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

The Women Helping to Empower and Enhance Lives (WHEEL) Project focused on female sexual partners of injection drug users (i.d.u.s). It was conducted in five sites, three within and two outside the continental United States. The study's two main intervention goals were to (a) reduce HIV-related sexual risk behaviors and (b) reduce HIV-related drug risk behaviors. The Project also featured needs assessment, planning, and staff training components. Baseline data were collected on 2,794 women, which made this the largest study of noninjecting female sexual partners of i.d.u.s in the United States. Six-month follow-up data were obtained on 1,953 women. The Wheel Project tested two interventions: an individual intervention and a group intervention. The study found significant reductions in drug use and risky sexual behaviors for the 6-month follow-up sample for both interventions. These changes were substantial and point to the viability of both interventions for this population of sexual partners of injection drug users.
J Subst Abuse Treat
PMID:The Wheel Project. Women Helping to Empower and Enhance Lives. 925 55

We provide a descriptive analysis of patients with a substance abuse diagnosis in Maryland hospitals in 1991. The intent of the study was not to model relationships between substance abuse and other outcomes (e.g., length of stay), but was to obtain a better understanding of the population receiving inpatient care and to motivate future research. We found that the majority of patients with a substance abuse diagnosis were male, African-American, single, and between the ages of 15 and 44. Medicaid was overwhelmingly the primary payer for their care. These patients were diagnosed with chronic liver disease, pancreas diseases, HIV infection, a number of psychiatric disorders, and respiratory symptoms. We surprisingly found that the average length of stay was shorter for patients with a substance abuse diagnosis and that their average charges were only slightly higher than other patients. We also found that substance abuse patients enter the hospital through the emergency room and the majority leave the hospital against medical advice.
J Subst Abuse Treat
PMID:An inpatient profile of patients with a substance abuse diagnosis in Maryland. 925 60

The prevalence of HIV infection among drug-dependent patients in Saudi Arabia was investigated for the first time in a study conducted at the Al Amal Hospital in Jeddah. 2628 men admitted to this rehabilitation facility from January 1995 to May 1996 were screened for HIV-1 and/or HIV-2. 81.2% of participants were aware of HIV/AIDS and two-thirds knew that the virus can be transmitted by sharing needles and syringes. Five samples were positive by enzyme immunoassay, but only 4 were confirmed by Western blot, for an HIV prevalence of 0.15%. An earlier report on drug-dependent Saudi nationals at this hospital found that at least 80% used the parenteral route of administration. In the 4 confirmed HIV cases in the present series, the risk factor was intravenous drug use in 2 cases, multiple sexual partners in 1 case, and both intravenous drug use and multiple sexual partners in another case. The low HIV prevalence detected in this study among a high-risk group suggests that Saudi Arabia is in a pre-epidemic stage. However, community-based data are necessary to establish the true situation in the country. Recommended, to prevent HIV spread among drug-dependent patients and into the community, are continued public awareness campaigns on the modes of HIV infection.
J Subst Abuse Treat
PMID:The prevalence of human immunodeficiency virus among drug-dependent patients in Jeddah, Saudi Arabia. 943 19

The diagnosis and management of infectious complications associated with injection drug use (IDU) are among some of the more challenging aspects of working with substance abusing populations. As the population of injection drug users age, we expect the number and severity of these complications to increase. Commonly seen infections, such as bacterial endocarditis and bacterial infections of bones, joints, and soft tissue, are now frequently complicated by concurrent immunodeficiency. Parenterally and sexually transmitted viral hepatitis is responsible for significant IDU morbidity and mortality. The human leukemia/lymphoma virus types I and II are increasing in prevalence in the IDU with uncertain long-term clinical effects. Immune dysfunction has been described in the IDU for decades, but the impact of host immune compromise on the transmission and the course of HIV-1 has yet to be fully appreciated. The integration of the treatment of substance abuse and its concurrent psychiatric disorders with the management of infectious complications, including immunodeficiency, promises to improve patient compliance with possible savings of overall medical costs.
J Subst Abuse Treat
PMID:Current management of infectious complications in the injecting drug user. 956 47

HIV-seropositive opioid-dependent patients maintained on an opiate-agonist who continue to use cocaine and to engage in other high-risk behaviors may benefit from enhanced treatment services; however, there is currently little data to guide the formulation of such services. We report on a preliminary study in which six HIV-seropositive opioid-and cocaine-dependent patients were provided a 12-week comprehensive pharmacologic/psychosocial treatment program developed specifically to meet the treatment needs of HIV-seropositive drug users. This program was comprised of buprenorphine (12 mg/day), bupropion (150 mg/day), and twice weekly manual-guided group therapy. Results showed significant decreases in intravenous cocaine use, cocaine craving, and symptoms of depression. A post-hoc comparison to outcomes of eight HIV-seropositive patients receiving standard methadone-maintenance found no improvements for patients receiving standard care. Controlled investigation of enhanced drug treatment programs for HIV-seropositive patients may be warranted.
J Subst Abuse Treat
PMID:A comprehensive pharmacologic-psychosocial treatment program for HIV-seropositive cocaine- and opioid-dependent patients. Preliminary findings. 963 38

Substance abusers with HIV/AIDS have a complex array of problems that are not easily addressed in outpatient or long-term residential programs. A new but promising treatment modality is residential detoxification for substance abusers with HIV/AIDS, such as described by this paper. The purpose of the program is profiled, as well as its general components and the aspects that address the special needs of HIV clients. Data indicating the successes and limitations of the program are presented, along with recommendations for further addressing the needs of substance abuses with HIV/AIDS.
J Subst Abuse Treat 1999 Jan
PMID:Residential detoxification for substance abusers with HIV/AIDS. Walden House Detoxification Program. 988 26

Thirty adolescents aged 12-18 years from each group (substance use disorders, psychiatric disorders, and controls) were assessed to explore HIV-risk behaviors and knowledge about HIV/AIDS. Semi-structured instruments for psychiatric and substance use disorders were also administered. There were no significant differences between groups in knowledge of HIV/AIDS. However, chi-square analysis of risk behaviors revealed significant differences between the substance use disorders group and the controls. The knowledge-behavior gap was greater for the substance users than all other groups, in that while they knew an equal amount about HIV/AIDS, they actually engaged in more risky sexual behaviors than the other two groups. It may be that the impulsivity associated with substance use disorders accounts for this difference. It is recommended that HIV/AIDS prevention education and impulse control strategies are included in the treatment of adolescents with substance use disorders.
J Subst Abuse Treat 1999 Mar
PMID:HIV-risk behaviors in adolescent substance abusers. 1002 16

Tuberculosis is an important health issue among drug users. We sought to evaluate active drug users' (DUs) knowledge of tuberculosis (TB) and to assess the relationship between TB knowledge and attitudes and tuberculin skin test (TST) return rates at a syringe exchange program. DUs were recruited at a syringe exchange program in New York City, were interviewed and offered TSTs, and received $15.00 upon returning for TST reading. The questionnaire evaluated knowledge of TB transmission, prevention, and treatment. From March 13, 1995 to January 31, 1996, 610 of 650 (94%) of DUs approached agreed to participate. Of these, 80% had previous TSTs within the past 2 years and 20% were known to be HIV infected. Almost all knew that TB is contagious and more than two thirds knew that TB is treatable and that TB preventive therapy existed. However, fewer than half knew that HIV-related TB could be treated, 30% thought TB could be treated without a medical doctor, and the majority (70%) thought a reactive TST implied infectivity. The rate of return for TST reading was 93%. In multivariate analysis, those who knew that HIV-related TB was curable were more likely to return for TST reading (odds ratio 2.0; 95% confidence interval 1.04 to 3.95; p = .03). The high acceptance and return rates suggest that TB services can be incorporated into syringe exchange programs. However, several important gaps in TB knowledge existed in this population at high risk of TB, which may impact on adherence and which support the need for TB education for drug users.
J Subst Abuse Treat 1999 Apr
PMID:Knowledge of tuberculosis among drug users. Relationship to return rates for tuberculosis screening at a syringe exchange. 1019 40

The Transtheoretical, or Stages of Change Model, has been applied to the investigation of help-seeking related to a number of addictive behaviors. Overall, the model has shown to be very important in understanding the process of help-seeking. However, substance abuse rarely exists in isolation from other health, mental health, and social problems. The present work extends the original Stages of Change Model by proposing "Steps of Change" as they relate to entry into substance abuse treatment programs for women. Readiness to make life changes in four domains-domestic violence, HIV sexual risk behavior, substance abuse, and mental health-is examined in relation to entry into four substance abuse treatment modalities (12-step, detoxification, outpatient, and residential). The Steps of Change Model hypothesizes that help-seeking behavior of substance-abusing women may reflect a hierarchy of readiness based on the immediacy, or time urgency, of their treatment issues. For example, women in battering relationships may be ready to make changes to reduce their exposure to violence before admitting readiness to seek substance abuse treatment. The Steps of Change Model was examined in a sample of 451 women contacted through a substance abuse treatment-readiness program in Los Angeles, California. A series of logistic regression analyses predict entry into four separate treatment modalities that vary. Results suggest a multidimensional Stages of Change Model that may extend to other populations and to other types of help-seeking behaviors.
J Subst Abuse Treat 2000 Apr
PMID:Women's steps of change and entry into drug abuse treatment. A multidimensional stages of change model. 1074 36

The objective of this study was to compare the prevalence of major depression in two cohorts of injection drug users, those enrolled in a Rhode Island Methadone Maintenance Treatment Program (MMTP) and those enrolled in a Rhode Island Needle Exchange Program (NEP) using cross-sectional interviews. Symptomatic and duration criteria for major depression in the last 6 months were identified using the Structured Clinical Interview for DSM-III-R (SCID). Among 528 persons interviewed, 54% of those in NEP and 42% of those in MMTP met criteria for major depression. Using multivariate logistic regression, women (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.7-3.7), persons with alcohol use disorders (OR 1.7; 95% CI 1.1-2. 7), and persons without a current partner (OR 1.8; 95% CI 1.2-2.6) were more likely to be depressed controlling for age, race, education and HIV status. Persons enrolled in MMTP were less likely to be depressed (OR 0.6; 95% CI 0.4-0.8) than NEP. Higher rates of depression were found among NEP attendees than among those enrolled in MMTP. Mental health referrals should be part of the growing number of needle exchanges in the United States.
J Subst Abuse Treat 2000 Jun
PMID:Depression among needle exchange program and methadone maintenance clients. 1081 5


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