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Mackesy-Amiti ME, Boodram B, Page K, Latkin C. Injection partnership characteristics and HCV status associations with syringe and equipment sharing among people who inject drugs. BMC Public Health 2023; 23:1191. [PMID: 37340398 PMCID: PMC10283252 DOI: 10.1186/s12889-023-16133-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Sharing of syringes is the leading transmission pathway for hepatitis C (HCV) infections. The extent to which HCV can spread among people who inject drugs (PWID) is largely dependent on syringe-sharing network factors. Our study aims to better understand partnership characteristics and syringe and equipment sharing with those partners, including measures of relationship closeness, sexual activity, and social support, as well as self and partner HCV status to better inform interventions for young urban and suburban PWID. METHODS Data are from baseline interviews of a longitudinal network-based study of young (aged 18-30) PWID (egos) and their injection network members (alters) in metropolitan Chicago (n = 276). All participants completed a computer-assisted interviewer-administered questionnaire and an egocentric network survey on injection, sexual, and support networks. RESULTS Correlates of syringe and ancillary equipment sharing were found to be similar. Sharing was more likely to occur in mixed-gender dyads. Participants were more likely to share syringes and equipment with injection partners who lived in the same household, who they saw every day, who they trusted, who they had an intimate relationship with that included condomless sex, and who provided personal support. PWID who had tested HCV negative within the past year were less likely to share syringes with an HCV positive partner compared to those who did not know their status. CONCLUSION PWID regulate their syringe and other injection equipment sharing to some extent by sharing preferentially with injection partners with whom they have a close personal or intimate relationship, and whose HCV status they are more likely to know. Our findings underscore the need for risk interventions and HCV treatment strategies to consider the social context of syringe and equipment sharing within partnerships.
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Affiliation(s)
- Mary Ellen Mackesy-Amiti
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA.
| | - Basmattee Boodram
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
| | - Kimberly Page
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Carl Latkin
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Yang C, Yang J, Davey-Rothwell M, Latkin C. Social network perspective on alcohol consumption among African American women: a longitudinal analysis. ETHNICITY & HEALTH 2018; 23:503-510. [PMID: 28277027 PMCID: PMC5550363 DOI: 10.1080/13557858.2017.1290215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of the study was to examine alcohol use in African American women's social networks. DESIGN This was a longitudinal study of African American women and their social networks in Baltimore, MD. Data were collected through face-to-face interviews at a community-based research clinic. Alcohol consumption frequency was assessed by a single question 'How often do you drink alcohol?' with a four-point ordinal rating scale 'never,' 'monthly or less,' '2-4 times a month' and '>2 times a week.' A longitudinal ordinal logistic model was conducted to use 317 African American women's alcohol consumption frequency as a predictor of their social networks' alcohol consumption frequency. RESULTS Results show that African American women's alcohol consumption frequency was a statistically significant predictor of their social network members' alcohol consumption frequency. CONCLUSION Findings suggest the merit of social network-based approaches to address alcohol use among urban minority populations.
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Affiliation(s)
- Cui Yang
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Jingyan Yang
- b Department of Epidemiology, Mailman School of Public Health , Columbia University , New York , USA
| | - Melissa Davey-Rothwell
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Carl Latkin
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
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Dombrowski K, Khan B, Habecker P, Hagan H, Friedman SR, Saad M. The Interaction of Risk Network Structures and Virus Natural History in the Non-spreading of HIV Among People Who Inject Drugs in the Early Stages of the Epidemic. AIDS Behav 2017; 21:1004-1015. [PMID: 27699596 PMCID: PMC5344741 DOI: 10.1007/s10461-016-1568-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This article explores how social network dynamics may have reduced the spread of HIV-1 infection among people who inject drugs during the early years of the epidemic. Stochastic, discrete event, agent-based simulations are used to test whether a "firewall effect" can arise out of self-organizing processes at the actor level, and whether such an effect can account for stable HIV prevalence rates below population saturation. Repeated simulation experiments show that, in the presence of recurring, acute, and highly infectious outbreaks, micro-network structures combine with the HIV virus's natural history to reduce the spread of the disease. These results indicate that network factors likely played a significant role in the prevention of HIV infection within injection risk networks during periods of peak prevalence. They also suggest that social forces that disturb network connections may diminish the natural firewall effect and result in higher rates of HIV.
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Affiliation(s)
- Kirk Dombrowski
- Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA.
| | - Bilal Khan
- Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA
| | - Patrick Habecker
- Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA
| | - Holly Hagan
- College of Nursing, New York University, New York, NY, USA
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Frimpong JA, D'Aunno T, Perlman DC, Strauss SM, Mallow A, Hernandez D, Schackman BR, Feaster DJ, Metsch LR. On-site bundled rapid HIV/HCV testing in substance use disorder treatment programs: study protocol for a hybrid design randomized controlled trial. Trials 2016; 17:117. [PMID: 26936623 PMCID: PMC4776446 DOI: 10.1186/s13063-016-1225-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/10/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND More than 1.2 million people in the United States are living with human immunodeficiency virus (HIV), and 3.2 million are living with hepatitis C virus (HCV). An estimated 25 % of persons living with HIV also have HCV. It is therefore of great public health importance to ensure the prompt diagnosis of both HIV and HCV in populations that have the highest prevalence of both infections, including individuals with substance use disorders (SUD). METHODS/DESIGN In this theory-driven, efficacy-effectiveness-implementation hybrid study, we will develop and test an on-site bundled rapid HIV/HCV testing intervention for SUD treatment programs. Its aim is to increase the receipt of HIV and HCV test results among SUD treatment patients. Using a rigorous process involving patients, providers, and program managers, we will incorporate rapid HCV testing into evidence-based HIV testing and linkage to care interventions. We will then test, in a randomized controlled trial, the extent to which this bundled rapid HIV/HCV testing approach increases receipt of HIV and HCV test results. Lastly, we will conduct formative research to understand the barriers to, and facilitators of, the adoption, implementation, and sustainability of the bundled rapid testing strategy in SUD treatment programs. DISCUSSION Novel approaches that effectively integrate on-site rapid HIV and rapid HCV testing are needed to address both the HIV and HCV epidemics. If feasible and efficacious, bundled rapid HIV/HCV testing may offer a scalable, potentially cost-effective approach to testing high-risk populations, such as patients of SUD treatment programs. It may ultimately lead to improved linkage to care and progress through the HIV and HCV care and treatment cascades. TRIAL REGISTRATION ClinicalTrials.gov: NCT02355080 . (30 January 2015).
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Affiliation(s)
- Jemima A Frimpong
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, USA.
| | - Thomas D'Aunno
- Robert F. Wagner Graduate School of Public Service, New York University, New York, USA.
| | - David C Perlman
- Mount Sinai Beth Israel; Ichan School of Medicine at Mount Sinai, New York, USA.
| | | | - Alissa Mallow
- Montefiore Health System, New York, USA, New York, USA.
| | - Diana Hernandez
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA.
| | - Bruce R Schackman
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, USA.
| | - Daniel J Feaster
- Division of Biostatistics, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, USA.
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA.
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Wilkerson JM, Noor SW, Breckenridge ED, Adeboye AA, Rosser BRS. Substance-use and sexual harm reduction strategies of methamphetamine-using men who have sex with men and inject drugs. AIDS Care 2015; 27:1047-54. [PMID: 25837492 DOI: 10.1080/09540121.2015.1020280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Research indicates that men who have sex with men (MSM), use methamphetamine, and inject drugs are at high risk of HIV infection and they employ multiple harm reduction strategies simultaneously to reduce that risk. In this study, we identified substances most commonly injected and harm reduction strategies most often employed by methamphetamine-using MSM, used latent class analysis (LCA) to identify patterns of harm reduction strategies, and differentiated MSM within each class by individual characteristics. We analyzed data from 284 participants who completed an online cross-sectional survey. Commonly injected substances were methamphetamine (93.70%), gamma-hydroxybutyrate/gamma-butyrolactone (41.55%), flunitrazepam (40.49%), and cocaine (35.56%). The substance-use strategies most often used were avoidance of sharing needles (85.92%) and use of bleach to clean drug paraphernalia (64.08%). The sexual strategy most often used was avoidance of condomless anal intercourse (CAS) while using drugs (77.11%). Using an LCA approach, we identified three classes distinguishable by age, race/ethnicity, and outness. One class (19%) employed lay strategies to reduce harm: they avoided sharing drug preparation equipment, serosorted when sharing needles and equipment or having CAS, and practiced withdrawal when having CAS. The largest class (53%) combined sexual and substance-use strategies: they avoided sharing needles, used bleach to clean needles and equipment, avoided CAS when using drugs, and used extra lubricant when having CAS. The remaining class (28%) employed only substance-use rather than sexual strategies. More MSM of color were in the substance-use class, and more young, non-Hispanic White men were in the lay class. The low utilization of sexual strategies by younger, non-Hispanic White men in the lay class is concerning as they are just as likely as older, non-Hispanic White men in the combined class to have CAS with multiple male partners. Interventionists should consider these differences when developing interventions tailored to methamphetamine-using MSM.
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Affiliation(s)
- J Michael Wilkerson
- a Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health , The University of Texas Health Science Center at Houston (UTHealth) , Houston , TX , USA
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Kim AY, Page K. Hepatitis C virus serosorting in people who inject drugs: sorting out the details. J Infect Dis 2013; 208:1929-31. [PMID: 24136791 DOI: 10.1093/infdis/jit526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Arthur Y Kim
- Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston
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Smith BD, Jewett A, Burt RD, Zibbell JE, Yartel AK, DiNenno E. "To share or not to share?" Serosorting by hepatitis C status in the sharing of drug injection equipment among NHBS-IDU2 participants. J Infect Dis 2013; 208:1934-42. [PMID: 24136794 DOI: 10.1093/infdis/jit520] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Persons who inject drugs (PWID) are at high risk for acquiring hepatitis C virus (HCV) infection. The Centers for Disease Control and Prevention estimates there are 17 000 new infections per year, mainly among PWID. This study examines injection equipment serosorting-considering HCV serostatus when deciding whether and with whom to share injection equipment. OBJECTIVE To examine whether injection equipment serosorting is occurring among PWID in selected cities. METHODS Using data from the National HIV Behavioral Surveillance System-Injection Drug Users (NHBS-IDU2, 2009), we developed multivariate logistic regression models to examine the extent to which participants' self-reported HCV status is associated with their injection equipment serosorting behavior and knowledge of last injecting partner's HCV status. RESULTS Participants who knew their HCV status were more likely to know the HCV status of their last injecting partner, compared to those who did not know their status (HCV+: adjusted odds ratio [aOR] 4.1, 95% confidence interval [CI], 3.4-4.9; HCV-: aOR 2.5, 95% CI, 2.0-3.0). Participants who reported being HCV+, relative to those of unknown HCV status, were 5 times more likely to share injection equipment with a partner of HCV-positive status (aOR 4.8, 95% CI, 3.9-6.0). CONCLUSIONS Our analysis suggests PWID are more likely to share injection equipment with persons of concordant HCV status.
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Affiliation(s)
- Bryce D Smith
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
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Current World Literature. Curr Opin Allergy Clin Immunol 2012; 12:440-5. [DOI: 10.1097/aci.0b013e328356708d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mizuno Y, Purcell DW, Metsch LR, Gomez CA, Knowlton AR, Latka MH. Is injection serosorting occurring among HIV-positive injection drug users? Comparison by injection partner's HIV status. J Urban Health 2011; 88:1031-43. [PMID: 21503815 PMCID: PMC3232423 DOI: 10.1007/s11524-011-9578-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research needs to build evidence for the roles that HIV status of injection partners may or may not play in injection risk behaviors of injection drug users (IDUs). Using baseline data collected from a randomized controlled study (INSPIRE) conducted in four cities (Baltimore, Miami, New York, and San Francisco) from 2001 to 2005, we categorized 759 primarily heterosexual HIV-positive IDUs into four groups based on HIV serostatus of drug injection partners. Thirty-two percent of the sample injected exclusively with HIV-positive partners in the past 3 months and more than 60% had risky injection behavior with these partners. Eight percent injected exclusively with HIV-negative partners and 49% injected with any unknown status partners. The remaining 11% reported having both HIV-positive and -negative injection partners, but no partners of unknown HIV status. Riskier injection behavior was found among the group with mixed status partners. The risk among the group with any unknown status partners appeared to be driven by the greater number of injection partners. No major group differences were observed in socio-demographic and psychosocial factors. Our analysis suggests that serosorting appeared to be occurring among some, but not an overwhelming majority of HIV-positive IDUs, and knowledge of HIV status of all injection partners per se did not appear to be as important as knowledge of sexual partner's HIV status in its association with risk behavior.
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Affiliation(s)
- Yuko Mizuno
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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