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Webb P, Ireland J, Colledge-Frisby S, Peacock A, Leung J, Vickerman P, Farrell M, Hickman M, Grebely J, Degenhardt L. Patterns of drug use among people who inject drugs: A global systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 128:104455. [PMID: 38796926 DOI: 10.1016/j.drugpo.2024.104455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/28/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND A better understanding of global patterns of drug use among people who inject drugs can inform interventions to reduce harms related to different use profiles. This review aimed to comprehensively present the geographical variation in drug consumption patterns among this population. METHODS Systematic searches of peer reviewed (PsycINFO, Medline, Embase) and grey literature published from 2008-2022 were conducted. Data on recent (past year) and lifetime drug use among people who inject drugs were included. Data were extracted on use of heroin, amphetamines, cocaine, benzodiazepines, cannabis, alcohol, and tobacco; where possible, estimates were disaggregated by route of administration (injecting, non-injecting, smoking). National estimates were generated and, where possible, regional, and global estimates were derived through meta-analysis. RESULTS Of 40,427 studies screened, 394 were included from 81 countries. Globally, an estimated 78.1 % (95 %CI:70.2-84.2) and 71.8 % (65.7-77.2) of people who inject drugs had recently used (via any route) and injected heroin, while an estimated 52.8 % (47.0-59.0) and 19.8 % (13.8-26.5) had recently used and injected amphetamines, respectively. Over 90 % reported recent tobacco use (93.5 % [90.8-95.3]) and recent alcohol use was 59.1 % (52.6-65.6). In Australasia recent heroin use was lowest (49.4 % [46.8-52.1]) while recent amphetamine injecting (64.0 % [60.8-67.1]) and recent use of cannabis (72.3 % [69.9-74.6]) were higher than in all other regions. Recent heroin use (86.1 % [78.3-91.4]) and non-injecting amphetamine use (43.3 % [38.4-48.3]) were highest in East and Southeast Asia. Recent amphetamine use (75.8 % [72.7-78.8]) and injecting heroin use (84.8 % (81.4-87.8) were highest in North America while non-injecting heroin use was highest in Western Europe (45.0 % [41.3-48.7]). CONCLUSION There is considerable variation in types of drugs and routes of administration used among people who inject drugs. This variation needs to be considered in national and global treatment and harm reduction interventions to target the specific behaviours and harms associated with these regional profiles of use.
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Affiliation(s)
- Paige Webb
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
| | - Jeremy Ireland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Samantha Colledge-Frisby
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; National Drug Research Institute (NDRI) Melbourne, Curtin University, Melbourne, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Australia
| | - Peter Vickerman
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, England
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Matthew Hickman
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, England
| | | | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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Horváth M, Farkas-Sütő K, Fábián A, Lakatos B, Kiss AR, Grebur K, Gregor Z, Mester B, Kovács A, Merkely B, Szűcs A. Highlights of right ventricular characteristics of left ventricular noncompaction using 3D echocardiography. IJC HEART & VASCULATURE 2023; 49:101289. [PMID: 38035261 PMCID: PMC10684825 DOI: 10.1016/j.ijcha.2023.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 12/02/2023]
Abstract
Highlights of right ventricular characteristics of left ventricular noncompaction using 3D echocardiography. The aspects of right ventricular volumes and function investigated with 3D echocardiography in a large cohort of left ventricular noncompaction morphology (LVNC) population remains unclear. The objective of our research was to study the left (LV) and right (RV) ventricular parameters using 3D echocardiography and analyze the clinical features of a LVNC population with preserved LV ejection fraction (EF > 50 %) in comparison with healthy controls (HC). We selected 41 LVNC subjects with preserved LV function (EF: 52.91 ± 3 %, male n = 26) and without any comorbidities and compared them with an age and sex-matched HC. Three dimensional endocardial contours were evaluated to determine the following LV and RV parameters: end-diastolic (EDV) and end-systolic (ESV) volumes, stroke volume, EF, LV global longitudinal and circumferential strain and RV septal and free wall longitudinal strain. Regarding the clinical characteristics, the family involvement had a notable proportion, accounting for 51%. The EF and strain values of the LVNC population were significantly decreased in both RV and LV compared to HC. Although the LV volumes of the LVNC group were significantly elevated, the RV volumetric parameters did not differ significantly compared to controls. We found significant correlations between LV and RV volumetric and functional parameters and linear regression models showed that LV EDV and LV ESV determined the RV volumetric values. While the alteration and relationship of the RV parameters may represent the potential of biventricular involvement, clinical characteristics of the LVNC group underlines the necessity of monitoring this population, even with preserved EF.
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Affiliation(s)
- Márton Horváth
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Kristóf Farkas-Sütő
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Alexandra Fábián
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Bálint Lakatos
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Anna Réka Kiss
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Kinga Grebur
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Zsófia Gregor
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Balázs Mester
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Attila Kovács
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
| | - Andrea Szűcs
- Heart and Vascular Center of Semmelweis University, Városmajor str. 68, 1122 Budapest, Hungary
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Rogers AH, Neighbors C, Sharp C, Giordano TP, Woods SP, Zvolensky MJ. The relationship between sex-related alcohol expectancies and hazardous drinking among persons with HIV disease. AIDS Care 2021; 33:1475-1481. [PMID: 33225738 DOI: 10.1080/09540121.2020.1845290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Hazardous drinking is a clinically significant problem among persons with HIV (PWH) disease, and is associated with a number of poor outcomes. Hazardous drinking among PWH is associated with risky substance use and sexual behavior, but little work has examined factors that may be associated with greater hazardous drinking and subsequent risky sexual behaviors among PWH. Research among the general population suggests that sex-related alcohol expectancies, defined as drinking to enhance sexual experience, increase sexual risk-taking, and disinhibition of sexual behavior, are associated with greater hazardous alcohol use and risky sexual behavior, but these relations have not been explored among PWH. Therefore, the current study examined the associations of sex-related alcohol expectancies with hazardous alcohol consumption, dependence, and problems among 146 PWH (Mage = 50.99, SD = 9.41) \ enrolled in a clinical trial examining a personalized feedback intervention to reduce hazardous drinking in primary HIV care. Results showed that only sexual disinhibition-related alcohol expectancies were significantly associated with the criterion variables, such that greater drinking alcohol for sexual disinhibition was associated with greater hazardous drinking behaviors. These results sit on the backdrop of a larger literature documenting the links between disinhibition and hazardous alcohol use and provide explanatory specificity to PWH who are hazardous drinkers.
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Affiliation(s)
- Andrew H Rogers
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Clayton Neighbors
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Carla Sharp
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Thomas P Giordano
- Health Services Research Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Steven P Woods
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Michael J Zvolensky
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA
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Mayer KH, Allan‐Blitz L. Similar, but different: drivers of the disproportionate HIV and sexually transmitted infection burden of key populations. J Int AIDS Soc 2019; 22 Suppl 6:e25344. [PMID: 31468653 PMCID: PMC6716057 DOI: 10.1002/jia2.25344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Kenneth H Mayer
- Beth Israel Deaconess Medical CenterHarvard Medical SchoolThe Fenway InstituteBostonMA
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El-Bassel N, Marotta PL. Alcohol and Sexual Risk Behaviors Among Male Central Asian Labor Migrants and Non-migrants in Kazakhstan: Implications for HIV Prevention. AIDS Behav 2017; 21:183-192. [PMID: 28983808 DOI: 10.1007/s10461-017-1918-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This paper examines the association between alcohol consumption and sexual risk behaviors (unprotected sex, multiple sex partners, sex under influence of drugs or alcohol and commercial sex) in a sample of Central Asian migrant and non-migrant laborers in the largest marketplace in Kazakhstan. We used data from The Silk Road Health Project, conducted from 2010 to 2013 with 1342 male migrant and non-migrant market workers. Participants were selected through respondent driven sampling at the Baraholka Market in Almaty, Kazakhstan. We used regression analyses adjusting for potential confounders to examine the relationship between alcohol consumption and sexual risk behavior. We found that hazardous drinking was associated with an increase in the odds of sex under the influence of drugs (aOR = 6.09, 95% CI 3.48, 10.65; p < .001) and purchasing commercial sex (aOR = 2.02, 95% CI 1.02, 4.02; p < .05). We identified potential targets for HIV interventions to reduce sexual risk behaviors among this key population.
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Goodman-Meza D, Pitpitan EV, Semple SJ, Wagner KD, Chavarin CV, Strathdee SA, Patterson TL. Hazardous drinking and HIV-risk-related behavior among male clients of female sex workers in Tijuana, Mexico. Am J Addict 2014; 23:502-9. [PMID: 25066863 DOI: 10.1111/j.1521-0391.2014.12138.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 02/14/2014] [Accepted: 04/12/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behavior among male clients in Tijuana. METHOD Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous). RESULTS Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs. DISCUSSION AND CONCLUSIONS Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana. SCIENTIFIC SIGNIFICANCE We systematically described patterns and correlates of hazardous alcohol use among male clients of FSWs in Tijuana, Mexico. The results suggest that HIV/STI risk reduction interventions must target hazardous alcohol users, and be tailored to address alcohol use.
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Affiliation(s)
- David Goodman-Meza
- Division of Global Public Health, Department of Medicine, University of California at San Diego, La Jolla, California
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The potential for bridging: HIV status awareness and risky sexual behaviour of injection drug users who have non-injecting permanent partners in Ukraine. J Int AIDS Soc 2014; 17:18825. [PMID: 24560341 PMCID: PMC3929068 DOI: 10.7448/ias.17.1.18825] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 12/17/2013] [Accepted: 01/17/2014] [Indexed: 11/25/2022] Open
Abstract
Objective To quantify potential bridging of HIV transmission between the injection drug using subpopulation to the non-injection drug using population through unprotected heterosexual sex. Design Secondary analysis of cross-sectional data. Methods A sub-sample of participants who reported having a permanent partner who are not injection drug users and have not injected drugs in the past (N=1379) was selected from a survey implemented in 26 Ukrainian cities in 2011. This study evaluates the association between consistent condom use and awareness of HIV status as measured by rapid testing during the study (known/unknown HIV+, known/unknown HIV− and undetermined) among a sub-sample of male injection drug users (IDUs) who have a non-injecting permanent partner. Poisson regression, with robust variance estimates, was utilized to identify associations while adjusting for other factors. Results Reported consistent condom use varied between 15.5% (unknown HIV−) and 37.5% (known HIV+); average use was 19.3%. In multivariate analysis, males who were aware of their HIV+ status were more likely to report recent consistent condom use compared to those who were unaware of their HIV+ status. This association remains after adjustment for age, region, education level, years of injection, alcohol use, self-reported primary drug use and being an NGO client (prevalence ratio=1.65; 95% CI 1.03–2.64). No such association was found for those who were HIV−. Conclusions Our results regarding HIV-positive male IDUs reinforce previous findings that HIV testing and counselling may be an effective means of secondary prevention. Further research is needed to understand how to effectively promote safer sex behaviours for IDUs who are currently HIV−.
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Huang J, Jiang J, Li JZ, Yang X, Deng W, Abdullah AS, Qin B, Upur H, Zhong C, Wang Q, Wang Q, Ruan Y, Zou Y, Ye L, Xie P, Wei F, Xu N, Wei B, Liang H. Prevalence and correlates of sexual risk behaviors among drug users in western China: implications for HIV transmission. AIDS Res Hum Retroviruses 2013; 29:673-80. [PMID: 23210514 DOI: 10.1089/aid.2012.0272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence and correlates of sexual risk behaviors among drug users in western China and the implications for HIV transmission in this population are described. A cross-sectional survey of male drug users was conducted in methadone maintenance therapy clinics and detoxification centers in three western provinces of China between September 2009 and December 2010. Participants in the study completed a questionnaire about demographics, HIV/AIDS knowledge, drug use history, sexual risk behaviors, and other psychosocial variables. Factors associated with HIV sexual risk behaviors were identified by multiple logistic regression analysis. Of 1,304 drug users surveyed, nearly 54% never used condoms during sexual intercourse with a spouse or cohabitant, and this behavior was associated with coming from Chongqing (OR=1.86, p<0.05), being aged 36 and older (OR=5.03, p<0.05), being married or cohabiting (OR=1.68, p<0.05), having first taken drugs at age 30 and above (OR=1.80, p<0.05), and having received AIDS advice or detection from authorities in the past year (OR=1.95, p<0.05). Twenty-six percent had had sex with casual sexual partners in the past year, and this behavior was associated with being married or cohabiting (OR=0.30, p<0.05), first taking drugs at age 31 and above (OR=0.42, p<0.05), and receiving AIDS advice or HIV detection from authorities in the past year (OR=0.70, p<0.05). About 34% never used a condom when having sex with casual sexual partners, and this behavior was associated with coming from Guangxi (OR=2.81, p<0.05) or Chongqing (OR=2.73, p<0.05). Almost 14% had had commercial sex in the past year, and this behavior was associated with coming from Guangxi (OR=6.26, p<0.05) or Chongqing (OR=5.44, p<0.05) and having exchanged needles or received clean needles from the Needle Exchange Centers in the past year (OR=2.76, p<0.05). Nearly 23% had never used condoms when having commercial sex, and this behavior was associated with having received free condoms from authorities in the past year (OR=0.26, p<0.05). Sexual risk behaviors among drug users in Guangxi, Chongqing, and Xinjiang are common. Additional intervention strategies are needed to control the spread of HIV in this population.
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Affiliation(s)
- Jiegang Huang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
| | - Junjun Jiang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
| | - Jonathan Z. Li
- Section of Retroviral Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts
| | - Xiaobo Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Wei Deng
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Abu S. Abdullah
- School of Public Health, Guangxi Medical University, Nanning, China
- Department of Medicine (MISU), Boston Medical Center, Boston, Massachusetts
| | - Bo Qin
- The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Halmurat Upur
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Chaohui Zhong
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qianqiu Wang
- National Center for STD Control, Chinese Center for Disease Control and Prevention, Nanjing, China
| | - Qian Wang
- School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunfeng Zou
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Li Ye
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Peiyan Xie
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Fumei Wei
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Na Xu
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Bo Wei
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hao Liang
- School of Public Health, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory Cultivation Base of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, China
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