] Título:Young people and injection drug use: Is there a need to expand harm reduction services and support?
[So] Source:Int J Drug Policy;39:14-20, 2017 01.
[Is] ISSN:1873-4758
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:A complex array of intersecting social contextual factors are known to influence safer and/or unsafe practices among people who inject drugs. However, less is known about the social contextual factors that may specifically influence injection practices for young people who inject drugs. In this qualitative study, we explored with young people, ages 18-29, living in an urban centre in Nova Scotia, Canada, their perceptions and experiences of the social contextual factors that influence their safer and/or unsafe injection practices. We found that many of the social contextual factors the young people reported as influencing unsafe practices are at the micro-environmental level, and a number of these factors also affect adults (as per the literature). Methadone maintenance treatment was identified by a number of the participants as an important factor influencing safer practices. An expansion of harm reduction services and supports may help to address many of the social contextual factors identified by young people who inject drugs and should be considered given their important role in reducing the harms associated with injection drug use.
[Mh] Termos MeSH primário: Redução do Dano
Meio Social
Abuso de Substâncias por Via Intravenosa/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Canadá
Feminino
Seres Humanos
Masculino
Pesquisa Qualitativa
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


  10 / 13700 MEDLINE  
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[PMID]:29202872
[Au] Autor:Mburu G; Ngin C; Tuot S; Chhoun P; Pal K; Yi S
[Ad] Endereço:Division of Health Research, Lancaster University, Lancaster, UK.
[Ti] Título:Patterns of HIV testing, drug use, and sexual behaviors in people who use drugs: findings from a community-based outreach program in Phnom Penh, Cambodia.
[So] Source:Addict Sci Clin Pract;12(1):27, 2017 Dec 05.
[Is] ISSN:1940-0640
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: People who use drugs are an important priority for HIV programs. However, data related to their utilization of HIV services are limited. This paper reports patterns of HIV testing, drug use, and risk and service perception among people who use drugs. Study participants were receiving HIV and harm reduction services from a community-based program in Phnom Penh, comprised of itinerant peer-led outreach and static drop-in centers. METHODS: This was a mixed-methods study conducted in 2014, comprising of a quantitative survey using a structured questionnaire, followed by two focus group discussions among a sub-sample of survey participants. Participants were recruited from hotspots in five HIV high-burden communes using a two-stage cluster sampling method. Quantitative descriptive analyses and qualitative thematic analyses were performed. RESULTS: This study included 151 people who use drugs with a mean age of 31.2 (SD = 6.5) years; 77.5% were male and 39.1% were married. The most common drugs used were methamphetamines (72.8%) and heroin (39.7%), and 38.0% injected drugs in the past 3 months. Overall, 83.3% had been tested for HIV in the past 6 months, of whom 62.5% had been tested by peers through community-based outreach. However, there were ongoing HIV risks: 37.3% were engaging in sex on drugs, only 35.6% used a condom at last sexual intercourse, and 10.8% had had a sexually transmitted infection in the last 6 months. Among people who reported injecting drugs in the past 3 months, 27.5% reported re-using needles/syringes. Almost half (46.5%) perceived themselves as being at lower risk of HIV compared to the general population. Qualitative results contextualized the findings of low perception of HIV risks and suggested that although services were often unavailable on weekends, at night, or during national holidays, peer-led community-based outreach was highly accepted. CONCLUSIONS: A peer-led community-based approach was effective in reaching people who use drugs with HIV and harm reduction interventions. To mitigate ongoing HIV risks, expanding access to combination prevention interventions and implementing strategies to enable people who use drugs to objectively assess their HIV risks are required. Additionally, community-based programs should collect data along the care continuum, to enable decentralized tracking of progress towards 90-90-90 goals at local levels.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Dependência de Heroína/prevenção & controle
Assunção de Riscos
Comportamento Sexual/estatística & dados numéricos
Abuso de Substâncias por Via Intravenosa/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Camboja
Relações Comunidade-Instituição
Feminino
Infecções por HIV/complicações
Dependência de Heroína/complicações
Seres Humanos
Masculino
Metanfetamina/efeitos adversos
Fatores de Risco
Abuso de Substâncias por Via Intravenosa/complicações
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
44RAL3456C (Methamphetamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1186/s13722-017-0094-9



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