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Lalanne L, Roux P, Donadille C, Briand Madrid L, Célerier I, Chauvin C, Hamelin N, Kervran C, Maradan G, Auriacombe M, Jauffret-Roustide M. Drug consumption rooms are effective to reduce at-risk practices associated with HIV/HCV infections among people who inject drugs: Results from the COSINUS cohort study. Addiction 2024; 119:180-199. [PMID: 37743675 DOI: 10.1111/add.16320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/05/2023] [Indexed: 09/26/2023]
Abstract
AIMS The primary aim of this study was to evaluate the impact of drug consumption rooms (DCRs) in France on injection equipment-sharing, while the secondary aims focused upon their impact on access to hepatitis C virus (HCV) testing and opioid agonist treatment (OAT). DESIGN The COhort to identify Structural and INdividual factors associated with drug USe (COSINUS cohort) was a 12-month longitudinal study of 665 people who inject drugs (PWID), conducted in Bordeaux, Marseille, Paris and Strasbourg. We used data from face-to-face interviews at enrolment and at 6-month and 12-month visits. SETTING AND PARTICIPANTS The participants were recruited in harm reduction programmes in Bordeaux and Marseille and in DCRs in Strasbourg and Paris. Participants were aged more than 18 years, French-speaking and had injected substances the month before enrolment. MEASUREMENTS We measured the impact of DCR exposure on injection equipment sharing, HCV testing and the use of medications for opioid use disorder, after adjustment for significant correlates. We used a two-step Heckman mixed-effects probit model, which allowed us to take into account the correlation of repeated measures and to control for potential bias due to non-randomization between the two groups (DCR-exposed versus DCR-unexposed participants). FINDINGS The difference of declared injection equipment sharing between PWID exposed to DCRs versus non-exposed was 10% (1% for those exposed versus 11% for those non-exposed, marginal effect = -0.10; 95% confidence interval = -0.18, -0.03); there was no impact of DCRs on HCV testing and OAT. CONCLUSIONS In the French context, drug consumption rooms appear to have a positive impact on at-risk practices for infectious diseases such as human immunodeficiency virus (HIV) and hepatitis C virus.
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Affiliation(s)
- Laurence Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Cécile Donadille
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Laelia Briand Madrid
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Isabelle Célerier
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Carole Chauvin
- Centre d'étude des Mouvements Sociaux (Inserm U1276/CNRS UMR8044/EHESS), Paris, France
| | - Naomi Hamelin
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Charlotte Kervran
- Addiction Team, SANPSY, CNRS UMR 6033, Bordeaux, France
- CH Charles Perrens and CHU de Bordeaux, Pôle inter-établissement Addictologie, Bordeaux, France
- Université Bordeaux, Bordeaux, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marc Auriacombe
- Addiction Team, SANPSY, CNRS UMR 6033, Bordeaux, France
- CH Charles Perrens and CHU de Bordeaux, Pôle inter-établissement Addictologie, Bordeaux, France
- Université Bordeaux, Bordeaux, France
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marie Jauffret-Roustide
- Centre d'étude des Mouvements Sociaux (Inserm U1276/CNRS UMR8044/EHESS), Paris, France
- British Columbia Center on Substance Use (BCCSU), Vancouver, Canada
- Baldy Center on Law and Social Policy, Buffalo University, New York City, NY, USA
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Kesten J, Hussey D, Lord C, Roberts L, Bayliss J, Erswell H, Preston A, Telfer M, Scott J, Harris M, Mellon D, Hickman M, MacArthur G, Fisher H. Development, acceptability and feasibility of a personalised, behavioural intervention to prevent bacterial skin and soft tissue infections among people who inject drugs: a mixed-methods Person-Based Approach study. Harm Reduct J 2023; 20:114. [PMID: 37608267 PMCID: PMC10463350 DOI: 10.1186/s12954-023-00823-9] [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: 12/02/2022] [Accepted: 07/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Skin and soft tissue infections (SSTI) among people who inject drugs (PWID) are a public health concern. This study aimed to co-produce and assess the acceptability and feasibility of a behavioural intervention to prevent SSTI. METHODS The Person-Based Approach (PBA) was followed which involves: (i) collating and analysing evidence; (ii) developing guiding principles; (iii) a behavioural analysis; (iv) logic model development; and (v) designing and refining intervention materials. Co-production activities with target group representatives and key collaborators obtained feedback on the intervention which was used to refine its design and content. The intervention, harm reduction advice cards to support conversation between service provider and PWID and resources to support safer injecting practice, was piloted with 13 PWID by four service providers in Bristol and evaluated using a mixed-methods approach. Semi-structured interviews were conducted with 11 PWID and four service providers. Questionnaires completed by all PWID recorded demographic characteristics, SSTI, drug use and treatment history. Interviews were analysed thematically and questionnaires were analysed descriptively. RESULTS Published literature highlighted structural barriers to safer injecting practices, such as access to hygienic injecting environments and injecting practices associated with SSTI included: limited handwashing/injection-site swabbing and use of too much acidifier to dissolve drugs. Co-production activities and the literature indicated vein care and minimisation of pain as PWID priorities. The importance of service provider-client relationships and non-stigmatising delivery was highlighted through the co-production work. Providing practical resources was identified as important to address environmental constraints to safer injecting practices. Most participants receiving the intervention were White British, male, had a history of SSTI and on average were 43.6 years old and had injected for 22.7 years. The intervention was well-received by PWID and service providers. Intervention content and materials given out to support harm reduction were viewed positively. The intervention appeared to support reflections on and intentions to change injecting behaviours, though barriers to safer injecting practice remained prominent. CONCLUSIONS The PBA ensured the intervention aligned to the priorities of PWID. It was viewed as acceptable and mostly feasible to PWID and service providers and has transferability promise. Further implementation alongside broader harm reduction interventions is needed.
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Affiliation(s)
- Joanna Kesten
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- The National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
| | | | | | | | - James Bayliss
- Bristol, North Somerset, South Gloucestershire Integrated Care System, Bristol, UK
| | - Helen Erswell
- UK Health Security Agency (UKHSA), South West Region, Bristol, UK
| | | | | | - Jenny Scott
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Dominic Mellon
- UK Health Security Agency (UKHSA), South West Region, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Georgie MacArthur
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Harriet Fisher
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
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Kimmel SD, Phillips KT, Anderson BJ, Stein MD. Characteristics associated with motivation to stop substance use and improve skin and needle hygiene among hospitalized patients who inject drugs. Subst Abus 2022; 43:878-883. [PMID: 35179454 PMCID: PMC9907781 DOI: 10.1080/08897077.2021.2007520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Hospitalizations for people who inject drugs (PWID) are opportunities to address substance use. However, little is known about hospitalized PWIDs' motivation to stop substance use or improve skin and needle hygiene, common means for reducing injection sequelae. Methods: We used baseline data from a randomized controlled trial of a behavioral intervention to improve skin and needle hygiene among 252 hospitalized PWID between January 2014 and June 2018. We examined motivation (scale 1-10) to stop substance use, use new needles, and clean skin and used multiple linear regression models to evaluate characteristics associated with these outcomes. Results: PWID were recruited during injection-related (154, 61.1%) and non-injection-related hospitalizations (98, 38.9%). Motivation to stop substance use was 7.11 (SD = 2.67), use new needles was 7.8 (SD = 1.9), and clean skin was 6.7 (SD = 2.3). In adjusted models, experiencing an injection-related hospitalization was not significantly associated (p > 0.05) with motivation to stop substance use (β = -0.76, SE = 0.299), use new needles (β = 0.301, SE = 0.255), or clean skin (β = 0.476, SE = 0.323). Number of past-year skin and soft tissue infections was negatively associated with motivation to use new needles (β = -0.109, SE = 0.049, p < 0.05) and clean skin (β = -0.131, SE = 0.062, p < 0.05). Greater opioid withdrawal was associated with lower motivation to use new needles (β = -0.275, SE = 0.92, p < 0.01). Conclusions: Among hospitalized PWID, motivation to stop substance use and improve skin and needle hygiene was moderately high, but injection-related hospitalizations were not associated with greater motivation. Efforts to reduce injection sequelae for all hospitalized PWID are needed.
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Affiliation(s)
- Simeon D. Kimmel
- Clinical Addiction Education and Research Unit, Sections of General Internal Medicine and Infectious Diseases, Department of Medicine, Boston University School of Medicine and Grayken Center for Addiction, Boston Medical Center, Boston, MA
| | - Kristina T. Phillips
- Center for Integrated Health Care Research, Kaiser Permanent Hawaii, Honolulu, HI
| | | | - Michael D. Stein
- Behavioral Medicine and Addiction Research, Butler Hospital, Providence, RI, Boston University School of Public Health, Boston MA
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A randomized controlled trial of a brief behavioral intervention to reduce skin and soft tissue infections among people who inject drugs. Drug Alcohol Depend 2021; 221:108646. [PMID: 33677353 PMCID: PMC8055301 DOI: 10.1016/j.drugalcdep.2021.108646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who inject drugs (PWID) are at high risk for skin and soft tissue infections (SSTIs), but few interventions have targeted their reduction. The goal of the current study was to test the effects of a brief skin and needle hygiene behavioral intervention (SKIN) in a two-group randomized controlled trial with 12-month follow-up. METHOD PWID (N = 252) were recruited from inpatient hospital units at a single urban medical center site and randomly assigned to an assessment-only (AO) condition or SKIN, which was a two-session intervention that included psychoeducation, behavioral skills demonstrations, and motivational interviewing. Mixed effects generalized linear models assessed the impact of the intervention on frequency of: 1) self-reported SSTIs, 2) uncleaned skin injections, and 3) injection. RESULTS Participants were 58.3 % male, 59.5 % White, and averaged 38 years of age. SKIN participants had 35 % fewer SSTIs compared to AO (p = .179), a difference of nearly one infection per year. The mean rate of uncleaned skin injections was about 66 % lower (IRR = 0.34, 95 % CI 0.20; 0.59, p < .001) among SKIN participants compared to AO. Almost one-third of participants reported no injection over follow-up and the mean rate of injection during follow-up was about 39 % lower (IRR = 0.61; 95 % CI 0.36; 1.02, p = .058) among persons randomized to SKIN than AO. CONCLUSIONS The SKIN intervention reduced uncleaned skin injections but did not reduce SSTIs significantly more than a control condition. Brief interventions can improve high-risk practices among PWID and lead to clinically meaningful outcomes.
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Mezaache S, Carrieri P, Briand-Madrid L, Laporte V, Morel A, Rojas Castro D, Roux P. Individual and structural correlates of willingness for intravenous buprenorphine treatment among people who inject sublingual buprenorphine in France. Harm Reduct J 2021; 18:11. [PMID: 33468133 PMCID: PMC7814710 DOI: 10.1186/s12954-021-00460-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some people do not benefit from oral administration of opioid agonist treatment, and an intravenous (IV) formulation may be more suitable. Our objective was to evaluate the willingness of people who regularly inject sublingual buprenorphine to receive IV buprenorphine as a prescribed treatment, and to examine related correlates. METHODS We performed a secondary analysis of data from the cross-sectional study PrebupIV, conducted in France in 2015 among 557 people who inject opioids. The study comprised questionnaires completed either face to face or online and community-based workshops. We only included participants who reported buprenorphine as their main injected drug (n = 209). Willingness to receive IV buprenorphine treatment was measured on a scale from 0 to 10. Ordinal logistic regression identified correlates of willingness. Artworks and testimonies from participants in the workshops were also used to illustrate correlates of willingness. RESULTS Among the 209 participants, the mean score (SD) for willingness to receive IV buprenorphine was 8.0 (2.8). Multivariate analysis showed that participants who reported using non-prescribed buprenorphine (AOR = 4.82, p = 0.019), a higher daily dosage of buprenorphine (AOR (for 1 mg) = 1.05, p = 0.043), and a higher number of complications due to injection (AOR = 2.28, p = 0.037), were more willing to receive IV buprenorphine treatment. CONCLUSIONS Willingness to initiate IV buprenorphine treatment was high among people who regularly inject sublingual buprenorphine. A prescribed IV formulation could attract and retain more people into care and reduce harms associated with the injection of buprenorphine tablets.
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Affiliation(s)
- Salim Mezaache
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France. .,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France.
| | - Patrizia Carrieri
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
| | - Laélia Briand-Madrid
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
| | | | | | - Daniela Rojas Castro
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France.,Laboratoire de Recherche Communautaire Coalition PLUS, Pantin, France
| | - Perrine Roux
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de La Santé & Traitement de L'information Médicale, Aix-Marseille Univ, Marseille, France.,ORS PACA, Observatoire Régional de La Santé Provence-Alpes-Côte D'Azur, Marseille, France
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Tran LT, Peacock A, Colledge S, Memedovic S, Grebely J, Leung J, Larney S, Trickey A, Stone J, Vickerman P, Hickman M, Degenhardt L. Injecting risk behaviours amongst people who inject drugs: A global multi-stage systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102866. [PMID: 32712484 DOI: 10.1016/j.drugpo.2020.102866] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Injecting risk behaviour, such as receptive sharing of injecting equipment and/or re-using one's equipment, is associated with bloodborne virus transmission and infections in people who inject drugs (PWID). We aimed to estimate prevalence and correlates of injecting risk behaviours amongst PWID. METHODS We conducted a systematic review and meta-analyses to estimate country, regional, and global prevalences of injecting risk behaviours (including sharing or re-using needle/syringe and sharing other injecting equipment). Using meta-regression analyses, we determined associations between study- and country-level characteristics and receptive needle/syringe sharing. RESULTS From 61,077 identified papers and reports and 61 studies from expert consutation, evidence on injecting risk behaviours was available for 464 studies from 88 countries. Globally, it is estimated that 17.9% (95%CI: 16.2-19.6%) of PWID engaged in receptive needle/syringe sharing at last injection, 23.9% (95%CI: 21.2-26.5%) in the past month, and 32.8% (95%CI: 28.6-37.0%) in the past 6-12 months. Receptive sharing of other injecting equipment was common. Higher prevalence of receptive needle/syringe sharing in the previous month was associated with samples of PWID with a lower proportion of females, shorter average injecting duration, a higher proportion with ≥daily injecting, and older studies. Countries with lower development index, higher gender inequality and lower NSP coverage had higher proportions reporting receptive needle/syringe sharing. CONCLUSIONS High levels of injecting risk behaviours were observed amongst PWID globally, although estimates were only available for half of the countries with evidence of injecting drug use. There is a need for better capturing of injecting risk behaviours in these countries to inform implementation of harm reduction services and evaluate potential impacts of interventions to reduce risk.
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Affiliation(s)
- Lucy Thi Tran
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Samantha Colledge
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Sonja Memedovic
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Jason Grebely
- Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Janni Leung
- School of Public Health, Faculty of Medicine, University of Queensland, QLD, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Adam Trickey
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, England
| | - Jack Stone
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, England
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, England
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, England
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
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Mezaache S, Briand-Madrid L, Laporte V, Mora M, Moudachirou K, Rojas Castro D, Carrieri P, Roux P. Correlates of Self-Reported Cotton Fever Experience among People Who Inject Opioids. Subst Use Misuse 2020; 55:1021-1027. [PMID: 32009485 DOI: 10.1080/10826084.2020.1720247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Cotton fever is a febrile syndrome occurring after intravenous drug injection. Although its clinical presentation is well described in the literature, data regarding prevention is lacking. We aimed to assess proportion and correlates of cotton fever experience among people who inject opioids. Methods: We performed a cross-sectional study using data from the community-based survey PrebupIV conducted in France in 2015 among 557 people who regularly injected opioids. Self-reported sociodemographic data, together with data on substance use, injecting practices and occurrence of cotton fever were all collected through face-to-face (n = 398) or online (n = 159) questionnaires. Factors associated with cotton fever experience were assessed using logistic regression model. Results: Over half of the participants (54%) reported cotton fever experience. In the multivariable logistic regression, crack cocaine injection (adjusted Odds Ratio (aOR) = 1.96, 95% Confidence Interval (CI) = 1.03-3.63), longer duration of opioid use (for 1 year of use: aOR = 1.05, 95%CI = 1.02-1.09), and filtering mainly with cotton filters (compared with membrane filters, aOR = 1.86, 95%CI = 1.24-2.78) were all associated with cotton fever experience. Conclusions: Our findings highlight that cotton fever is a frequent complication of injecting drug use. Avoiding the use and reuse of cotton balls to filter injected solutions, and promoting membrane filters use could reduce the risk of the condition occurring.
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Affiliation(s)
- Salim Mezaache
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France
| | - Laélia Briand-Madrid
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France
| | | | - Marion Mora
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France
| | | | - Daniela Rojas Castro
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France.,Coalition Plus, Pantin, France.,Groupe de Recherche en Psychologie Sociale (EA 4163), Université Lyon 2, Bron, France
| | - Patrizia Carrieri
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France
| | - Perrine Roux
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,Observatoire régional de la santé Provence-Alpes-Côte d'Azur, ORS PACA, Marseille, France
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