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

Research on the relationship between illicit drug use and infectious diseases have primarily focused on the major problem of heroin injection and HIV transmission. Over the past decade, however, research have shown that rates of hepatitis C infection among injection drug users have surpassed those of HIV infection. There has been little systematic study on the relationship between hepatitis C virus (HCV) and the role of methamphetamine (MA) use in the transmission of the virus. This study examined the prevalence of hepatitis C infection among a sample of 723 MA-dependent individuals who sought outpatient treatment from 1999 through 2005. Roughly 15% of the total sample and 44% of the injectors were found to be infected with HCV. Controlling for participant characteristics, we found through multiple logistic regression analyses that HCV infection was more associated with injection use, older age, and female sex. Findings suggest a need for targeted education and prevention efforts about hepatitis C among high-risk MA users, including HCV testing coupled with referrals to HCV treatments.
J Subst Abuse Treat 2006 Sep
PMID:Hepatitis C virus infection among methamphetamine-dependent individuals in outpatient treatment. 1691 48

This randomized placebo-controlled trial tested the efficacy of oral naltrexone with or without fluoxetine for preventing relapse to heroin addiction and for reducing HIV risk, psychiatric symptoms, and outcome. All patients received drug counseling with parental or significant-other involvement to encourage adherence. Patients totaling 414 were approached, 343 gave informed consent, and 280 were randomized (mean age, 23.6 +/- 0.4 years). At 6 months, two to three times as many naltrexone patients as naltrexone placebo patients remained in treatment and had not relapsed, odds ratio (OR) = 3.5 (1.96-6.12), p < .0001. Overall, adding fluoxetine did not improve outcomes, OR = 1.35 (0.68-2.66), p = .49; however, women receiving naltrexone and fluoxetine showed a trend toward a statistically significant advantage when compared to women receiving naltrexone and fluoxetine placebo, OR = 2.4 (0.88-6.59), p = .08. HIV risk, psychiatric symptoms, and overall adjustment were markedly improved among all patients who remained on treatment and did not relapse, regardless of group assignment. More widespread use of naltrexone could be an important addition to addiction treatment and HIV prevention in Russia.
J Subst Abuse Treat 2006 Dec
PMID:Naltrexone with or without fluoxetine for preventing relapse to heroin addiction in St. Petersburg, Russia. 1708 85

We examined the association of substance abuse treatment with access to liver specialty care among 231 persons coinfected with HIV and hepatitis C virus (HCV) with a history of alcohol problems who were recruited and followed up in the HIV-Longitudinal Interrelationships of Viruses and Ethanol cohort study from 2001 to 2004. Variables regarding demographics, substance use, health service use, clinical variables, and substance abuse treatment were from a standardized research questionnaire administered biannually. We defined substance abuse treatment services as any of the following in the previous 6 months: 12 weeks in a halfway house or residential facility, 12 visits to a substance abuse counselor or mental health professional, day treatment for at least 30 days, or any participation in a methadone maintenance program. Liver specialty care was defined as a visit to a liver doctor, a hepatologist, or a specialist in treating hepatitis C in the past 6 months. At study entry, most of the 231 subjects (89%, n = 205) had seen a primary care physician, 50% had been exposed to substance abuse treatment, and 50 subjects (22%) had received liver specialty care. An additional 33 subjects (14%) reported receiving liver specialty care during the follow-up period. In the multivariable model, we observed a clinically important although not statistically significant association between having been in substance abuse treatment and receiving liver specialty care (adjusted odds ratio = 1.38; 95% confidence interval = 0.9-2.11). Substance abuse treatment systems should give attention to the need of patients to receive care for prevalent treatable diseases such as HIV/HCV coinfection and facilitate its medical care to improve the quality of care for individuals with substance use disorders. The data illustrate the need for clinical care models that give explicit attention to the coordination of primary health care with addiction and hepatitis C specialty care while providing ongoing support to engage and retain these patients with complex health needs.
J Subst Abuse Treat 2006 Dec
PMID:Substance abuse treatment and receipt of liver specialty care among persons coinfected with HIV/HCV who have alcohol problems. 1708 95

This study examined the factor structure and reliability of a brief but comprehensive measure, the adolescent risk inventory (ARI), designed to assess adolescent risk behaviors and attitudes. Measures assessing demographics and risk behaviors were administered to 134 youth (ages 12-19) in psychiatric treatment. A confirmatory factor analysis of the four attitude scales (HIV Anxiety, HIV Prevention Self-Efficacy, General Distress, and General Risk) revealed excellent goodness of fit statistics. Exploratory factor analysis of the behavior items revealed three behavior factors (Sex Risk, Abuse/Self-Harm, and Acting Out). The preliminary analysis suggested that all subscales had reasonable internal consistency reliability and appeared to be independent measures, rather than part of a single unitary construct. Differences emerged based on gender, sexual activity status, and trauma history. Exploratory regression analyses revealed that, even when controlling for demographic factors and sex risk attitudes (e.g., HIV Prevention Self-Efficacy), Abuse/self-harm behaviors were highly significantly predictive of sex risk. These analyses suggest that the ARI can be useful in quickly identifying the broad range of risk behaviors found among adolescents with psychiatric disorders.
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PMID:A brief screening measure of adolescent risk behavior. 1710 22

Thirty publications that evaluated health care-based interventions for women who experienced sexual violence were reviewed. The findings highlight that clinicians often need training in the provision sexual assault care, and that not all emergency departments have sexual assault care protocols. Studies examining effectiveness found that Sexual Assault Nurse Examiner programs are very helpful, that health care-based sexual assault treatment settings attract more women than do forensic-based settings, that sexual assault survivors often prefer a combination of medication and counseling treatment, and that preexam administration of a video explaining the collection of forensic evidence may reduce women's stress during the procedure. Studies on postexposure HIV prophylaxis found that many women did not complete the treatment regimen, often because of side effects. Emergency contraception to prevent postrape pregnancy is not consistently offered to women. Only one study reported on abortion as part of the range of sexual assault services.
Trauma Violence Abuse 2007 Jan
PMID:Health care-based interventions for women who have experienced sexual violence: a review of the literature. 1720 97

Countless barriers come between people who are struggling with substance abuse and those charged with providing substance abuse treatment. The check-up, a form of motivational enhancement therapy, is a harm reduction intervention that offers a manner of supporting individuals by lowering specific barriers to reaching those who are untreated. The check-up was originally developed to reach problem drinkers who were neither seeking treatment nor self-initiating change. The intervention, marketed as an opportunity to take stock of one's experiences, involves an assessment and personalized feedback delivered with a counseling style termed motivational interviewing. Check-ups can be offered in care settings to individuals who, as a result of screening, manifest risk factors for specific disorders such as alcoholism. They can also be free-standing and publicized widely to the general public. This paper will discuss illustrations of in-person, computerized, in-school, and telephone applications of the free-standing type of check-up with reference to alcohol consumers, adult and adolescent marijuana smokers, and gay/bisexual males at risk for sexual transmission of HIV. The paper's major focus is to highlight how unique features of each application have the potential of reducing barriers to reaching specific at-risk populations. Also considered are key policy issues such as how check-up services can be funded, which venues are appropriate for the delivery of check-up interventions, pertinent competency criteria in evaluating staff who deliver this intervention, how marketing can be designed to reach contemplators in untreated at-risk populations, and how a check-up's success ought to be defined.
Subst Abuse Treat Prev Policy 2007 Jan 08
PMID:The check-up: in-person, computerized, and telephone adaptations of motivational enhancement treatment to elicit voluntary participation by the contemplator. 1721 75

Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.
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PMID:Triple jeopardy for HIV: substance using Severely Mentally Ill Adults. 1729 27

Drug users are disproportionately affected by hepatitis C virus (HCV), yet they face barriers to health care that place them at risk for levels of HCV-related care that are lower than those of nondrug users. Substance abuse treatment physicians may treat more HCV-infected persons than other generalist physicians, yet little is known about how such physicians facilitate HCV-related care. We conducted a nationwide survey of American Society of Addiction Medicine physicians (n = 320) to determine substance abuse physicians' HCV-related management practices and to describe factors associated with these practices. We found that substance abuse treatment physicians promote several elements of HCV-related care, including screening for HCV antibodies, recommending vaccinations against hepatitis A and B, and referring patients to subspecialists for HCV treatment. Substance abuse physicians who also provide primary medical or HIV-related care were most likely to facilitate HCV-related care. A significant minority of physicians were either providing HCV antiviral treatment or willing to provide HCV antiviral treatment.
J Subst Abuse Treat 2007 Jul
PMID:Hepatitis C management by addiction medicine physicians: results from a national survey. 1737 72

This study compares the provision of HIV testing in a nationally representative sample of correctional agencies and community-based substance abuse treatment programs and identifies the internal organizational-level correlates of HIV testing in both organizations. Data are derived from the Criminal Justice Drug Abuse Treatment Studies' National Criminal Justice Treatment Practices Survey. Using an organizational diffusion theoretical framework [Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: The Free Press], the impact of Centralization of Power, Complexity, Formalization, Interconnectedness, Organizational Resources, and Organizational Size on HIV testing was examined in correctional agencies and treatment programs. Although there were no significant differences in the provision of HIV testing among correctional agencies (49%) and treatment programs (50%), the internal organizational-level correlates were more predictive of HIV testing in correctional agencies. Specifically, all dimensions, with the exception of Formalization, were related to the provision of HIV testing in correctional agencies. Implications for correctional agencies and community treatment to adopt HIV testing are discussed.
J Subst Abuse Treat 2007 Apr
PMID:HIV testing in correctional agencies and community treatment programs: the impact of internal organizational structure. 1738 54

This article reviews 35 U.S. studies on the intersection of HIV and adult intimate partner violence (IPV). Most studies describe rates of IPV among women at risk or living with HIV/AIDS and identify correlates, using multiple types of convenience samples (e.g., women in methadone treatment, women in shelters or clinics), cross-sectional designs, and self-reported risk behaviors. HIV-positive women appear to experience any IPV at rates comparable to HIV-negative women from the same underlying populations; however, their abuse seems to be more frequent and more severe. The authors found only four relevant interventions and none addressed sexually transmitted HIV and partner violence risk reduction simultaneously. There is a critical need for research on (a) causal pathways and cumulative effects of the syndemic issues of violence, HIV, and substance abuse and (b) interventions that target IPV victims at risk for HIV, as well as HIV-positive women who may be experiencing IPV.
Trauma Violence Abuse 2007 Apr
PMID:HIV/AIDS and intimate partner violence: intersecting women's health issues in the United States. 1754 73


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