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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Drug use is a major mode of HIV transmission in Thailand. This study determined HIV incidence rates among drug users in a regional drug treatment centre in northern Thailand. A retrospective cohort of repeatedly-hospitalized drug users between 1993 and 1997 was formed and HIV incidence rates were calculated. The overall incidence was 11.44 per 100 person-years of observation. Gender, age, religion, ethnicity, education, employment, income, reasons for drug use, type of drugs, mode of use, spending on drugs, and referral for treatment are associated with HIV incidence. However, there are no associations between HIV incidence and history of treatment and mode of discharge from the centre. This implies that current treatment modality has no impact on HIV infection risk and other therapeutic approaches should be explored.
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PMID:HIV incidence rates among drug users in northern Thailand, 1993-7. 1105 70

Drug use is now widespread amongst Australian youth. Substance abuse and dependence are becoming increasingly significant health problems. Approximately 50% of 17-year-old Australians report regular consumption of alcohol and nearly 30% report tobacco smoking. The age of onset of substance use is reported to be decreasing. Between 1993 and 1995 the proportion of heroin users who had used the drug before the age of 16 years increased from 2% to 14%. The debate about youth substance use tends to be polarized between the views of Zero Tolerance and Legalization of drugs. The harm reduction approach spans between these two extremes. Examples of harm reduction strategies, such as education campaigns on safe injecting and needle exchange programs, have been effective in curbing the spread of blood-borne viruses such as HIV amongst intravenous drug using youth. The harm reduction approach, taking social context and developmental stage of the individual into account, may also be applied to adolescents at the less extreme end of the substance use spectrum. It is proposed that the harm reduction framework used in this way enables a rational, relevant and consistent response to contemporary youth substance use, aiming to minimize drug related harm.
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PMID:Putting harm reduction into an adolescent context. 1116 60

Estonia is a country with a low incidence rate of HIV infection, but a high rate of STDs. Drug use is increasing among young people, with an unknown number of users. A considerable number of IVDUs are infected with hepatitis B and C viruses. There are conditions for rapid spread of HIV infection in Estonia. From 1997 to 1999, three prevention projects were carried out with young people by the Estonian Association Anti-AIDS. The idea of preventive strategies was to promote the young people's own decision making about risk behaviour. Interactive learning methods were designed for work with young people. Teachers and peer educators were seen as collaborators in prevention: for them an innovative methodological manual was issued and they were also provided with training sessions. During interactive workshops the project staff learnt from young people background issues such as aspects of their psychosocial and sexual development. From our experience, prevention must be carried out among the young people continuously as they need the development of the motivation and personal insight to establish the goals of personal (and sexual) health.
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PMID:Promotion of safer sexual behaviour and HIV/STD prevention among adolescent students and army recruits. 1117 57

American Indians and Alaska Natives have had low employment in recent history. Drug users also have low employment due to cycles of drug use and relapse,and the impact of the type of drug abused on levels of functioning. Drug use is associated with increased HIV risk through injection drug use, frequency of injection, and needle sharing. Data from three sites of the NIDA Cooperative Agreement for Community Based-Outreach/Intervention Research were analyzed to determine the relationship among race/ethnicity, age, and level of educational attainment on employment and unemployment at intake interview and six-month follow-up. HIV risk for those employed and unemployed was then assessed. American Indian and Alaska Native drug users were younger, less educated, and less likely to have a paid job at both intake and follow-up than non-Native drug users. Those participants who were unemployed at baseline interview who were American Indian/Alaska Native were less likely to transition to employment at six-month follow-up than other race/ethnicity groups in the cohort. However, all participants showed low levels of employment at follow-up. Individuals who were employed at baseline and those who transitioned to employment had lower levels of injection drug use and needle sharing than those who were unemployed at both baseline and follow-up. American Indian and Alaska Native drug users may be at risk for acquisition of HIV due to drug risk behaviors that appear to be associated with unemployment.
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PMID:Unemployment, drug use, and HIV risk among American Indian and Alaska Native drug users. 1127 51

State AIDS Drug Assistance Programs (ADAPs) are the most heavily utilized AIDS programs in the nation, with over 50,000 people with HIV or AIDS enrolled. Initiated in 1987, the federally-funded programs are now running out of money because of increased caseloads and drug usage, higher drug costs, and more expensive combination therapies coupled with stagnant financial resources. Since 1990, the ADAPs have been funded by the Ryan White CARE Act, with each state administering its own ADAP, so eligibility criteria and formularies vary from state to state. Two states, Colorado and Missouri, have already run out of money and others have cut services, limited enrollment or canceled formulary expansions in the face of growing budget constraints. The National Association of State and Territorial AIDS Directors (NASTAD) surveyed state ADAPs and found that budget gaps ranged from $5.9 million in New York to $15,000 in Nebraska, and calculated that a total of $12 million would be needed just to make up the budget gaps for this fiscal year. The shortfall has led AIDS organizations to press for more funds at the state and Federal levels.
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PMID:ADAP faces financial abyss. AIDS Drug Assistance Programs. 1136 81

A study of sexual activity and intravenous drug use in U.S. correctional facilities reveals that condoms, dental dams, and sterile needles should be made available to inmates. The rate of AIDS is 7 times higher among prisoners than among the general population. The study revealed that sexual activity and drug use occurs frequently and usually without the use of measures that would protect inmates from HIV transmission. Focus group participants disclosed that prisoners often exchange sex for drugs, and protection. Drug use is common and inmates reportedly use dirty syringes and use makeshift syringes from unsafe material. An editorial accompanying the study indicates that current measures to prevent HIV transmission in prisons are ineffective and do not recognize the diverse nature of inmates' needs and behavior. It is also noted that making condoms available to male prisoners might be challenging since most male inmates will not acknowledge that they have sex with other men. Female prisoners, however, freely admit to having consensual sex with other female inmates.
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PMID:Study urges prisons to consider condoms, drug needles. 1136 77

Combination therapies that are being prescribed for HIV are complex, confusing to patients, and often involve taking more than 20 pills per day. The side effects can be considerable, and many of the drugs require that they either be taken with food or not be taken at mealtimes. As a result, adherence to the prescribed regimen is difficult. The mechanics of resistance and several studies that demonstrate a correlation between adherence and treatment effectiveness are described. It is difficult to monitor a patient's adherence, primarily because the drug usage in any study is self-reported and prone to errors. Drug testing may be a way to track the varying dosage levels. In some studies, the amount of drugs prescribed has varied by 300 percent to achieve the same blood levels. Adherence to a combination HIV therapy is so complex now that patients need to organize their lives around their treatment regimen, and physicians need to spend extra time with them to make sure they understand both the regimen and the implications of non-compliance.
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PMID:How much does it really matter if you take your pills on time? 1136 10

Harm reduction is a set of practical strategies used for working with drug users to help them choose behaviors that are less risky. The harm reduction approach accepts that illicit drug use occurs, and encourages input from drug users in designing programs and services to help educate themselves. Drug use is a complex problem related to poverty, class, racism, social isolation, and discrimination, and calls for non-judgmental, non-coercive services for the drug using population. Federal money for drug interventions is more often spent on incarcerations and prosecutions, than on education, research, prevention, or treatment. Public policy changes, such as teaching drug users how to lower their risks, may reduce the number of deaths and HIV transmissions among drug users and their partners.
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PMID:Principles of harm reduction. Harm Reduction Coalition. 1136 72

Human Herpes virus type-8 (HHV-8) seroprevalence was studied in a population of HIV positive intravenous drug users (IVDUs) from Argentina. Analysis of this population also indirectly made it possible to study HHV-8 blood transmission, because these individuals frequently engage in needle sharing behavior and are capable of acquiring a broad array of blood borne pathogens, including Hepatitis B/C virus. The seroprevalence of HHV-8 in IVDUs was compared to a group of non-IVDUs and HIV negative individuals. Of the 223 individuals tested, 13.45% were HHV-8 positive, 16.99% in the IVDUs group, and 5.71% in the non-IVDUs. Among HIV positive IVDUs, 25/144 (17.36%) were also HHV-8 seropositive. The seropositivity rate of HHV-8 in HIV negative IVDUs was 11.1%. In contrast, HHV-8 seroprevalence in HIV negative heterosexual individuals without drug usage behavior was even lower (5.71%). The rate of HHV-8 infection in HIV positive IVDUs was three times as high compared to the non IVDU HIV negative individuals, suggesting that IVDU is a risk for HHV-8 infection. Furthermore, it was found that IVDUs showed a very high rate of Hepatitis B/C (52.77%), which also correlate with HHV-8 infection in this population (23.68%). All Hepatitis B/C positive individuals were also HIV positive. Our data confirm other studies showing that individuals who share needles are at risk for acquiring Hepatitis B/C and HIV infections. In addition, our results suggest that they are also at risk to acquiring HHV-8 infection by the same route.
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PMID:Human herpesvirus 8 can be transmitted through blood in drug addicts. 1147 76

This study explored different types of high risk behaviors of Mexican-American college students attending a small university in south Texas. High risk behaviors for contracting HIV/AIDS examined in this study included unprotected sex, drug use, and alcohol abuse. In 1995 in the United States, HIV/AIDS is the leading cause of death in people between the ages of 25 and 44. Because use of alcohol and certain recreational drugs lowers inhibitions, their use could increase the possibility of having unprotected and unplanned sex with multiple partners. Thus, it was expected that Mexican-American college students who use drugs and alcohol would be more likely to engage in unprotected sex. Data were from 105 men and 211 women between the ages of 18 and 30 years. Drug use and alcohol abuse were significantly associated with high risk sexual behavior. Individuals in monogamous relationships were more likely to not use condoms than those involved in casual relationships. Self-reported religiosity was not correlated with high risk behaviors, although there were implications that stronger religious affiliation did alter sexual beliefs and practices. Lastly, parental communication was not significantly associated with high risk behaviors, but family unity did seem related to some risky sexual practices.
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PMID:High risk behaviors in a sample of Mexican-American college students. 1189 72


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