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

Evidence suggests that stimulant use may exacerbate the deleterious cognitive effects of HIV, and that it has similar neuropathological consequences. In the current study, we examined the effect of recent stimulant use on sustained attention in adults infected with HIV. The sample consisted of 23 non-drug users and 17 stimulant users (cocaine and/or methamphetamine), all who were HIV-positive. Drug use was determined via urine toxicology. Sustained attention was assessed with the Conners' Continuous Performance Task--second edition (CPT-II). Groups were compared on overall performance variables, as well as patterns of performance across time. Compared to the non-drug users, stimulant users showed a gradual increase in reaction time variability and omission errors. Stimulant users' scores indicated impaired vigilance relative to an age and gender-matched normative sample. The groups were equivalent on other measures of attention, global neuropsychological functioning, mood, and demographic variables. The results indicate that recent stimulant use among HIV-infected adults adversely affects sustained attention.
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PMID:The effect of recent stimulant use on sustained attention in HIV-infected adults. 1644 74

The study examined South African adolescents' beliefs and attitudes regarding drug use, sexual risk behaviour and relationships between the two behaviours. Eleven single-gender focus groups were held among male and female Grade 8 and 11 students from three schools in Cape Town. The adolescents' opined that drugs' reinforcing effects were the main factor underlying their use, and that sexual risk behaviours resulted from girls' limited power in sexual relationships and boys' perceived invulnerability to HIV infection and the positive status associated with having multiple partners. Drug use was considered to exacerbate underlying vulnerabilities to risky sexual behaviour mainly due to drugs' effects on adolescents' inhibitions, rational thinking, and safer sex negotiation skills. The findings suggest that adolescent HIV intervention programmes should address the risks posed by drug use on sexual behaviour.
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PMID:Perceptions of sexual risk behaviours and substance abuse among adolescents in South Africa: a qualitative investigation. 1654 81

Drug use and HIV infection may affect sex hormone levels in women. One hundred and ninety-six women with and without a history of illicit drug use (50 HIV-negative and 148 HIV-infected), with regular menses, who never used antiretrovirals, were evaluated. Luteinizing hormone levels were significantly higher in women with a CD4 cell count <200/microl (p < 0.002). Current methadone use was associated with lower levels of total testosterone (p = 0.03) and higher levels of prolactin (p = 0.002); mean estradiol levels were 43% lower in women who used intravenous drugs (p < 0.001). Alcohol and crack cocaine use was not associated with sex hormone levels. Age, race, body mass index and degree of HIV immunosuppression were also associated with differences in sex hormone levels.
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PMID:The effects of illicit drug use and HIV infection on sex hormone levels in women. 1678 44

Until recently, Malaysia has lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. By the end of 2004, 234,000 heroin users or heroin-dependent individuals had been registered in the official government registry, but other estimates exceed 500,000 for heroin abusers in the country. Amphetamine-type stimulant abuse is also increasing and of considerable public and government concern. Among the population of drug users, HIV and other infectious diseases rates are very high. In the Western Pacific regions, Malaysia has the second highest HIV prevalence (after Vietnam) among adult populations (0.62%) and the highest proportion of HIV cases resulting from injection drug use (76.3%). Drug use and related disorders exert a heavy burden on the country's health care and legal systems. Historically, drug abusers were rehabilitated involuntarily in correctional, rather than health-care, facilities. This primarily criminal treatment approach had limited effectiveness which led to widespread public dissatisfaction and the recent introduction of medical treatments for addiction. Naltrexone was introduced in 1999; buprenorphine was introduced in 2001 and methadone in 2003. Agonist maintenance programmes were embraced rapidly by the medical community in Malaysia. Currently, over 30,000 opiate-dependent patients are treated with agonist maintenance treatments by more than 500 medical practitioners in Malaysia. Despite these recent advances, treatments for amphetamine-type stimulant abuse or dependence are underdeveloped, and diversion of agonist medications is an emerging concern.
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PMID:New challenges and opportunities in managing substance abuse in Malaysia. 1693 45

The stability of living situation was examined as a predictor of young people's HIV-related sexual and drug use acts two years after leaving home for the first time. Newly homeless youth aged 12-20 years were recruited in Los Angeles County, California, U.S.A. (n = 261) and Melbourne, Australia (n = 165) and followed longitudinally at 3, 6, 12, 18, and 24 months. Their family history of moves and the type and frequency of moves over the two years following becoming newly homeless were examined. Regression analyses indicated that recent sexual risk two years after becoming newly homeless was not related to the instability of youths' living situations; condom use was higher among youth with more placements in institutional settings and among males. Drug use was significantly related to having moved more often over two years and Melbourne youth used drugs significantly more than youth in Los Angeles.
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PMID:Housing stability over two years and HIV risk among newly homeless youth. 1749 19

We studied predictors of HIV-related sexual risk-taking among individuals who initiated the use of heroin or methamphetamine during the past 5 years. Many studies have linked drug use to HIV risk and most research has been based on samples of users with long-established drug careers. We conducted face-to-face interviews with 153 adult new drug users in Atlanta, GA. Drug use was not a statistically significant predictor of sexual risk, but gender, age, race, homelessness status, childhood neglect, level of paranoia, and level of (dys)functionality in handling disagreements were associated with the frequency of sexual risk-taking. We discuss the need to incorporate new drug users in HIV/AIDS and other health-related prevention and intervention programs.
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PMID:Predictors of sexual risk-taking among new drug users. 1759 53

Previous research with travelers points to higher risk behaviors during vacations. Relative to their day-to-day lives, leisure travelers have more free time to pursue sexual activities and are likely to engage in higher rates of substance use than when at home. Risk behaviors during vacation have not been thoroughly examined in men who have sex with men (MSM), a key group at risk for HIV. The present investigation examined substance use, sexual risk behaviors, and components of the Information-Motivation-Behavioral Skills (IMB) Model in MSM attending Mardi Gras celebrations in New Orleans. Almost half of the sexually active men reported having sex with a partner of unknown HIV status while in New Orleans and a similar number did not disclose their own HIV status to all of their sexual partners. Drug use and excessive alcohol use were associated with unprotected sex (ps < .05). Components of the IMB model also predicted sexual risk behavior: individuals with more accurate HIV transmission information reported fewer unprotected sex acts, and motivation to engage in sexual activity on vacation was associated with more unprotected sex (ps < .05). Findings suggest that some MSM on vacation are placing themselves at risk for HIV. Traditional HIV prevention interventions do not readily lend themselves for use with transient populations. New intervention approaches are needed to reduce sexual risk behaviors in persons traveling for leisure.
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PMID:Sexual risk behavior in men attending Mardi Gras celebrations in New Orleans, Louisiana. 1792 5

Drug use, commercial sex work, and migration each play a role in the spread of HIV in the Caribbean, yet the intersection of these factors in the region is not well understood. This paper explores the connections between substance use and HIV risk among migrant female sex workers in the US Virgin Islands. Participants were located through targeted sampling techniques in Christiansted and Frederiksted, St. Croix, and Charlotte Amalie, St. Thomas where 101 women were interviewed regarding their drug use, sexual behaviours, migration patterns and health status. In the month prior to interview, 25.7% reported no substance use, 57.4% reported alcohol use only and 16.8% indicated use of an illicit drug. Drug using sex workers reported a significantly greater number of past-month sexual partners than alcohol-only and non-drug users. In logistic regression analyses, illicit drug users were significantly more likely to report unprotected sexual activity, client violence and sexually transmitted infections as well. In addition, illicit drug users engaged in sex work in a significantly greater number of countries and were more likely to work in locations outside the US Virgin Islands. The intersection of multiple risk factors for HIV identified among drug-involved sex workers in the region, including unprotected sexual activity with multiple partners, violent victimization and migration between high and low HIV-prevalence areas, suggests that illicit drug use may play an important role in driving the growing heterosexual HIV epidemic in the Caribbean.
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PMID:Sex work in the Caribbean Basin: patterns of substance use and HIV risk among migrant sex workers in the US Virgin Islands. 1807 71

The purpose of this investigation was to consider person characteristics, treatment level variables, and illicit drug use to help explain the HIV antiviral adherence patterns of a community-based, non-drug-treatment-seeking sample of men who have sex with men (MSM). Adherence data were gathered for 300 MSM eight times over the course of 1 year using electronic monitoring. Treatment and person level characteristics were assessed at baseline assessment using computer-administered surveys, and drug usage was established via a diagnostic inventory. These longitudinal data were analyzed via Hierarchical Linear Modeling. The sample was diverse in terms of age and race/ethnicity. Across the span of the year in which the participants were assessed, adherence rates were relatively stable and high (means: 82% to 90%) at each time point and remained relatively stable across the yearlong investigation. Lower adherence rates were evident among those who were drug users, black identified (in terms of race), older, and by pill burden. Individuals on HIV antiretroviral therapy demonstrated consistent although not optimal adherence rates when assessed during the course of a year. The significance of numerous person level factors such as age, race, and drug use suggest that adherence to treatment may in part be impacted by the circumstances that the individual brings to the treatment behavior, and suggests interventions that delve beyond the behavioral to consider and address life social and intrapersonal circumstances that may interfere with adherence behaviors.
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PMID:Analysis of HIV medication adherence in relation to person and treatment characteristics using hierarchical linear modeling. 1829 Jul 34

We examined the role of drug use and addiction in same-sex sexuality among non-gay-identifying African American men who have sex with men or with both men and women (MSM/MSMW). Between July 2005 and February 2006, we conducted seven focus groups with 46 predominately low socioeconomic status African American MSM/MSMW. A total of 29 men self-identified as HIV-infected and 17 self-identified as uninfected. Focus group transcripts were analyzed using consensual qualitative research techniques. Alcohol, crack cocaine, and crystal methamphetamine were the primary drugs mentioned by participants. Drug use was identified as playing a central role in same-sex sexuality for many African American MSM/MSMW. Participants described alcohol use and drug transactions, use, and addiction as motivating sex with men, allowing and rationalizing same-sex activity and unprotected sex, and facilitating access to male sex partners. Some of those in treatment for substance abuse indicated that a readiness to admit their same-sex activity and come to terms with their homosexuality/bisexuality was necessary for recovery. Because successful engagement of non-gay-identifying African American MSM/MSMW is essential to the reduction of HIV transmission and substance abuse in Black communities, findings call for drug treatment approaches that acknowledge and accept diverse sexuality in clients. Service providers and policy-makers may be guided by these findings toward building cultural competency among direct service staff. Future research should examine interrelated dynamics of sexual activity, identity, and drug use as they evolve within individual African American MSM/MSMW and compare the frequency with which sex, condom use, and substance use co-occur with male versus female partners.
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PMID:Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. 1854 69


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