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Hong H, Shi X, Liu Y, Feng W, Fang T, Tang C, Xu G. HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform. JMIR Public Health Surveill 2024; 10:e52366. [PMID: 39045869 PMCID: PMC11287094 DOI: 10.2196/52366] [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: 09/01/2023] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/25/2024] Open
Abstract
Background Sexual transmission among men who have sex with men (MSM) has become the major HIV transmission route. However, limited research has been conducted to investigate the association between transactional sex (TS) and HIV incidence in China. Objective This study aims to investigate HIV incidence and distinguish sociodemographic and sexual behavioral risk factors associated with HIV incidence among MSM who engage in TS (MSM-TS) in China. Methods We conducted a prospective cohort study using a WeChat-based platform to evaluate HIV incidence among Chinese MSM, including MSM-TS in Ningbo, recruited from July 2019 until June 2022. At each visit, participants completed a questionnaire and scheduled an appointment for HIV counseling and testing on the WeChat-based platform before undergoing offline HIV tests. HIV incidence density was calculated as the number of HIV seroconversions divided by person-years (PYs) of follow-up, and univariate and multivariate Cox proportional hazards regression was conducted to identify factors associated with HIV incidence. Results A total of 932 participants contributed 630.9 PYs of follow-up, and 25 HIV seroconversions were observed during the study period, resulting in an estimated HIV incidence of 4.0 (95% CI 2.7-5.8) per 100 PYs. The HIV incidence among MSM-TS was 18.4 (95% CI 8.7-34.7) per 100 PYs, which was significantly higher than the incidence of 3.2 (95% CI 2.1-5.0) per 100 PYs among MSM who do not engage in TS. After adjusting for sociodemographic characteristics, factors associated with HIV acquisition were MSM-TS (adjusted hazard ratio [aHR] 3.93, 95% CI 1.29-11.93), having unprotected sex with men (aHR 10.35, 95% CI 2.25-47.69), and having multiple male sex partners (aHR 3.43, 95% CI 1.22-9.64) in the past 6 months. Conclusions This study found a high incidence of HIV among MSM-TS in Ningbo, China. The risk factors associated with HIV incidence include TS, having unprotected sex with men, and having multiple male sex partners. These findings emphasize the need for developing targeted interventions and providing comprehensive medical care, HIV testing, and preexposure prophylaxis for MSM, particularly those who engage in TS.
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Affiliation(s)
- Hang Hong
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Xiaojun Shi
- Beilun Center for Disease Control and Prevention, Ningbo, China
| | - Yuhui Liu
- Ningbo Center for Disease Control and Prevention, Ningbo, China
| | - Wei Feng
- Fenghua Center for Disease Control and Prevention, Ningbo, China
| | - Ting Fang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Guozhang Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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Romo E, Stopka TJ, Jesdale BM, Wang B, Mazor KM, Friedmann PD. Association of spatial proximity to fixed-site syringe services programs with HCV serostatus and injection equipment sharing practices among people who inject drugs in rural New England, United States. Harm Reduct J 2024; 21:23. [PMID: 38282000 PMCID: PMC10822149 DOI: 10.1186/s12954-023-00916-5] [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: 07/31/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) disproportionately affects rural communities, where health services are geographically dispersed. It remains unknown whether proximity to a syringe services program (SSP) is associated with HCV infection among rural people who inject drugs (PWID). METHODS Data are from a cross-sectional sample of adults who reported injecting drugs in the past 30 days recruited from rural counties in New Hampshire, Vermont, and Massachusetts (2018-2019). We calculated the road network distance between each participant's address and the nearest fixed-site SSP, categorized as ≤ 1 mile, 1-3 miles, 3-10 miles, and > 10 miles. Staff performed HCV antibody tests and a survey assessed past 30-day injection equipment sharing practices: borrowing used syringes, borrowing other used injection equipment, and backloading. Mixed effects modified Poisson regression estimated prevalence ratios (aPR) and 95% confidence intervals (95% CI). Analyses were also stratified by means of transportation. RESULTS Among 330 PWID, 25% lived ≤ 1 mile of the nearest SSP, 17% lived 1-3 miles of an SSP, 12% lived 3-10 miles of an SSP, and 46% lived > 10 miles from an SSP. In multivariable models, compared to PWID who lived within 1 mile of an SSP, those who lived 3 to 10 miles away had a higher prevalence of HCV seropositivity (aPR: 1.25, 95% CI 1.06-1.46), borrowing other used injection equipment (aPR: 1.23, 95% CI 1.04-1.46), and backloading (aPR: 1.48, 95% CI 1.17-1.88). Similar results were observed for PWID living > 10 miles from an SSP: aPR [HCV]: 1.19, 95% CI 1.01-1.40; aPR [borrowing other used equipment]:1.45, 95% CI 1.29-1.63; and aPR [backloading]: 1.59, 95% CI 1.13-2.24. Associations between living 1 to 3 miles of an SSP and each outcome did not reach statistical significance. When stratified by means of transportation, associations between distance to SSP and each outcome (except borrowing other used injection equipment) were only observed among PWID who traveled by other means (versus traveled by automobile). CONCLUSIONS Among PWID in rural New England, living farther from a fixed-site SSP was associated with a higher prevalence of HCV seropositivity, borrowing other used injection equipment, and backloading, reinforcing the need to increase SSP accessibility in rural areas. Means of transportation may modify this relationship.
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Affiliation(s)
- Eric Romo
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
| | - Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Bill M Jesdale
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Kathleen M Mazor
- Department of Medicine, University of Massachusetts Chan Medical, Worcester, MA, USA
| | - Peter D Friedmann
- Office of Research, University of MA Chan Medical School - Baystate, Springfield, MA, USA
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3
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Rowan SE, Haukoos J, Kamis KF, Hopkins E, Gravitz S, Lyle C, Al-Tayyib AA, Gardner EM, Galbraith JW, Hsieh YH, Lyons MS, Rothman RE, White DAE, Morgan JR, Linas BP, Sabel AL, Wyles DL. The Determining Effective Testing in Emergency Departments and Care Coordination on Treatment Outcomes (DETECT) for Hepatitis C (Hep C) Linkage-to-Care Trial: rationale and design of an emergency department-based randomized clinical trial of linkage-to-care strategies for hepatitis C. Trials 2023; 24:63. [PMID: 36707909 PMCID: PMC9880363 DOI: 10.1186/s13063-022-07018-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/15/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Hepatitis C (HCV) poses a major public health problem in the USA. While early identification is a critical priority, subsequent linkage to a treatment specialist is a crucial step that bridges diagnosed patients to treatment, cure, and prevention of ongoing transmission. Emergency departments (EDs) serve as an important clinical setting for HCV screening, although optimal methods of linkage-to-care for HCV-diagnosed individuals remain unknown. In this article, we describe the rationale and design of The Determining Effective Testing in Emergency Departments and Care Coordination on Treatment Outcomes (DETECT) for Hepatitis C (Hep C) Linkage-to-Care Trial. METHODS The DETECT Hep C Linkage-to-Care Trial will be a single-center prospective comparative effectiveness randomized two-arm parallel-group superiority trial to test the effectiveness of linkage navigation and clinician referral among ED patients identified with untreated HCV with a primary hypothesis that linkage navigation plus clinician referral is superior to clinician referral alone when using treatment initiation as the primary outcome. Participants will be enrolled in the ED at Denver Health Medical Center (Denver, CO), an urban, safety-net hospital with approximately 75,000 annual adult ED visits. This trial was designed to enroll a maximum of 280 HCV RNA-positive participants with one planned interim analysis based on methods by O'Brien and Fleming. This trial will further inform the evaluation of cost effectiveness, disparities, and social determinants of health in linkage-to-care, treatment, and disease progression. DISCUSSION When complete, the DETECT Hep C Linkage-to-Care Trial will significantly inform how best to perform linkage-to-care among ED patients identified with HCV. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT04026867 Original date: July 1, 2019 URL: https://clinicaltrials.gov/ct2/show/NCT04026867.
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Affiliation(s)
- Sarah E. Rowan
- grid.241116.10000000107903411Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, CO USA ,grid.239638.50000 0001 0369 638XPublic Health Institute at Denver Health, Denver, CO USA
| | - Jason Haukoos
- grid.241116.10000000107903411Department of Emergency Medicine, Denver Health Medical Center and University of Colorado School of Medicine, 777 Bannock Street, Mail Code 0108, Denver, CO 80204 USA ,grid.414594.90000 0004 0401 9614Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA ,Colorado Social Emergency Medicine Collaborative, Denver, CO USA
| | - Kevin F. Kamis
- grid.239638.50000 0001 0369 638XPublic Health Institute at Denver Health, Denver, CO USA
| | - Emily Hopkins
- grid.241116.10000000107903411Department of Emergency Medicine, Denver Health Medical Center and University of Colorado School of Medicine, 777 Bannock Street, Mail Code 0108, Denver, CO 80204 USA ,Colorado Social Emergency Medicine Collaborative, Denver, CO USA
| | - Stephanie Gravitz
- grid.241116.10000000107903411Department of Emergency Medicine, Denver Health Medical Center and University of Colorado School of Medicine, 777 Bannock Street, Mail Code 0108, Denver, CO 80204 USA ,Colorado Social Emergency Medicine Collaborative, Denver, CO USA
| | - Carolynn Lyle
- grid.241116.10000000107903411Department of Emergency Medicine, Denver Health Medical Center and University of Colorado School of Medicine, 777 Bannock Street, Mail Code 0108, Denver, CO 80204 USA ,Colorado Social Emergency Medicine Collaborative, Denver, CO USA
| | - Alia A. Al-Tayyib
- grid.239638.50000 0001 0369 638XPublic Health Institute at Denver Health, Denver, CO USA ,grid.414594.90000 0004 0401 9614Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA
| | - Edward M. Gardner
- grid.241116.10000000107903411Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, CO USA ,grid.239638.50000 0001 0369 638XPublic Health Institute at Denver Health, Denver, CO USA
| | - James W. Galbraith
- grid.410721.10000 0004 1937 0407Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS USA
| | - Yu-Hsiang Hsieh
- grid.21107.350000 0001 2171 9311Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Michael S. Lyons
- grid.412332.50000 0001 1545 0811Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH USA
| | - Richard E. Rothman
- grid.21107.350000 0001 2171 9311Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Douglas A. E. White
- grid.414076.00000 0004 0427 1107Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA USA
| | - Jake R. Morgan
- grid.189504.10000 0004 1936 7558Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA USA ,Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV, Boston, MA USA
| | - Benjamin P. Linas
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV, Boston, MA USA ,grid.189504.10000 0004 1936 7558Division of Infectious Diseases, Boston University School of Medicine, Boston, MA USA
| | - Allison L. Sabel
- grid.239638.50000 0001 0369 638XDepartment of Patient Safety and Quality, Denver Health, Denver, CO USA ,grid.414594.90000 0004 0401 9614Department of Biostatistics, Colorado School of Public Health, Aurora, CO USA
| | - David L. Wyles
- grid.241116.10000000107903411Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, CO USA
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Carpenter DM, Zule WA, Hennessy CM, Evon DM, Hurt CB, Ostrach B. Factors associated with perceived ease of access to syringes in Appalachian North Carolina. J Rural Health 2023; 39:212-222. [PMID: 35819251 PMCID: PMC9772148 DOI: 10.1111/jrh.12698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To examine associations between perceived ease of syringe access, syringe sources, injection behaviors, and law enforcement (LE) interactions among people who inject drugs (PWID) in rural Appalachian North Carolina (NC). METHODS Using respondent-driven sampling, a diverse sample of 309 self-reported PWID were recruited from rural Appalachian NC. Data were collected via audio computer-assisted self-interview technology from February 2019 through March 2020. Respondents reported demographics, sources of syringes, LE interactions, and injection behaviors. Univariate, bivariate, and linear regression analyses were performed. FINDINGS Respondents most often obtained syringes from pharmacies and syringe service programs (SSPs). Twenty-one percent disagreed that it was easy to obtain sterile syringes, with 28% reporting low or no access to an SSP. PWID who reported longer physical distances to an SSP had greater difficulty accessing syringes (P<.001). PWID who reported greater ease of access to syringes reported engaging in receptive syringe sharing less often (P<.01). PWID who were stopped and searched by LE more often reported injecting drugs somebody else prepared with nonsterile supplies more often (P<.01). Participants shared used injection supplies more than twice as often than they shared used syringes. CONCLUSIONS These results underscore the importance of SSPs to mitigate the spread of human immunodeficiency virus and viral hepatitis in rural areas. Supporting mobile SSP services in rural areas could increase access to sterile syringes and injection supplies. SSPs should educate PWID about the importance of not sharing injection supplies. Pharmacies could increase syringe access in areas where SSPs do not operate.
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Affiliation(s)
- Delesha M. Carpenter
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - William A. Zule
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Donna M. Evon
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Christopher B. Hurt
- Institute for Global Health & Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bayla Ostrach
- Family Medicine & Medical Anthropology, Boston University School of Medicine, Boston, Massachusetts, USA
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5
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Romo E, Rudolph AE, Stopka TJ, Wang B, Jesdale BM, Friedmann PD. HCV serostatus and injection sharing practices among those who obtain syringes from pharmacies and directly and indirectly from syringe services programs in rural New England. Addict Sci Clin Pract 2023; 18:2. [PMID: 36597153 PMCID: PMC9809047 DOI: 10.1186/s13722-022-00358-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Among people who inject drugs (PWID), obtaining syringes via syringe services programs (SSPs) and pharmacies reduces injection sharing practices associated with hepatitis C virus (HCV). Whether indirect use of SSPs via secondary exchange confers a similar benefit remains unknown, particularly in rural settings. We compared HCV serostatus and injection sharing practices by primary syringe source among a sample of rural PWID. METHODS Data are from a cross-sectional study of adults who use drugs recruited from eleven rural counties in New Hampshire, Vermont, and Massachusetts using respondent-driven sampling (2018-2019). Study staff performed HCV antibody testing. An audio computer-assisted self-interview assessed sociodemographic characteristics, past 30-day injection practices, and past 30-day primary syringe source. Primary syringe source was classified as direct SSP, pharmacy, indirect SSP (secondary exchange), or "other" (friend/acquaintance, street seller, partner/relative, found them). Mixed effects modified Poisson models assessed the association of primary syringe source with HCV seroprevalence and injection sharing practices. RESULTS Among 397 PWID, the most common primary syringe source was "other" (33%), then pharmacies (27%), SSPs (22%), and secondary exchange (18%). In multivariable models, compared with those obtaining most syringes from "other" sources, those obtaining most syringes from pharmacies had a lower HCV seroprevalence [adjusted prevalence ratio (APR):0.85, 95% confidence interval (CI) 0.73-0.9985]; however, the upper bound of the 95% CI was close to 1.0. Compared with those obtaining most syringes from other sources, PWID obtaining most syringes directly from SSPs or pharmacies were less likely to report borrowing used syringes [APR(SSP):0.60, 95% CI 0.43-0.85 and APR(Pharmacies):0.70, 95% CI 0.52-0.93], borrowing used injection equipment [APR(SSP):0.59, 95% CI 0.50-0.69 and APR (Pharmacies):0.81, 95% CI 0.68-0.98], and backloading [APR(SSP):0.65, 95% CI 0.48-0.88 and APR(Pharmacies):0.78, 95% CI 0.67-0.91]. Potential inverse associations between obtaining most syringes via secondary exchange and injection sharing practices did not reach the threshold for statistical significance. CONCLUSIONS PWID in rural New England largely relied on informal syringe sources (i.e., secondary exchange or sources besides SSPs/pharmacies). Those obtaining most syringes from an SSP or pharmacy were less likely to share injection equipment/syringes and had a lower HCV seroprevalence, which suggests using these sources reduces the risk of new HCV infections or serves as proxy for past injection behavior.
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Affiliation(s)
- Eric Romo
- grid.168645.80000 0001 0742 0364Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA USA
| | - Abby E. Rudolph
- grid.264727.20000 0001 2248 3398Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA USA
| | - Thomas J. Stopka
- grid.67033.310000 0000 8934 4045Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
| | - Bo Wang
- grid.168645.80000 0001 0742 0364Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA USA
| | - Bill M. Jesdale
- grid.168645.80000 0001 0742 0364Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA USA
| | - Peter D. Friedmann
- grid.266683.f0000 0001 2166 5835Office of Research, University of Massachusetts Chan Medical School-Baystate, Springfield, MA USA
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Seff I, Steven S, Deitch J, Akika V, Puls C, Okoro C, Sughrue S, Stark L. Developing ACASI questionnaires in Borno State, Nigeria during COVID-19: Using data-informed processes to address complexity, sensitivity, and functionality of family functioning and wellbeing measures. Glob Public Health 2022; 17:3611-3626. [PMID: 35770693 DOI: 10.1080/17441692.2022.2095654] [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: 02/07/2023]
Abstract
Audio Computer-Assisted Self-Interview (ACASI) has become increasingly popular for collecting data on sensitive topics among populations with lower levels of literacy. However, the development of an ACASI tool is an involved process that can be further complicated when working in humanitarian contexts during the COVID-19 pandemic. This study describes the development of an ACASI tool to be used in a family-focused intervention evaluation. Participants included adolescent girls aged 10-14, adolescent boys aged 15-19, and caregivers in Borno State, Nigeria. Data to inform the tool's development were collected using cognitive interviews, ACASI demonstrations, and post-demonstration assessments with adolescent girls, adolescent boys, and caregivers, as well as a focus group discussion with enumerators. Data found high levels of acceptance for the tool and helped identify appropriate visual representations for various answer options to maximize usability. The survey was found to be too long to administer solely through ACASI; the final tool employs a combination of ACASI and computer-assisted personal interview formats. Findings highlight the importance of repeatedly piloting and testing these types of tools to ensure content and language resonate with intended users. However, the steps employed demonstrate that researchers can maintain a commitment to developing high-quality, community-grounded research tools despite challenges germane to humanitarian settings.
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Affiliation(s)
- Ilana Seff
- Washington University in St. Louis, Abuja, Nigeria
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Durham MD, Armon C, Novak RM, Mahnken JD, Carlson K, Li J, Buchacz K. Longitudinal Changes in, and Factors Associated with, the Frequency of Condomless Sex Among People in Care for HIV Infection, HIV Outpatient Study USA, 2007-2019. AIDS Behav 2022; 26:3199-3209. [PMID: 35364730 PMCID: PMC10246446 DOI: 10.1007/s10461-022-03655-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 11/01/2022]
Abstract
During 2007-2019, the percentage of HIV Outpatient Study participants reporting anal or vaginal condomless sex in the past 6 months ranged from a low of 17% among heterosexual males to 59% for men who have sex with men (MSM). MSM reported having had condomless sex more frequently than heterosexual males and females and were the only group in which an increase in condomless sex was observed during the study period (from 39 to 59%). Although persons with undetectable HIV viral load have effectively no risk of transmitting HIV sexually (U = U), there is still the potential risk of transmission or acquisition of other sexually transmitted infections (STIs) when engaging in condomless sex. Continuing education about risks of HIV and STI transmission as well as ongoing screening for and treatment of STIs, retention in HIV treatment, and support for sexual health are critical components of care for people living with HIV.
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Affiliation(s)
- Marcus D Durham
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS US8-4, Atlanta, GA, 30333, USA.
| | - Carl Armon
- Cerner Corporation, Kansas City, MO, USA
| | | | - Jonathan D Mahnken
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Jun Li
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS US8-4, Atlanta, GA, 30333, USA
| | - Kate Buchacz
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS US8-4, Atlanta, GA, 30333, USA.
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8
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Butler TG, Gullotta M, Greenberg D. Reliability of prisoners' survey responses: comparison of self-reported health and biomedical data from an australian prisoner cohort. BMC Public Health 2022; 22:64. [PMID: 35012501 PMCID: PMC8747873 DOI: 10.1186/s12889-021-12460-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/12/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Prisoner health surveys primarily rely on self-report data. However, it is unclear whether prisoners are reliable health survey respondents. This paper aimed to determine the level of agreement between self-report and biomedical tests for a number of chronic health conditions. METHOD This study was a secondary analysis of existing data from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey. The health surveys were cross-sectional in nature and included a stratified random sample of men (n=2,114) from all NSW prisons. Self-reported histories of hepatitis, sexually transmissible infections, and diabetes were compared to objective biomedical measures of these conditions. RESULTS Overall, the sensitivity (i.e., the respondents who self-reported having the condition also had markers indicative of the condition using biomedical tests) was high for hepatitis C (96%) and hepatitis B (83%), but low for all other assessed conditions (ranging from 9.1% for syphilis using RPR to 64% for diabetes). However, Kappa scores indicated substantial agreement only for hepatitis C. That is, there were false positives and false negatives which occurred outside of chance leading to poor agreement for all other assessed conditions. CONCLUSIONS Prisoners may have been exposed to serious health conditions while failing to report a history of infection. It may be possible that prisoners do not get tested given the asymptomatic presentation of some conditions, were unaware of their health status, have limited health-service usage preventing the opportunity for detection, or are subject to forgetting or misunderstanding prior test results. These findings demonstrate the importance of the custodial environment in screening for health conditions and referral for treatment should this be needed. Testing on entry, periodically during incarceration, and prior to release is recommended.
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Affiliation(s)
- Tony Gerard Butler
- School of Population Health, University of New South Wales, 2052, Sydney, NSW, Australia
| | - Mathew Gullotta
- School of Population Health, University of New South Wales, 2052, Sydney, NSW, Australia. .,The Wellbeing Group, 2040, Sydney, NSW, Australia.
| | - David Greenberg
- Statewide Community Court Liaison Service, Justice Health and Forensic Mental Health Network, 2036, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, 2052, Sydney, NSW, Australia
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Towe SL, Sullivan CA, McKellar MS, Meade CS. Examining the Potential of Pre-exposure Prophylaxis (PrEP) for HIV Prevention in a Community Sample of Persons Who Use Stimulants Living in the Southern United States. AIDS Behav 2021; 25:1480-1489. [PMID: 32757101 DOI: 10.1007/s10461-020-02987-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention strategy, is currently underutilized by several at-risk groups, including both persons who inject drugs and those who use drugs via other routes. Stimulant use is associated with increased HIV risk due to both sexual and injection risk behaviors. In this study, we examined PrEP awareness and acceptability in persons with biologically confirmed HIV-negative status who use stimulant drugs. We also examined HIV risk behaviors to identify how many participants met behavioral eligibility for PrEP. The sample of 352 participants was 46% female, 87% African American, and 45.69 years old on average. Over half the sample (n = 213) met criteria for PrEP candidacy, but less than 20% had heard of PrEP. Ratings for willingness to take PrEP were high. PrEP candidates reported more frequent and problematic stimulant use relative to non-candidates. Our results show that persons who use stimulants are a high-risk population that could benefit significantly from PrEP. Efforts to increase PrEP awareness among high-risk populations are critical for facilitating PrEP implementation and ensuring effective HIV prevention within these communities.
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Affiliation(s)
- Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA.
| | - Catherine A Sullivan
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Mehri S McKellar
- Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
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Dionne-Odom J, Westfall AO, Dombrowski JC, Kitahata MM, Crane HM, Mugavero MJ, Moore RD, Karris M, Christopoulos K, Geng E, Mayer KH, Marrazzo J. Intersecting Epidemics: Incident Syphilis and Drug Use in Women Living With Human Immunodeficiency Virus in the United States (2005-2016). Clin Infect Dis 2021; 71:2405-2413. [PMID: 31712815 DOI: 10.1093/cid/ciz1108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rates of early syphilis in US women are steadily increasing, but predictors of infection in this group are not clearly defined. METHODS This retrospective analysis focused on women enrolled in the US CFAR Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with syphilis testing performed. The primary outcome of incident syphilis infection was defined serologically as a newly positive test with positive confirmatory testing after a negative test or a 2-dilution increase in rapid plasma regain titer. Infection rates were calculated for each woman-year in care with testing. Predictors of syphilis were sought among sociodemographics, clinical information, and self-reported behaviors. Multivariable logistic regression models were created; a subgroup analysis assessed predictors in women of reproductive age. RESULTS The annual rate of incident syphilis among 4416 women engaged in human immunodeficiency virus (HIV) care and tested during the 12-year study period was 760/100 000 person-years. Independent predictors of infection were injection drug use as a risk factor for HIV acquisition (aOR, 2.2; 95% CI, 1.3-3.9), hepatitis C infection (aOR, 1.9; 95% CI, 1.1-3.4), black race (aOR, 2.2; 95% CI, 1.3-3.7 compared with white race), and more recent entry to care (since 2005 compared with 1994-2004). Predictors were similar in women aged 18-49. CONCLUSIONS Syphilis infection is common among US women in HIV care. Syphilis screening and prevention efforts should focus on women reporting drug use and with hepatitis C coinfection. Future studies should identify specific behaviors that mediate syphilis acquisition risk in women who use drugs.
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Affiliation(s)
- Jodie Dionne-Odom
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrew O Westfall
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Julia C Dombrowski
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Mari M Kitahata
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Michael J Mugavero
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard D Moore
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maile Karris
- Division of Infectious Diseases, Department of Medicine, University of California at San Diego, San Diego, California, USA
| | - Katerina Christopoulos
- Division of Infectious Diseases, Department of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Elvin Geng
- Division of Infectious Diseases, Department of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Kenneth H Mayer
- Division of Infectious Diseases, Fenway Health and Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jeanne Marrazzo
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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11
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Spinazze P, Aardoom J, Chavannes N, Kasteleyn M. The Computer Will See You Now: Overcoming Barriers to Adoption of Computer-Assisted History Taking (CAHT) in Primary Care. J Med Internet Res 2021; 23:e19306. [PMID: 33625360 PMCID: PMC7946588 DOI: 10.2196/19306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/23/2020] [Accepted: 01/24/2021] [Indexed: 01/10/2023] Open
Abstract
Patient health information is increasingly collected through multiple modalities, including electronic health records, wearables, and connected devices. Computer-assisted history taking could provide an additional channel to collect highly relevant, comprehensive, and accurate patient information while reducing the burden on clinicians and face-to-face consultation time. Considering restrictions to consultation time and the associated negative health outcomes, patient-provided health data outside of consultation can prove invaluable in health care delivery. Over the years, research has highlighted the numerous benefits of computer-assisted history taking; however, the limitations have proved an obstacle to adoption. In this viewpoint, we review these limitations under 4 main categories (accessibility, affordability, accuracy, and acceptability) and discuss how advances in technology, computing power, and ubiquity of personal devices offer solutions to overcoming these.
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Affiliation(s)
- Pier Spinazze
- Global Digital Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jiska Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Marise Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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12
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Lisnyj KT, Pearl DL, McWhirter JE, Papadopoulos A. Targeting components of social capital on campus to alleviate Canadian post-secondary students’ academic stress. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01376-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Hammoud MA, Grulich A, Holt M, Maher L, Murphy D, Jin F, Bavinton B, Haire B, Ellard J, Vaccher S, Saxton P, Bourne A, Degenhardt L, Storer D, Prestage G. Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men. J Acquir Immune Defic Syndr 2021; 86:22-30. [PMID: 33027151 PMCID: PMC7727320 DOI: 10.1097/qai.0000000000002514] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM). METHODS Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors. RESULTS Among 847 men, mean age was 44.1 years (SD: 12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR: 0.17; 95% CI: 0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR: 0.28; 95% CI: 0.14 to 0.54; P < 0.001). CONCLUSIONS By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.
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Affiliation(s)
| | | | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Lisa Maher
- Kirby Institute, UNSW Sydney, Kensington, Australia
| | - Dean Murphy
- Kirby Institute, UNSW Sydney, Kensington, Australia
| | - Fengyi Jin
- Kirby Institute, UNSW Sydney, Kensington, Australia
| | | | | | - Jeanne Ellard
- Australian Federation of AIDS Organisations (AFAO), Newtown, Australia
| | | | - Peter Saxton
- Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia; and
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Kensington, Australia
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14
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Bloom BE, Jain S, Sun X, Garfein RS, Strathdee SA, Milloy MJ, Hayashi K, DeBeck K, Bluthenthal R, Werb D, Rafful C. Self-perception of assisting with future injection drug initiation: The influence of relationships in the process of drug injecting initiation. Drug Alcohol Rev 2020; 40:109-117. [PMID: 32840027 DOI: 10.1111/dar.13145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/01/2020] [Accepted: 07/12/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND AIMS People who inject drugs (PWID) play critical roles in assisting others into injection drug use (IDU) initiation. Understanding perceptions of PWID's risk of initiating others is needed to inform interventions for prevention. The objective was to examine factors associated with self-perception of assisting with future IDU initiation events. The primary variables of interest are the relationships of PWID with the person(s) they assisted and their reasons for previously providing initiation assistance. DESIGN AND METHODS Data from Preventing Injecting by Modifying Existing Responses, a multi-site prospective community-recruited cohort study, were analysed. Analyses were restricted to PWID who reported ever providing IDU initiation assistance. Site-specific (Vancouver, Canada [n = 746]; San Diego, USA [n = 95] and Tijuana, Mexico [n = 92]) multivariable logistic regression analyses were performed to determine factors associated with self-perception of assisting with future IDU initiation. RESULTS Having provided IDU initiation assistance to a family member or intimate partner decreased the odds of self-perception of assisting with future IDU initiation in Vancouver (AOR = 0.4; 95% CI 0.2-0.8); however, previous IDU initiation assistance to an 'other' increased the odds of self-perception of assisting with future IDU in Tijuana (AOR = 12.0; 95% CI 2.1-70.3). Daily IDU (Vancouver: AOR = 3.7; 95% CI 2.1-6.4) and less than daily IDU (San Diego: AOR = 5.9; 95% CI 1.3-27.1) (Vancouver: AOR = 2.6; 95% CI 1.4-2.9) were associated with increased self-perception of assisting with future IDU compared to current non-injectors. DISCUSSION AND CONCLUSIONS Relationship to past initiates and IDU frequency might increase PWID's self-perception of assisting with future IDU. Interventions focused on social support and reducing IDU frequency may decrease occurrences of IDU initiation assistance.
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Affiliation(s)
- Brittnie E Bloom
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, USA.,Graduate School of Public Health, San Diego State University, San Diego, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, Biostatistics Research Center, University of California, San Diego, San Diego, USA
| | - Xiaoying Sun
- Department of Family Medicine and Public Health, Biostatistics Research Center, University of California, San Diego, San Diego, USA
| | - Richard S Garfein
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, USA
| | - Steffanie A Strathdee
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, USA
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kora DeBeck
- Department of Medicine, University of British Columbia, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Ricky Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Dan Werb
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, USA.,Centre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, Canada
| | - Claudia Rafful
- Centre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, Canada.,Universidad Nacional Autónoma de México, Mexico City, Mexico.,Center on Global Mental Health Research, National Institute of Psychiatry, Mexico City, Mexico
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15
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Meade CS, Towe SL, Xu Y, Rainer C. HIV Prevalence and Associated Risks in a Respondent-Driven Sample of Illicit Stimulant Users in a Southern United States City. AIDS Behav 2020; 24:2336-2346. [PMID: 31960197 PMCID: PMC7369231 DOI: 10.1007/s10461-020-02793-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Stimulant abuse is a major contributor to HIV transmission in the United States, yet HIV prevalence among persons who use illicit stimulants remains unknown. We implemented respondent driven sampling (RDS) to estimate the prevalence of HIV infection in this high-risk population. We also examined RDS-adjusted rates of risk behaviors among HIV-positive and HIV-negative participants. Recruited from seven seeds, our sample of 387 participants was 46% female, 89% African American, and 45.94 years old on average. Participants were predominantly non-injection cocaine users, had large networks of stimulant users, and reported an established relationship with their recruiter. The adjusted population proportion of HIV infection was 0.07 (0.04, 0.11). The majority of sexually active participants reported engagement in risk behaviors (73%), but rates generally did not differ by HIV status. Our results highlight that stimulant use is a risk factor for HIV infection. This study also demonstrates that RDS is a very effective strategy for reaching stimulant users in the community.
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Affiliation(s)
- Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA.
| | - Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
| | - Yunan Xu
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
| | - Crissi Rainer
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27705, USA
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16
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Cutts JC, Quinn B, Seed CR, Kotsiou G, Pearson R, Scott N, Wilson DP, Harrod ME, Maher L, Caris S, Thompson AJ, Farrell M, Pink J, Hellard ME. A Systematic Review of Interventions Used to Increase Blood Donor Compliance with Deferral Criteria. Transfus Med Hemother 2020; 48:118-129. [PMID: 33976612 DOI: 10.1159/000509027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/28/2020] [Indexed: 11/19/2022] Open
Abstract
Background and Objectives Pre-donation screening of potential blood donors is critical for ensuring the safety of the donor blood supply, and donor deferral as a result of risk factors is practised worldwide. This systematic review was conducted in the context of an expert review convened by the Australian Red Cross Lifeblood in 2013 to consider Lifeblood's injecting drug use (IDU)-related policies and aimed to identify studies assessing interventions to improve compliance with deferral criteria in blood donation settings. Materials and Methods MEDLINE/PubMed, OVID Medline, OVID Embase, LILACS, and the Cochrane Library (CENTRAL and DARE) databases were searched for studies conducted within blood donation settings that examined interventions to increase blood donor compliance with deferral criteria. Observational and experimental studies from all geographical areas were considered. Results Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tickbox questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low. Conclusion This review identified several interventions to improve donor compliance that have been tested in blood donation settings and provided evidence for the effectiveness of computerized interviews in improving detection of risk factors.
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Affiliation(s)
| | - Brendan Quinn
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Clive R Seed
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - George Kotsiou
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Ruth Pearson
- Burnet Institute, Melbourne, Victoria, Australia
| | - Nick Scott
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Mary Ellen Harrod
- NSW Users and AIDS Association, Surry Hills, New South Wales, Australia
| | - Lisa Maher
- Burnet Institute, Melbourne, Victoria, Australia.,Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sharon Caris
- Haemophilia Foundation Australia, Malvern East, Victoria, Australia
| | - Alex J Thompson
- Department of Gastroenterology, St Vincent's Hospital and the University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Joanne Pink
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.,Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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17
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Artenie AA, Cunningham EB, Dore GJ, Conway B, Dalgard O, Powis J, Bruggmann P, Hellard M, Cooper C, Read P, Feld JJ, Hajarizadeh B, Amin J, Lacombe K, Stedman C, Litwin AH, Marks P, Matthews GV, Quiene S, Erratt A, Bruneau J, Grebely J. Patterns of Drug and Alcohol Use and Injection Equipment Sharing Among People With Recent Injecting Drug Use or Receiving Opioid Agonist Treatment During and Following Hepatitis C Virus Treatment With Direct-acting Antiviral Therapies: An International Study. Clin Infect Dis 2020; 70:2369-2376. [PMID: 31300820 PMCID: PMC7245153 DOI: 10.1093/cid/ciz633] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/10/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In many settings, recent or prior injection drug use remains a barrier to accessing direct-acting antiviral treatment (DAA) for hepatitis C virus (HCV) infection. We examined patterns of drug and alcohol use and injection equipment sharing among people with recent injecting drug use or receiving opioid agonist treatment (OAT) during and following DAA-based treatment. METHODS SIMPLIFY and D3FEAT are phase 4 trials evaluating the efficacy of DAA among people with past 6-month injecting drug use or receiving OAT through a network of 25 international sites. Enrolled in 2016-2017, participants received sofosbuvir/velpatasvir (SIMPLIFY) or paritaprevir/ritonavir/dasabuvir/ombitasvir ± ribavirin (D3FEAT) for 12 weeks and completed behavioral questionnaires before, during, and up to 2 years posttreatment. The impact of time in HCV treatment and follow-up on longitudinally measured longitudinally measured behaviors was estimated using generalized estimating equations. RESULTS At screening, of 190 participants (mean age, 47 years; 74% male), 62% reported any past-month injecting 16% past-month injection equipment sharing, and 61% current OAT. Median alcohol use was 2 (Alcohol Use Disorders Identification Test-Consumption; range, 1-12). During follow-up, opioid injecting (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.92-0.99) and sharing (OR, 0.87; 95% CI, 0.80-0.94) decreased, whereas no significant changes were observed for stimulant injecting (OR, 0.98; 95% CI, 0.94-1.02) or alcohol use (OR, 0.99; 95% CI, 0.95-1.04). CONCLUSIONS Injecting drug use and risk behaviors remained stable or decreased following DAA-based HCV treatment. Findings further support expanding HCV treatment to all, irrespective of injection drug use. CLINICAL TRIALS REGISTRATION SIMPLIFY, NCT02336139; D3FEAT, NCT02498015.
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Affiliation(s)
- Andreea A Artenie
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Canada
| | | | - Gregory J Dore
- Kirby Institute, University of New South Wales, Australia
- Department of Infectious Diseases, St Vincent’s Hospital, Sydney, Australia
| | | | - Olav Dalgard
- Department of Infectious Disease, Akershus University Hospital, Oslo, Norway
| | - Jeff Powis
- South Riverdale Community Health Centre, Toronto, Canada
| | | | - Margaret Hellard
- Centre for Population Health, Burnet Institute, Australia
- Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia
| | | | - Philip Read
- Kirby Institute, University of New South Wales, Australia
- Kirketon Road Centre, Sydney, Australia
| | | | | | - Janaki Amin
- Kirby Institute, University of New South Wales, Australia
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Karine Lacombe
- Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, Paris, France
- Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France
| | | | - Alain H Litwin
- Department of Medicine, School of Medicine Greenville, University of South Carolina
- Department of Medicine, School of Health Research, Clemson University, Greenville, South Carolina
- Prisma Health—Upstate, Greenville, South Carolina
| | - Pip Marks
- Kirby Institute, University of New South Wales, Australia
| | - Gail V Matthews
- Kirby Institute, University of New South Wales, Australia
- Department of Infectious Diseases, St Vincent’s Hospital, Sydney, Australia
| | - Sophie Quiene
- Kirby Institute, University of New South Wales, Australia
| | - Amanda Erratt
- Kirby Institute, University of New South Wales, Australia
| | - Julie Bruneau
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Canada
- Research Centre, Centre Hospitalier de l’Université de Montréal, Canada
| | - Jason Grebely
- Kirby Institute, University of New South Wales, Australia
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18
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Bajis S, Grebely J, Hajarizadeh B, Applegate T, Marshall AD, Ellen Harrod M, Byrne J, Bath N, Read P, Edwards M, Gorton C, Hayllar J, Cock V, Peterson S, Thomson C, Weltman M, Jefferies M, Wood W, Haber P, Ezard N, Martinello M, Maher L, Dore GJ. Hepatitis C virus testing, liver disease assessment and treatment uptake among people who inject drugs pre- and post-universal access to direct-acting antiviral treatment in Australia: The LiveRLife study. J Viral Hepat 2020; 27:281-293. [PMID: 31698545 DOI: 10.1111/jvh.13233] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/04/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023]
Abstract
Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treatment uptake among people who inject drugs (PWID) persist. We aimed to describe the cascade of HCV care among PWID in Australia, prior to and following unrestricted access to direct-acting antiviral (DAA) treatment. Participants enrolled in an observational cohort study between 2014 and 2018 provided fingerstick whole-blood samples for dried blood spot, Xpert HCV Viral Load and venepuncture samples. Participants underwent transient elastography and clinical assessment by a nurse or general practitioner. Among 839 participants (mean age 43 years), 66% were male (n = 550), 64% (n = 537) injected drugs in the previous month, and 67% (n = 560) reported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had detectable HCV RNA, of whom 23% (n = 86) received HCV treatment within 12 months of enrolment. HCV treatment uptake increased from 2% in the pre-DAA era to 38% in the DAA era. Significant liver fibrosis (F2-F4) was more common in participants with HCV infection (38%) than those without (19%). Age 50 years or older (aOR, 2.88; 95% CI, 1.18-7.04) and attending a clinical follow-up with nurse (aOR, 3.19; 95% CI, 1.61-6.32) or physician (aOR, 11.83; 95% CI, 4.89-28.59) were associated with HCV treatment uptake. Recent injection drug use and unstable housing were not associated with HCV treatment uptake. HCV treatment uptake among PWID has increased markedly in the DAA era. Evaluation of innovative and simplified models of care is required to further enhance treatment uptake.
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Affiliation(s)
- Sahar Bajis
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | | | - Alison D Marshall
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | | | - Jude Byrne
- Australian Injecting and Illicit Drug Users League, Canberra, ACT, Australia
| | - Nicky Bath
- NSW Users and AIDS Association, Sydney, NSW, Australia
| | | | - Michael Edwards
- South Western Sydney Local Health District Drug Health Services, Sydney, NSW, Australia
| | - Carla Gorton
- Cairns Sexual Health Service, Cairns, QLD, Australia
| | - Jeremy Hayllar
- Alcohol and Drug Service, Metro North Mental Health, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Victoria Cock
- Drug and Alcohol Services of South Australia, Adelaide, SA, Australia
| | | | - Claire Thomson
- Bayside Alcohol and Drug Services, Cleveland, QLD, Australia
| | | | | | - William Wood
- Sydney Medically Supervised Injecting Centre, Sydney, NSW, Australia
| | - Paul Haber
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital, Sydney, NSW, Australia.,Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | | | - Lisa Maher
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Burnet Institute, Melbourne, Vic, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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19
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A Longitudinal Study of Behavioral Risk, Adherence, and Virologic Control in Adolescents Living With HIV in Asia. J Acquir Immune Defic Syndr 2020; 81:e28-e38. [PMID: 30865173 DOI: 10.1097/qai.0000000000002008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Adolescents living with HIV (ALHIV) have poorer adherence and clinical outcomes than adults. We conducted a study to assess behavioral risks and antiretroviral therapy outcomes among ALHIV in Asia. METHODS A prospective cohort study among ALHIV and matched HIV-uninfected controls aged 12-18 years was conducted at 9 sites in Malaysia, Thailand, and Vietnam from July 2013 to March 2017. Participants completed an audio computer-assisted self-interview at weeks 0, 48, 96, and 144. Virologic failure (VF) was defined as ≥1 viral load (VL) measurement >1000 copies/mL. Generalized estimating equations were used to identify predictors for VF. RESULTS Of 250 ALHIV and 59 HIV-uninfected controls, 58% were Thai and 51% females. The median age was 14 years at enrollment; 93% of ALHIV were perinatally infected. At week 144, 66% of ALHIV were orphans vs. 28% of controls (P < 0.01); similar proportions of ALHIV and controls drank alcohol (58% vs. 65%), used inhalants (1% vs. 2%), had been sexually active (31% vs. 21%), and consistently used condoms (42% vs. 44%). Of the 73% of ALHIV with week 144 VL testing, median log VL was 1.60 (interquartile range 1.30-1.70) and 19% had VF. Over 70% of ALHIV had not disclosed their HIV status. Self-reported adherence ≥95% was 60% at week 144. Smoking cigarettes, >1 sexual partner, and living with nonparent relatives, a partner or alone, were associated with VF at any time. CONCLUSIONS The subset of ALHIV with poorer adherence and VF require comprehensive interventions that address sexual risk, substance use, and HIV-status disclosure.
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Abstract
OBJECTIVE The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample characteristics, and baseline outcomes of the NIAAA 2-question screen. METHODS Participants included 12- to 17-year-olds treated in one of the participating pediatric emergency departments across the United States. After enrollment, a criterion assessment battery including the NIAAA 2-question screen and other measures of alcohol, drug use, and risk behavior was self-administered by participants on a tablet computer. Two subsamples were derived from the sample. The first subsample was readministered the NIAAA 2-question screen 1 week after their initial visit to assess test-retest reliability. The second subsample is being reassessed at 12 and 24 months to examine predictive validity of the NIAAA 2-question screen. RESULTS There were 4834 participants enrolled into the study who completed baseline assessments. Participants were equally distributed across sex and age. Forty-six percent of the participants identified as white, and 26% identified as black. Approximately one quarter identified as Hispanic. Using the NIAAA 2-question screen algorithm, approximately 8% were classified as low risk, 12% were classified as moderate risk, and 4% were classified as highest risk. Alcohol use was less likely to be reported by black participants, non-Hispanic participants, and those younger than 16 years. DISCUSSION This study successfully recruited a large, demographically diverse sample to establish rates of the NIAAA screen risk categories across age, sex, ethnicity, and race within pediatric emergency departments.
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Bajis S, Grebely J, Cooper L, Smith J, Owen G, Chudleigh A, Hajarizadeh B, Martinello M, Adey S, Read P, Gilliver R, Applegate T, Treloar C, Maher L, Dore GJ. Hepatitis C virus testing, liver disease assessment and direct-acting antiviral treatment uptake and outcomes in a service for people who are homeless in Sydney, Australia: The LiveRLife homelessness study. J Viral Hepat 2019; 26:969-979. [PMID: 30980785 DOI: 10.1111/jvh.13112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/27/2019] [Accepted: 03/18/2019] [Indexed: 01/22/2023]
Abstract
People who are homeless have increased hepatitis C virus (HCV) infection risk, and are less likely to access primary healthcare. We aimed to evaluate HCV RNA prevalence, liver disease burden, linkage to care and treatment uptake and outcomes among people attending a homelessness service in Sydney. Participants were enrolled in an observational cohort study with recruitment at a homelessness service over eight liver health campaign days. Finger-stick whole-blood samples for Xpert® HCV Viral Load and venepuncture blood samples were collected. Participants completed a self-administered survey and received transient elastography and clinical assessment by a general practitioner or nurse. Clinical follow-up was recommended 2-12 weeks after enrolment. For participants initiating direct-acting antiviral (DAA) therapy, medical records were audited retrospectively and treatment outcome data were collected. Among 202 participants (mean age, 48 years), 82% were male (n = 165), 39% (n = 78) reported ever injecting drugs, of whom 63% (n = 49) injected in the previous month. Overall, 23% (n = 47) had detectable HCV RNA and 6% (n=12) had cirrhosis. HCV RNA prevalence among participants with either injecting or incarceration history was 35% (37/105), compared to 4% (3/73) among participants without these risk factors. Among those with detectable HCV RNA, 23 (49%) commenced therapy, of whom 65% (n = 15) achieved sustained virological response, while the remainder had no available treatment outcome. No participant had documented virological failure. HCV DAA treatment uptake among people attending a homelessness service was encouraging, but innovative models of HCV care are required to improve linkage to care and treatment uptake among this highly marginalized population.
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Affiliation(s)
- Sahar Bajis
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lucy Cooper
- Matthew Talbot Hostel, St Vincent de Paul Society NSW Support Services, Sydney, New South Wales, Australia
| | - Julie Smith
- Matthew Talbot Hostel, St Vincent de Paul Society NSW Support Services, Sydney, New South Wales, Australia
| | - Greg Owen
- Matthew Talbot Hostel, St Vincent de Paul Society NSW Support Services, Sydney, New South Wales, Australia
| | - Alan Chudleigh
- Matthew Talbot Hostel, St Vincent de Paul Society NSW Support Services, Sydney, New South Wales, Australia
| | | | | | - Sara Adey
- NSW Users and AIDS Association, Sydney, New South Wales, Australia
| | - Phillip Read
- Kirketon Road Centre, Sydney, New South Wales, Australia
| | | | - Tanya Applegate
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lisa Maher
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
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Dowsett M, Islam MM, Ganora C, Day C, Lee KSK, Dawson A, Joseph T, White A, Freeburn B, Conigrave KM. Asking young Aboriginal people who use illicit drugs about their healthcare preferences using audio‐computer‐assisted self‐interviewing. Drug Alcohol Rev 2019; 38:482-493. [DOI: 10.1111/dar.12957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - M. Mofizul Islam
- Department of Public HealthLa Trobe University Bundoora Australia
| | - Christopher Ganora
- Department of General PracticeThe University of Sydney, Faculty of Medicine and Health (Westmead) Sydney Australia
| | - Carolyn Day
- Addiction MedicineThe University of Sydney, Faculty of Medicine and Health Sydney Australia
| | - K. S. Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and AlcoholThe University of Sydney, Faculty of Medicine and Health, Addiction Medicine Sydney Australia
- Centre for Alcohol Policy ResearchLa Trobe University Bundoora Australia
| | - Angela Dawson
- Australian Centre for Public and Population Health ResearchThe University of Technology Sydney Australia
| | - Telphia Joseph
- School of Public Health and Community MedicineThe University of New South Wales Sydney Australia
| | - Ann White
- Drug Health ServiceSydney Local Health District, Royal Prince Alfred Hospital Sydney Australia
| | | | - Katherine M. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and AlcoholThe University of Sydney, Faculty of Medicine and Health, Addiction Medicine Sydney Australia
- Drug Health ServiceSydney Local Health District, Royal Prince Alfred Hospital Sydney Australia
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Ayon S, Jeneby F, Hamid F, Badhrus A, Abdulrahman T, Mburu G. Developing integrated community-based HIV prevention, harm reduction, and sexual and reproductive health services for women who inject drugs. Reprod Health 2019; 16:59. [PMID: 31138238 PMCID: PMC6538559 DOI: 10.1186/s12978-019-0711-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite being a priority population for HIV prevention and harm reduction programs, the sexual and reproductive health (SRH) needs of women who inject drugs are being overlooked. Furthermore, models for providing integrated SRH, HIV, and harm reduction services for women who inject drugs are rare. This article reports the development of community-based outreach services that integrated family planning and other SRH interventions with HIV and harm reduction services for this population in coastal Kenya. METHODS Using mixed-methods implementation research, a qualitative baseline needs assessment was conducted with women who inject drugs and harm reduction stakeholders using a combination of in-depth interviews and focus group discussions. The qualitative data from participants was subjected to thematic analysis using Nvivo. Based on the baseline needs assessment, integration of SRH into existing HIV and harm reduction services was implemented. After two years of implementation, an evaluation of the program was conducted using a combination of qualitative interviews and review of quantitative service delivery records and other program documents. The process, impacts, and challenges of integrating SRH into a community-based HIV prevention and harm reduction program were identified. RESULTS This article highlights: 1) low baseline utilization of family planning services among women who inject drugs, 2) improved utilization and high acceptability of outreach-based provision of SRH services including contraception among this population, 3) importance of training, capacity strengthening, technical support and financial resourcing of community-based organizations to integrate SRH into HIV prevention and harm reduction services, and 4) the value of beneficiary involvement, advocacy, and collaboration with other partners in the planning, designing and implementing of SRH interventions for women who inject drugs. CONCLUSIONS Women who inject drugs in this study had low utilization of family planning and other SRH services, which can be improved through the integration of contraceptive and other SRH interventions into existing outreach-based HIV prevention and harm reduction programs. This integration is acceptable to women who inject drugs, and is programmatically feasible. For successful integration, a rights-based beneficiary involvement, coupled with sustainable technical and financial capacity strengthening at the community level is essential.
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Affiliation(s)
| | - Fatma Jeneby
- Muslim Education and Welfare Association, Mombasa, Kenya
| | | | | | | | - Gitau Mburu
- Division of Health Research, University of Lancaster, Lancaster, LA1 4YW, UK. .,Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Lee KSK, Conigrave JH, Callinan S, Wilson S, Room R, Perry J, Slade T, Chikritzhs TN, Hayman N, Weatherall T, Leggat G, Gray D, Conigrave KM. Asking about the last four drinking occasions on a tablet computer as a way to record alcohol consumption in Aboriginal and Torres Strait Islander Australians: a validation. Addict Sci Clin Pract 2019; 14:15. [PMID: 31039824 PMCID: PMC6492339 DOI: 10.1186/s13722-019-0148-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol consumption among Indigenous Australians can be irregular, depending on social and geographic context. The Finnish method uses the last four drinking occasions to estimate drinking quantity and pattern. The Grog Survey App is an interactive and visual tablet computer application which uses touch-screen technology to deliver questions on drinking. METHODS Alcohol consumption recorded on the Grog Survey App using the last four occasions (Finnish) method was compared with a clinical interview conducted by an Indigenous Australian health professional. To assess convergent validity, Spearman's ranked correlations between consumption estimates from the App and from interview were calculated. Sensitivity and specificity analyses were used to compare how well the App and clinical interview agreed when classifying drinkers' risk. To assess criterion validity, average grams alcohol per day as estimated by the App (and by interview) were compared against presence of self-reported withdrawal tremors (from App or interview). Test-retest reliability was assessed by correlations between measures of alcohol consumption recorded on two occasions. RESULTS The App recorded higher numbers of standard drinks consumed per drinking occasion than the interview. There was reasonable agreement between the App and interview across common reference periods (sensitivity 92.7%, specificity 69.8%, short-term risk; sensitivity 70.7%, specificity 68.8%, long-term risk). Average consumption recorded by the App was as good or better predictor of withdrawal tremors than consumption as estimated by interview. CONCLUSIONS The Finnish method, as delivered by the App, offers an innovative way to collect survey data on alcohol in a population with an intermittent drinking pattern.
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Affiliation(s)
- K. S. Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - James H. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Scott Wilson
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, Adelaide, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, Adelaide, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Tanya N. Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, WA Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD Australia
- School of Medicine, Griffith University, Brisbane, QLD Australia
- School of Medicine, University of Queensland, Brisbane, QLD Australia
| | - Teagan Weatherall
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Dennis Gray
- School of Medicine, University of Queensland, Brisbane, QLD Australia
| | - Katherine M. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Drug Health Services, Sydney Local Health District, Royal Prince Alfred Hospital, Sydney, NSW Australia
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Lee KK, Conigrave JH, Al Ansari M, Wilson S, Perry J, Zheng C, Freeburn B, Room R, Callinan S, Hayman N, Chikritzhs T, Slade T, Gray D, Conigrave KM. Acceptability and feasibility of a computer-based application to help Aboriginal and Torres Strait Islander Australians describe their alcohol consumption. J Ethn Subst Abuse 2019; 20:16-33. [PMID: 30887909 DOI: 10.1080/15332640.2019.1579144] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We examined acceptability and feasibility of a tablet application ("App") to record self-reported alcohol consumption among Aboriginal and Torres Strait Islander Australians. Four communities (1 urban; 3 regional/remote) tested the App, with 246 adult participants (132 males, 114 females). The App collected (a) completion time; (b) participant feedback; (c) staff observations. Three research assistants were interviewed. Only six (1.4%) participants reported that the App was "hard" to use. Participants appeared to be engaged and to require minimal assistance; nearly half verbally reflected on their drinking or drinking of others. The App has potential for surveys, screening, or health promotion.
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Affiliation(s)
- Ks Kylie Lee
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia.,La Trobe University, Centre for Alcohol Policy Research, Victoria, Australia
| | - James H Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia
| | - Mustafa Al Ansari
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia
| | - Scott Wilson
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia.,Aboriginal Drug and Alcohol Council (ADAC), South Australia, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC), South Australia, Australia
| | - Catherine Zheng
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia
| | - Bradley Freeburn
- Aboriginal Medical Service Redfern Co-op Limited, New South Wales, Australia
| | - Robin Room
- La Trobe University, Centre for Alcohol Policy Research, Victoria, Australia
| | - Sarah Callinan
- La Trobe University, Centre for Alcohol Policy Research, Victoria, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland, Australia.,School of Medicine, University of Queensland, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
| | - Tanya Chikritzhs
- Curtin University, Health Sciences, National Drug Research Institute, Western Australia, Australia
| | - Tim Slade
- University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia
| | - Dennis Gray
- Curtin University, Health Sciences, National Drug Research Institute, Western Australia, Australia
| | - Katherine M Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia.,Royal Prince Alfred Hospital, Drug Health Services, Sydney Local Health District, New South Wales, Australia
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Power J, Salmon AM, Latimer J, Jauncey M, Day CA. Overdose Risk and Client Characteristics Associated With the Injection of Buprenorphine at a Medically Supervised Injecting Center in Sydney, Australia. Subst Use Misuse 2019; 54:1646-1653. [PMID: 30973286 DOI: 10.1080/10826084.2019.1600147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Buprenorphine and buprenorphine/naloxone (BNX) were developed to improve the safety profile of opioid substitution treatment (OST) and reduce diversion and injection, yet continue to be injected, despite the risk of harm. Previous studies examining injection of these substances have relied on self-reported injection and overdose. Using data from the Uniting Medically Supervised Injecting Center (MSIC) in Sydney, this study aimed to assess the overdose risk associated with the use of buprenorphine and BNX and identify factors associated with injecting. Methods: Client data routinely collected from MSIC, a drug consumption room where clients can legally inject drugs under supervision, was used. Odds ratios (OR) to assess the risk of overdose and their associated 95% confidence intervals (95%CI) were calculated and compared to other substances. Univariate analysis using χ-square and multivariate logistic regressions were used to determine characteristics associated with buprenorphine and BNX injection. Results: Data from 1,020,782 injections by 15,832 individuals were analyzed. Risk of overdose was low for buprenorphine compared to other substances (OR 0.16; 95%CI: 0.07-0.19) and no overdoses occurred when BNX was injected. Injection of both buprenorphine and BNX was associated with male gender, homelessness, no income/reliance upon government payments, and prior imprisonment. Conclusions: Buprenorphine and BNX continue to be injected, albeit in small numbers. This is the first study to report on injection and overdose risk using direct observation, and has confirmed the lower overdose risk. MSIC clients who inject buprenorphine and BNX tend to be marginalized and may benefit from targeted harm reduction measures.
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Affiliation(s)
- Joseph Power
- a The Sydney Central Clinical School, Faculty of Medicine and Health , University of Sydney , Sydney , NSW , Australia
| | - Allison M Salmon
- b Uniting Medically Supervised Injecting Centre , Kings Cross , NSW , Australia
| | - Julie Latimer
- b Uniting Medically Supervised Injecting Centre , Kings Cross , NSW , Australia
| | - Marianne Jauncey
- a The Sydney Central Clinical School, Faculty of Medicine and Health , University of Sydney , Sydney , NSW , Australia.,b Uniting Medically Supervised Injecting Centre , Kings Cross , NSW , Australia
| | - Carolyn A Day
- a The Sydney Central Clinical School, Faculty of Medicine and Health , University of Sydney , Sydney , NSW , Australia.,b Uniting Medically Supervised Injecting Centre , Kings Cross , NSW , Australia
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Use of Audio Computer-Assisted Self-Interviews to Gather Information on Risk Behaviors in a Population of Pregnant Adolescents. J Pediatr 2018; 203:450-453. [PMID: 30244989 DOI: 10.1016/j.jpeds.2018.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/18/2018] [Accepted: 08/09/2018] [Indexed: 11/24/2022]
Abstract
In a prospective study comparing the use of the Audio Computer-Assisted Self-Interview (ACASI) with a traditional clinical interview in 40 pregnant adolescents, there was significantly greater disclosure of violence with the ACASI method. Better identification of high-risk behaviors may help to optimize care and programing for pregnant adolescents.
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Ndimbii J, Ayon S, Abdulrahman T, Mahinda S, Jeneby F, Armstrong G, Mburu G. Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya: Findings from a qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 18:48-55. [DOI: 10.1016/j.srhc.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 09/25/2018] [Accepted: 10/05/2018] [Indexed: 11/25/2022]
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Mital S, Windle M, Cooper HLF, Crawford ND. Trends in non-medical prescription opioids and heroin co-use among adults, 2003-2014. Addict Behav 2018; 86:17-23. [PMID: 29778489 DOI: 10.1016/j.addbeh.2018.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/24/2018] [Accepted: 05/07/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patterns in non-medical prescription opioid (NMPO) and heroin use have recently shifted, with evidence that NMPO-only users transition to NMPO and heroin co-use. Co-use is associated with increased risk of morbidity and overdose, highlighting the need for further investigation. This study aims to quantify, describe, and explore trends in co-use. METHODS Using data from the 2003-2014 National Surveys on Drug Use and Health, we compared co-use to NMPO- and heroin-only use across demographic, substance use and mental health characteristics with chi-squared tests. Logistic regression models assessed trends in opioid use overall, and among co-users. RESULTS From 2003 to 2014, the prevalence of all opioid use (NMPO-only, heroin-only, and co-use) and NMPO-only use decreased 6.08% (p < 0.01) and 4.65% (p < 0.001), respectively, while prevalence of heroin-only use increased 21.32% (non-significant). Co-use increased 248.17% (p < 0.001) overall, and did so in all demographic, substance use, and mental health groups. Demographic, substance use, and mental health characteristics of co-users were more similar to the heroin-only group than to NMPO-only. The highest co-use prevalence was among those: without health insurance (8.72%), aged 26-34 (9.76%), reporting unemployment (12.08%), and with a major depressive episode, psychological distress, and who illicitly use or abuse drugs other than opioids or marijuana in the past year (9.33%, 10.75%, 11.87%, and 16.81%, respectively). DISCUSSION The increased prevalence of co-use and differences across demographic, substance use, and mental health characteristics highlight the need for targeted prevention and response interventions for this emerging, high-risk group.
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Affiliation(s)
- Sasha Mital
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States.
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Hannah L F Cooper
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Natalie D Crawford
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
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Bajis S, Maher L, Treloar C, Hajarizadeh B, Lamoury FMJ, Mowat Y, Schulz M, Marshall AD, Cunningham EB, Cock V, Ezard N, Gorton C, Hayllar J, Smith J, Whelan M, Martinello M, Applegate TL, Dore GJ, Grebely J. Acceptability and preferences of point-of-care finger-stick whole-blood and venepuncture hepatitis C virus testing among people who inject drugs in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 61:23-30. [PMID: 30388566 DOI: 10.1016/j.drugpo.2018.08.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 08/08/2018] [Accepted: 08/15/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Uptake of hepatitis C virus (HCV) testing remains inadequate globally. Simplified point-of-care tests should enhance HCV diagnosis and elimination. We aimed to assess the acceptability of finger-stick and venepuncture HCV RNA testing among people who inject drugs (PWID). METHODS Participants were enrolled in an observational cohort study with recruitment at 13 sites between June 2016 and February 2018. Capillary whole-blood collected by finger-stick and plasma collected by venepuncture were performed for Xpert® HCV viral load testing. Participants completed a questionnaire on acceptability of, and preferences for, blood collection methods. RESULTS Among 565 participants (mean age, 44 years; 69% male), 64% reported injecting drugs in the last month, and 63% were receiving opioid substitution treatment. Eighty three percent reported that finger-stick testing was very acceptable. Overall, 65% of participants preferred finger-stick over venepuncture testing, with 61% of these preferring to receive results in 60 min. The most common reason for preferring finger-stick over venepuncture testing was it was quick (62%) followed by venous access difficulties (21%). The main reasons for preferring venepuncture over finger-stick testing were that it was quick (61%) and accurate (29%). Females were more likely to prefer finger-stick testing than males (adjusted OR 1.96; 95% CI 1.30, 2.99; p = 0.002). Among people with recent (previous month) injecting drug use, Aboriginal and/or Torres Strait Islander people were less likely than non-Aboriginal people to prefer finger-stick testing (adjusted OR 0.57; 95% CI 0.34, 0.9; p = 0.033). CONCLUSIONS Finger-stick whole-blood collection is acceptable to people who inject drugs, with males and Aboriginal and/or Torres Strait Islander people with recent injecting drug use less likely to prefer finger-stick testing. Further research is needed to evaluate interventions integrating simplified point-of-care HCV testing to engage people in care in a single-visit, thereby facilitating HCV treatment scale-up.
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Affiliation(s)
- Sahar Bajis
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
| | - Lisa Maher
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia; The Burnet Institute, Melbourne, Victoria, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | | | | | - Yasmin Mowat
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Marcel Schulz
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alison D Marshall
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Evan B Cunningham
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Victoria Cock
- Drug and Alcohol Services of South Australia, Adelaide, South Australia, Australia
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital, Sydney, New South Wales, Australia; Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Carla Gorton
- Cairns Sexual Health Service, Cairns, Queensland, Australia
| | - Jeremy Hayllar
- Alcohol and Drug Service, Metro North Mental Health, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Julie Smith
- Matthew Talbot Hostel, St Vincent de Paul Society NSW Support Services, Sydney, New South Wales, Australia
| | - Michelle Whelan
- Campbelltown Drug Health Services, Sydney, New South Wales, Australia
| | | | - Tanya L Applegate
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
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31
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Haghir E, Madampage C, Mahmood R, Moraros J. Risk Factors Associated with Self-reported Sexually Transmitted Infections among Postsecondary Students in Canada. Int J Prev Med 2018; 9:49. [PMID: 29963300 PMCID: PMC5998606 DOI: 10.4103/ijpvm.ijpvm_444_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/03/2018] [Indexed: 11/08/2022] Open
Abstract
Background: Despite major public health efforts in addressing the burden of disease caused by sexually transmitted infections (STIs), rates among young adults continue to rise in Canada. The purpose of the study was to examine the prevalence and risk factors associated with acquiring STIs among postsecondary students in Canada. Methods: A secondary analysis of the American College Health Association-National College Health Assessment II-C Spring 2016 survey data (n = 43,780) was conducted. Sexually active participants (n = 28,831) were examined for their demographics, sexual behavior, alcohol and marijuana use, testing for human immunodeficiency virus (HIV), and human papillomavirus vaccination history. These factors were analyzed to help identify their possible association with acquiring an STI using logistic regression and multivariate modeling. Results: Among the study participants, 3.88% had an STI, with the highest rates observed among females and individuals aged 21–24 years old. Multivariate logistic analysis showed that participants who engaged in anal intercourse within the past 30 days (odds ratio [OR] = 1.634; 95% confidence interval [CI], 1.343–1.988), had four or more sexual partners in the last 12 months (OR = 4.223; 95% CI, 3.595–4.962), used marijuana within the past 30 days (OR = 1.641; 95% CI, 1.387–1.941), and had ever been tested for HIV (OR = 3.008; 95% CI, 2.607–3.471) had greater odds of acquiring an STI. Conclusions: The findings of this study highlight certain high-risk behaviors that are strongly associated with acquiring an STI among postsecondary students. Thus, efforts to design and deliver relevant educational programming and health promotion initiatives for this particular population are of utmost importance.
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Affiliation(s)
- Edris Haghir
- School of Public Health, University of Saskatchewan, Saskatchewan, Canada
| | - Claudia Madampage
- School of Public Health, University of Saskatchewan, Saskatchewan, Canada
| | - Razi Mahmood
- School of Public Health, University of Saskatchewan, Saskatchewan, Canada
| | - John Moraros
- School of Public Health, University of Saskatchewan, Saskatchewan, Canada
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32
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Thriemer K, Bobogare A, Ley B, Gudo CS, Alam MS, Anstey NM, Ashley E, Baird JK, Gryseels C, Jambert E, Lacerda M, Laihad F, Marfurt J, Pasaribu AP, Poespoprodjo JR, Sutanto I, Taylor WR, van den Boogaard C, Battle KE, Dysoley L, Ghimire P, Hawley B, Hwang J, Khan WA, Mudin RNB, Sumiwi ME, Ahmed R, Aktaruzzaman MM, Awasthi KR, Bardaji A, Bell D, Boaz L, Burdam FH, Chandramohan D, Cheng Q, Chindawongsa K, Culpepper J, Das S, Deray R, Desai M, Domingo G, Duoquan W, Duparc S, Floranita R, Gerth-Guyette E, Howes RE, Hugo C, Jagoe G, Sariwati E, Jhora ST, Jinwei W, Karunajeewa H, Kenangalem E, Lal BK, Landuwulang C, Le Perru E, Lee SE, Makita LS, McCarthy J, Mekuria A, Mishra N, Naket E, Nambanya S, Nausien J, Duc TN, Thi TN, Noviyanti R, Pfeffer D, Qi G, Rahmalia A, Rogerson S, Samad I, Sattabongkot J, Satyagraha A, Shanks D, Sharma SN, Sibley CH, Sungkar A, Syafruddin D, Talukdar A, Tarning J, ter Kuile F, Thapa S, Theodora M, Huy TT, Waramin E, Waramori G, Woyessa A, Wongsrichanalai C, Xa NX, Yeom JS, Hermawan L, Devine A, Nowak S, Jaya I, Supargiyono S, Grietens KP, Price RN. Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group. Malar J 2018; 17:241. [PMID: 29925430 PMCID: PMC6011582 DOI: 10.1186/s12936-018-2380-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 06/08/2018] [Indexed: 01/13/2023] Open
Abstract
The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness.
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Affiliation(s)
- Kamala Thriemer
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Albino Bobogare
- Ministry of Health and Medical Services, National Vector-Borne Disease Control Programme, Honiara, Solomon Islands
| | - Benedikt Ley
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | | | - Mohammad Shafiul Alam
- 0000 0004 0600 7174grid.414142.6International Center for Diarrheal Diseases (ICDDR,B), Dhaka, Bangladesh
| | - Nick M. Anstey
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Elizabeth Ashley
- Myanmar-Oxford Clinical Research Unit, Yangon, Myanmar ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - J. Kevin Baird
- 0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,0000 0004 1795 0993grid.418754.bEijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - Charlotte Gryseels
- 0000 0001 2153 5088grid.11505.30Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Elodie Jambert
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | - Marcus Lacerda
- Instituto Leônidas & Maria Deane (Fiocruz), Manaus, Amazonas Brazil ,0000 0004 0486 0972grid.418153.aFundação de Medicina Tropical Dr, Heitor Vieira Dourado, Manaus, Amazonas Brazil
| | - Ferdinand Laihad
- National Forum on Indonesia RBM/National Forum on Gebrak Malaria, Jakarta, Indonesia
| | - Jutta Marfurt
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | | | | | - Inge Sutanto
- 0000000120191471grid.9581.5University of Indonesia, Jakarta, Indonesia
| | - Walter R. Taylor
- 0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Christel van den Boogaard
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Katherine E. Battle
- 0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | - Lek Dysoley
- grid.452707.3National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia ,grid.436334.5School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Prakash Ghimire
- 0000 0001 2114 6728grid.80817.36Microbiology Department, Tribhuvan University, Kathmandu, Nepal
| | - Bill Hawley
- 0000 0001 2163 0069grid.416738.fEntomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jimee Hwang
- 0000 0001 2163 0069grid.416738.fPresident’s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA ,0000 0001 2297 6811grid.266102.1Global Health Group, University of California San Francisco, San Francisco, USA
| | - Wasif Ali Khan
- 0000 0004 0600 7174grid.414142.6International Center for Diarrheal Diseases (ICDDR,B), Dhaka, Bangladesh
| | - Rose Nani Binti Mudin
- 0000 0001 0690 5255grid.415759.bDisease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Rukhsana Ahmed
- 0000 0004 1936 9764grid.48004.38Liverpool School of Tropical Medicine, Liverpool, UK
| | - M. M. Aktaruzzaman
- grid.466907.aDirectorate General of Health Services, Ministry of Health & Family Welfare Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | | | - Azucena Bardaji
- 0000 0000 9635 9413grid.410458.cISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - David Bell
- 0000 0004 0406 7608grid.471104.7Intellectual Ventures Global Good Fund, Bellevue, USA
| | - Leonard Boaz
- Ministry of Health and Medical Services, National Vector-Borne Disease Control Programme, Honiara, Solomon Islands
| | | | - Daniel Chandramohan
- 0000 0004 0425 469Xgrid.8991.9The London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Qin Cheng
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia
| | | | - Janice Culpepper
- 0000 0000 8990 8592grid.418309.7Bill & Melinda Gates Foundation, Seattle, USA
| | - Santasabuj Das
- 0000 0004 1767 225Xgrid.19096.37Indian Council of Medical Research, New Delhi, India
| | - Raffy Deray
- Department of Health, National Centre for Disease Control & Prevention, Manila, Philippines
| | - Meghna Desai
- 0000 0001 2163 0069grid.416738.fMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Wang Duoquan
- 0000 0000 8803 2373grid.198530.6National Institute of Parasitic Diseases, China CDC, Shanghai, China
| | - Stephan Duparc
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | | | | | - Rosalind E. Howes
- 0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | | | - George Jagoe
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | - Elvieda Sariwati
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Sanya Tahmina Jhora
- grid.466907.aDirectorate General of Health Services, Ministry of Health & Family Welfare Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Wu Jinwei
- Tengchong Center for Disease Control and Prevention, Tengchong, China
| | - Harin Karunajeewa
- grid.1042.7Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Enny Kenangalem
- Yayasan Pengembangan Kesehatan dan Masyarakat, Papua (YPKMP), Papua, Indonesia
| | - Bibek Kumar Lal
- Epidemiology & Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | - Sang-Eun Lee
- 0000 0004 1763 8617grid.418967.5Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Seoul, South Korea
| | - Leo Sora Makita
- Ministry of Health, National Malaria Control Programme, Port Mosby, Papua New Guinea
| | - James McCarthy
- 0000 0001 2294 1395grid.1049.cQIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Asrat Mekuria
- 0000 0001 1250 5688grid.7123.7School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Neelima Mishra
- 0000 0004 1767 225Xgrid.19096.37Indian Council of Medical Research, New Delhi, India
| | - Esau Naket
- Ministry of Health, Malaria and Other Vector-Borne Diseases Control Program (MOVBDCP), Port Vila, Vanuatu
| | - Simone Nambanya
- Center of Malariology, Parasitology and Entomology, Communicable Diseases Control, Vientiane, Lao PDR
| | - Johnny Nausien
- Ministry of Health, Malaria and Other Vector-Borne Diseases Control Program (MOVBDCP), Port Vila, Vanuatu
| | - Thang Ngo Duc
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Thuan Nguyen Thi
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Rinitis Noviyanti
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Daniel Pfeffer
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | - Gao Qi
- grid.452515.2Jiangsu Institute of Parasitic Diseases, Wuxi, China ,WHO Collaborative Centre for Research and Training of Malaria Elimination, Wuxi, China
| | - Annisa Rahmalia
- 0000 0004 1796 1481grid.11553.33Tuberculosis-HIV Research Center Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia ,0000000122931605grid.5590.9Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Stephen Rogerson
- 0000 0001 2179 088Xgrid.1008.9Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Iriani Samad
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Jetsumon Sattabongkot
- 0000 0004 1937 0490grid.10223.32Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Bangok, Thailand
| | - Ari Satyagraha
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Dennis Shanks
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia
| | - Surender Nath Sharma
- grid.415820.aNational Vector Borne Disease Control Programme Directorate General of Health Services Ministry of Health & Family Welfare, New Delhi, India
| | - Carol Hopkins Sibley
- WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK ,0000000122986657grid.34477.33University of Washington, Seattle, WA USA
| | - Ali Sungkar
- 0000 0004 0470 8161grid.415709.eFamily Health Directorate, Ministry of Health, Jakarta, Indonesia
| | - Din Syafruddin
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Arunansu Talukdar
- 0000 0004 1768 2335grid.413204.0Medicine Department, Medical College Kolkata, Kolkata, India
| | - Joel Tarning
- Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Feiko ter Kuile
- 0000 0004 1936 9764grid.48004.38Liverpool School of Tropical Medicine, Liverpool, UK ,0000 0001 0155 5938grid.33058.3dKenya Medical Research Institute (KEMRI) Centre for Global Health Research, Kisumu, Kenya
| | | | - Minerva Theodora
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Tho Tran Huy
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Edward Waramin
- Family Health Services, Ministry of Health, Port Mosby, Papua New Guinea
| | | | - Adugna Woyessa
- grid.452387.fEthiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Nguyen Xuan Xa
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Joon Sup Yeom
- 0000 0004 0470 5454grid.15444.30Yonsei University College of Medicine, Seoul, South Korea
| | - Lukas Hermawan
- 0000 0004 0470 8161grid.415709.eFamily Health Directorate, Ministry of Health, Jakarta, Indonesia
| | - Angela Devine
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Spike Nowak
- 0000 0000 8940 7771grid.415269.dPATH, Seattle, USA
| | - Indra Jaya
- Program and Information Department, Directorate General of Disease Prevention and Control, Jakarta, Indonesia
| | | | - Koen Peeters Grietens
- 0000 0001 2153 5088grid.11505.30Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Ric N. Price
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
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33
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Islam MM, Oni HT, Lee KSK, Hayman N, Wilson S, Harrison K, Hummerston B, Ivers R, Conigrave KM. Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia. Addict Sci Clin Pract 2018; 13:5. [PMID: 29592801 PMCID: PMC5875000 DOI: 10.1186/s13722-018-0108-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
Introduction and aims Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test—Consumption) tool has become a national key performance indicator. Here we provide an overview of suitability of AUDIT-C and other brief alcohol screening tools for use in ACCHSs. Methods All peer-reviewed literature providing original data on validity, acceptability or feasibility of alcohol screening tools among Indigenous Australians was reviewed. Narrative synthesis was used to identify themes and integrate results. Results Three screening tools—full AUDIT, AUDIT-3 (third question of AUDIT) and CAGE (Cut-down, Annoyed, Guilty and Eye-opener) have been validated against other consumption measures, and found to correspond well. Short forms of AUDIT have also been found to compare well with full AUDIT, and were preferred by primary care staff. Help was often required with converting consumption into standard drinks. Researchers commented that AUDIT and its short forms prompted reflection on drinking. Another tool, the Indigenous Risk Impact Screen (IRIS), jointly screens for alcohol, drug and mental health risk, but is relatively long (13 items). IRIS has been validated against dependence scales. AUDIT, IRIS and CAGE have a greater focus on dependence than on hazardous or harmful consumption. Discussion and conclusions Detection of unhealthy drinking before harms occur is a goal of screening, so AUDIT-C offers advantages over tools like IRIS or CAGE which focus on dependence. AUDIT-C’s brevity suits integration with general health screening. Further research is needed on facilitating implementation of systematic alcohol screening into Indigenous primary healthcare.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia.
| | - Helen T Oni
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - K S Kylie Lee
- NHMRC Centre of Research Excellence: Indigenous Health and Alcohol, Sydney, Australia.,Indigenous Health and Substance Use, Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia.,School of Medicine, Griffith University, Brisbane, Australia
| | - Scott Wilson
- Aboriginal Drug and Alcohol Council SA, Underdale, South Australia, Australia.,Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Kristie Harrison
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Beth Hummerston
- Alcohol Treatment Project, Aboriginal Health Council of South Australia Ltd, Adelaide, Australia
| | - Rowena Ivers
- Illawarra Aboriginal Medical Service, Wollongong, Australia.,Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Katherine M Conigrave
- NHMRC Centre of Research Excellence: Indigenous Health and Alcohol, Sydney, Australia.,Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Australia
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34
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Lee KSK, Wilson S, Perry J, Room R, Callinan S, Assan R, Hayman N, Chikritzhs T, Gray D, Wilkes E, Jack P, Conigrave KM. Developing a tablet computer-based application ('App') to measure self-reported alcohol consumption in Indigenous Australians. BMC Med Inform Decis Mak 2018; 18:8. [PMID: 29334962 PMCID: PMC5769490 DOI: 10.1186/s12911-018-0583-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The challenges of assessing alcohol consumption can be greater in Indigenous communities where there may be culturally distinct approaches to communication, sharing of drinking containers and episodic patterns of drinking. This paper discusses the processes used to develop a tablet computer-based application ('App') to collect a detailed assessment of drinking patterns in Indigenous Australians. The key features of the resulting App are described. METHODS An iterative consultation process was used (instead of one-off focus groups), with Indigenous cultural experts and clinical experts. Regular (weekly or more) advice was sought over a 12-month period from Indigenous community leaders and from a range of Indigenous and non-Indigenous health professionals and researchers. RESULTS The underpinning principles, selected survey items, and key technical features of the App are described. Features include culturally appropriate questioning style and gender-specific voice and images; community-recognised events used as reference points to 'anchor' time periods; 'translation' to colloquial English and (for audio) to traditional language; interactive visual approaches to estimate quantity of drinking; images of specific brands of alcohol, rather than abstract description of alcohol type (e.g. 'spirits'); images of make-shift drinking containers; option to estimate consumption based on the individual's share of what the group drank. CONCLUSIONS With any survey platform, helping participants to accurately reflect on and report their drinking presents a challenge. The availability of interactive, tablet-based technologies enables potential bridging of differences in culture and lifestyle and enhanced reporting.
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Affiliation(s)
- K S Kylie Lee
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia. .,Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia.
| | - Scott Wilson
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Aboriginal Drug and Alcohol Council (ADAC) South Australia, 155 Holbrooks Road Underdale, Adelaide, South Australia, 5032, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, 155 Holbrooks Road Underdale, Adelaide, South Australia, 5032, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Robert Assan
- Alcohol, Tobacco and other Drugs Service, Queensland Health, 190 Palmerston Vincent, Townsville, QLD, 4814, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, 37 Wirraway Parade, Inala, QLD, 4077, Australia.,School of Medicine, University of Queensland, Herston Road, Brisbane, QLD, 4006, Australia.,School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Brisbane, QLD, 4222, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Dennis Gray
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Edward Wilkes
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Peter Jack
- Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, KGV Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Katherine M Conigrave
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, KGV Building, Missenden Road, Camperdown, NSW, 2050, Australia
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35
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Grebely J, Dalgard O, Conway B, Cunningham EB, Bruggmann P, Hajarizadeh B, Amin J, Bruneau J, Hellard M, Litwin AH, Marks P, Quiene S, Siriragavan S, Applegate TL, Swan T, Byrne J, Lacalamita M, Dunlop A, Matthews GV, Powis J, Shaw D, Thurnheer MC, Weltman M, Kronborg I, Cooper C, Feld JJ, Fraser C, Dillon JF, Read P, Gane E, Dore GJ. Sofosbuvir and velpatasvir for hepatitis C virus infection in people with recent injection drug use (SIMPLIFY): an open-label, single-arm, phase 4, multicentre trial. Lancet Gastroenterol Hepatol 2018; 3:153-161. [PMID: 29310928 DOI: 10.1016/s2468-1253(17)30404-1] [Citation(s) in RCA: 219] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/16/2017] [Accepted: 11/16/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite revised guidelines that no longer exclude people who inject drugs (PWID) from treatment for hepatitis C virus (HCV) infection, many clinicians are reluctant to treat recent PWID. This study aimed to evaluate the efficacy of sofosbuvir and velpatasvir therapy in people with chronic HCV infection and recent injection drug use. METHODS In this open-label, single-arm phase 4 trial (SIMPLIFY), we recruited participants with recent injection drug use (past 6 months) and chronic HCV genotype 1-6 infection from seven countries (19 sites). Participants received oral sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks. Therapy was given in 1-week electronic blister packs to record the time and date of each dose. The primary endpoint was the proportion of patients with sustained virological response 12 weeks after completion of treatment (SVR12; defined as HCV RNA <12 IU/mL), analysed in all patients who received at least one dose. This study is registered with ClinicalTrials.gov, number NCT02336139, and follow-up is ongoing to evaluate the secondary endpoint of HCV reinfection. FINDINGS Between March 29, and Oct 31, 2016, we enrolled 103 participants; 29 (28%) of whom were female, nine (9%) had cirrhosis, 36 (35%) had HCV genotype 1, five (5%) had genotype 2, 60 (58%) had genotype 3, and two (2%) had genotype 4. 61 (59%) participants were receiving opioid substitution therapy during the study, 76 (74%) injected in the past month, and 27 (26%) injected at least daily in the past month. 100 (97%) of 103 participants completed treatment; two people were lost to follow-up and one person died from an overdose. There were no virological failures. 97 (94%, 95% CI 88-98) of 103 people achieved SVR12. Three participants with an end-of-treatment response did not have a SVR; two were lost to follow-up and one had reinfection. Drug use before and during treatment did not affect SVR12. Treatment-related adverse events were seen in 48 (47%) patients (one grade 3, no grade 4). Seven (7%) patients had at least one serious adverse event; only one such event (rhabdomyolysis, resolved) was possibly related to the therapy. One case of HCV reinfection was observed. INTERPRETATION HCV treatment should be offered to PWID, irrespective of ongoing drug use. Recent injection drug use should not be used as a reason to withhold reimbursement of HCV therapy. FUNDING Gilead Sciences.
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Affiliation(s)
- Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
| | | | - Brian Conway
- Vancouver Infectious Diseases Center, Vancouver, BC, Canada
| | | | | | | | - Janaki Amin
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Julie Bruneau
- Centre Hospitalier de l'Université de Montréal, QC, Canada
| | - Margaret Hellard
- The Burnet Institute, Melbourne, VIC, Australia; Department of Infectious Disease, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alain H Litwin
- Montefiore Medical Center, United States and Albert Einstein College of Medicine, New York, NY, USA
| | - Philippa Marks
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Sophie Quiene
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | | | - Tracy Swan
- International Network on Hepatitis in Substance Users, New York, NY, USA
| | - Jude Byrne
- Australian Injecting & Illicit Drug Users League, Canberra, NSW, Australia
| | - Melanie Lacalamita
- Department of Infectious Diseases, Bern University Hospital, Bern, Switzerland
| | - Adrian Dunlop
- Newcastle Pharmacotherapy Service, Newcastle, NSW, Australia
| | - Gail V Matthews
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; St Vincent's Hospital, Sydney, NSW, Australia
| | - Jeff Powis
- South Riverdale Community Health Centre, Toronto, ON, Canada
| | - David Shaw
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | | | | | - Curtis Cooper
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Chris Fraser
- Cool Aid Community Health Centre, Victoria, BC, Canada
| | - John F Dillon
- Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Phillip Read
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Kirketon Road Centre, Sydney, NSW, Australia
| | - Ed Gane
- Auckland City Hospital, Auckland, New Zealand
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; St Vincent's Hospital, Sydney, NSW, Australia
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Scheidell JD, Quinn K, McGorray SP, Frueh BC, Beharie NN, Cottler LB, Khan MR. Childhood traumatic experiences and the association with marijuana and cocaine use in adolescence through adulthood. Addiction 2018; 113:44-56. [PMID: 28645136 PMCID: PMC5725274 DOI: 10.1111/add.13921] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/06/2017] [Accepted: 06/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Examination of longitudinal relationships between childhood traumatic experiences and drug use across the life-course at the national level, with control of confounding by other forms of trauma, is needed. We aimed to estimate the prevalence of nine typologies of childhood traumas and the cumulative number experienced, correlation between traumas and associations between individual and cumulative number of traumas with drug use during adolescence, emerging adulthood and adulthood. DESIGN Secondary data analysis using the National Longitudinal Study of Adolescent to Adult Health. SETTING United States. PARTICIPANTS A nationally representative sample of individuals in grades 7-12 (aged 11-21 years) during 1994-95, who were re-interviewed during emerging adulthood (2001-02; aged 18-28) and adulthood (2007-08; aged 24-34). The analytical sample comprised 12 288 participants with data at all three waves. MEASUREMENTS Nine typologies of childhood traumas: neglect; emotional, physical and sexual abuse; parental incarceration and binge drinking; and witnessing, being threatened with and experiencing violence. Indicators of each were summed to measure cumulative dose. Outcomes were marijuana and cocaine use during adolescence, emerging adulthood and adulthood. FINDINGS Approximately half experienced at least one childhood trauma; traumas were not highly correlated. We observed a dose-response relationship between the number of traumas and drug use in adolescence [marijuana, adjusted odds ratio (aOR) one trauma versus none = 1.65, 95% confidence interval (CI) = 1.42, 1.92; two traumas = 2.58, 95% CI = 2.17, 3.06; ≥ four traumas = 6.92, 95% CI = 5.17, 9.26; cocaine, aOR one trauma = 1.87, 95% CI = 1.23, 2.84; two traumas = 2.80, 95% CI = 1.74, 4.51; ≥ four traumas = 9.54, 95% CI = 5.93, 15.38]. Similar dose-response relationships with drug use were observed in emerging adulthood and adulthood. Each individual trauma was associated independently with either marijuana or cocaine use in adolescence, emerging adulthood and/or adulthood. CONCLUSIONS Childhood trauma is prevalent in the United States, and individual types as well as the total number experienced are associated significantly with marijuana and cocaine use throughout the life-course.
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Affiliation(s)
- Joy D Scheidell
- Department of Population Health, New York University School of Medicine
| | - Kelly Quinn
- Department of Population Health, New York University School of Medicine
| | - Susan P McGorray
- Department of Biostatistics, College of Public Health & Health Professions, College of Medicine, University of Florida
| | | | | | - Linda B Cottler
- Department of Epidemiology, College of Public Health & Health Professions, College of Medicine, University of Florida
| | - Maria R Khan
- Department of Population Health, New York University School of Medicine
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Ahmad FA, Jeffe DB, Plax K, Schechtman KB, Doerhoff DE, Garbutt JM, Jaffe DM. Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department. J Accid Emerg Med 2018. [DOI: https:/doi:10.1136/emermed-2016-206199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ObjectivesAdolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested.MethodsThis was a prospective study conducted in a paediatric ED between April and December 2011. After triage, eligible patients between 15 and 21 years presenting with non-life-threatening conditions were asked to participate in the study. Consenting participants used an ACASI to provide their demographic data and answer questions about their sexual history and willingness to be tested. Our primary outcome was the association of demographics, chief complaint and ACASI recommendation with the participant’s willingness to be tested.ResultsWe approached 1337 patients, of whom 800 (59%) enrolled and completed the ACASI. Eleven who did not answer questions related to their sexual history were excluded from analysis. Of 789 participants, 461 (58.4%) were female and median age was 16.9 years (IQR 16.0–17.8); 509 (64.5%) endorsed a history of anal, oral and/or vaginal intercourse. Disclosing a sexual history and willingness to be tested did not differ significantly by gender. 131 (16.6%) had a chief complaint potentially referable to an STI; among the 658 participants with non-STI-related complaints, 412 (62.6%) were sexually active, many of whom disclosed risky behaviours, including multiple partners (46.4%) and inconsistent condom use (43.7%). The ACASI identified 419 patients as needing immediate STI testing; the majority (81%) did not have a chief complaint potentially related to STIs. 697 (88.3%) participants were willing to receive STI testing. Most (94.6%) of the patients with STI-related complaints were willing to be tested, and 92.1% of patients with a recommendation for immediate testing by the ACASI indicated a willingness to be tested.ConclusionsAdolescents were willing to disclose sexual activity via electronic questionnaires and were willing to receive STI testing, even when their chief complaint was not STI related. The ACASI facilitated identification of adolescent ED patients needing STI testing regardless of chief complaint.
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Anderson RE, Hruska B, Boros AP, Richardson CJ, Delahanty DL. Patterns of co-occurring addictions, posttraumatic stress disorder, and major depressive disorder in detoxification treatment seekers: Implications for improving detoxification treatment outcomes. J Subst Abuse Treat 2017; 86:45-51. [PMID: 29415850 DOI: 10.1016/j.jsat.2017.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/11/2017] [Accepted: 12/18/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Poly-substance use and psychiatric comorbidity are common among individuals receiving substance detoxification services. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are the most common co-occurring psychiatric disorders with substance use disorder (SUD). Current treatment favors a one-size-fits-all approach to treating addiction focusing on one substance or one comorbidity. Research examining patterns of substance use and comorbidities can inform efforts to effectively identify and differentially treat individuals with co-occurring conditions. METHODS Using latent class analysis, the current study identified four patterns of PTSD, MDD, and substance use among 375 addiction treatment seekers receiving medically supervised detoxification. RESULTS The four identified classes were: 1) a PTSD-MDD-Poly SUD class characterized by PTSD and MDD occurring in the context of opioid, cannabis, and tobacco use disorders; 2) an MDD-Poly SUD class characterized by MDD and alcohol, opioid, tobacco, and cannabis use disorders; 3) an alcohol-tobacco class characterized by alcohol and tobacco use disorders; and 4) an opioid-tobacco use disorder class characterized by opioid and tobacco use disorders. The observed classes differed on gender and clinical characteristics including addiction severity, trauma history, and PTSD/MDD symptom severity. DISCUSSION AND CONCLUSIONS The observed classes likely require differing treatment approaches. For example, people in the PTSD-MDD-Poly SUD class would likely benefit from treatment approaches targeting anxiety sensitivity and distress tolerance, while the opioid-tobacco class would benefit from treatments that incorporate motivational interviewing. Appropriate matching of treatment to class could optimize treatment outcomes for polysubstance and comorbid psychiatric treatment seekers. These findings also underscore the importance of well-developed referral networks to optimize outpatient psychotherapy for detoxification treatment-seekers to enhance long-term recovery, particularly those that include transdiagnostic treatment components.
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Affiliation(s)
- RaeAnn E Anderson
- Kent State University, Department of Psychological Sciences, Kent, OH, USA
| | - Bryce Hruska
- Kent State University, Department of Psychological Sciences, Kent, OH, USA
| | - Alec P Boros
- Oriana House Alcohol, Drug Addiction, and Mental Health Crisis Center, Akron, OH, USA
| | | | - Douglas L Delahanty
- Kent State University, Department of Psychological Sciences, Kent, OH, USA; Northeastern Ohio Medical University, Rootstown, OH, USA.
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Merchant RC, Romanoff J, Zhang Z, Liu T, Baird JR. Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients. Alcohol 2017; 65:71-80. [PMID: 29084632 PMCID: PMC5681406 DOI: 10.1016/j.alcohol.2017.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 05/30/2017] [Accepted: 07/13/2017] [Indexed: 11/22/2022]
Abstract
Most previous brief intervention (BI) studies have focused on alcohol or drug use, instead of both substances. Our primary aim was to determine if an alcohol- and drug-use BI reduced alcohol use and increased alcohol treatment services utilization among adult emergency department (ED) patients who drink alcohol and require an intervention for their drug use. Our secondary aims were to assess when the greatest relative reductions in alcohol use occurred, and which patients (stratified by need for an alcohol use intervention) reduced their alcohol use the most. In this secondary analysis, we studied a sub-sample of participants from the Brief Intervention for Drug Misuse in the Emergency Department (BIDMED) randomized, controlled trial of a BI vs. no BI, whose responses to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) indicated a need for a BI for any drug use, and who also reported alcohol use. Participants were stratified by their ASSIST alcohol subscore: 1) no BI needed, 2) a BI needed, or 3) an intensive intervention needed for alcohol use. Alcohol use and alcohol treatment services utilization were measured every 3 months for 12 months post-enrollment. Of these 833 participants, median age was 29 years-old, 46% were female; 55% were white/non-Hispanic, 27% black/non-Hispanic, and 15% Hispanic. Although any alcohol use, alcohol use frequency, days of alcohol use, typical drinks consumed/day, and most drinks consumed/day decreased in both the BI and no BI arms, there were no differences between study arms. Few patients sought alcohol use treatment services in follow-up, and utilization also did not differ by study arm. Compared to baseline, alcohol use reduced the most during the first 3 months after enrollment, yet reduced little afterward. Participants whose ASSIST alcohol subscores indicated a need for an intensive intervention generally had the greatest relative decreases in alcohol use. These results indicate that the BI was not efficacious in reducing alcohol use among alcohol- and drug-using adult ED patients than the self-assessments alone, but suggest that self-assessments with or without a BI may confer reductions in alcohol use.
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Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Justin Romanoff
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Zihao Zhang
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Tao Liu
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Janette R Baird
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA
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Roux P, Rojas Castro D, Ndiaye K, Briand Madrid L, Laporte V, Mora M, Maradan G, Morel S, Spire B, Carrieri P. Willingness to receive intravenous buprenorphine treatment in opioid-dependent people refractory to oral opioid maintenance treatment: results from a community-based survey in France. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:46. [PMID: 29096661 PMCID: PMC5667450 DOI: 10.1186/s13011-017-0131-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/23/2017] [Indexed: 11/10/2022]
Abstract
Background Injectable opioids are an interesting option for people who inject drugs (PWID) that do not respond to oral Opioid Maintenance Treatment (OMT). To date, intravenous (IV) buprenorphine - a safer drug than full-opioid agonists in terms of overdose risk - has never been tested in a clinical trial on opioid dependence. We designed a survey to better understand the profile of PWID eligible for IV buprenorphine, and their willingness to receive it. Methods This cross-sectional community-based national survey was conducted through face-to-face interviews (in low-threshold and addiction care services) and online questionnaires (on https://psychoactif.org and other websites). Among the 557 participants, we selected those who were eligible for IV buprenorphine treatment (history of oral OMT, regular opioid injection) (n = 371). We used regression models to study factors associated with willingness to receive IV buprenorphine treatment among those with data on willingness (n = 353). In those who were willing (n = 294), we subsequently studied their willingness to receive daily supervised IV buprenorphine treatment. Results Among the selected 353 participants, 59% mainly injected buprenorphine, 15% heroin, 16% morphine sulfate and 10% other opioids. Eighty-three percent of the sample reported willingness to receive IV buprenorphine treatment. Factors associated with willingness were: more than 5 injection-related complications, regular buprenorphine injection, no lifetime overdose, and completion of the questionnaire online. Factors associated with unwillingness to receive daily supervised treatment were younger age (OR[IC95%]=1.04[1.01; 1.07]) and stable housing (OR[IC95%]=0.61[0.37;1.01]) while regular heroin injectors were more willing to receive daily supervision (OR[IC95%]=2.94 [1.42; 6.10]). Conclusions PWID were very willing to receive intravenous buprenorphine as a treatment, especially those with multiple injection-related complications. In addition, our findings show that IV buprenorphine may be less acceptable to PWID who inject morphine sulfate. Young PWID and those with stable housing were unwilling to receive IV buprenorphine if daily supervision were required. This preliminary study provides useful information for the development of a clinical trial on IV buprenorphine treatment.
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Affiliation(s)
- Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France. .,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Daniela Rojas Castro
- AIDES, Poitiers, France.,Groupe de Recherche en Psychologie Sociale (EA 4163), Université Lyon 2, Bron, France
| | - Khadim Ndiaye
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Laélia Briand Madrid
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | | | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaelle Maradan
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | | | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Abstract
OBJECTIVE Computerized brief interventions are a promising approach for integrating substance use interventions into primary care settings. We sought to examine the effectiveness of a computerized brief intervention for illicit drug misuse, which prior research showed performed no worse than a traditional in-person brief intervention. METHODS Community health center patients were screened for eligibility using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Participants were adult patients (aged 18-62 years; 53% female) with moderate-risk illicit drug use (N = 80), randomized to receive the computerized brief intervention either immediately or at their 3-month follow-up. Assessments were conducted at baseline, 3, and 6-month follow-up, and included the ASSIST and drug hair testing. RESULTS Most participants in the sample (90%) reported moderate-risk marijuana use. Although the sample as a whole reported significant decreases in ASSIST Global Drug Risk scores and ASSIST marijuana-specific scores, no significant differences were detected between "immediate" and "delayed" conditions on either of these measures. Likewise, no significant differences were detected between conditions in drug-positive hair test results at either follow-up. CONCLUSIONS This study did not find differences between immediate versus delayed computerized brief intervention in reducing drug use or associated risks, suggesting potential regression to the mean or reactivity to the consent, screening, or assessment process. The findings are discussed in light of the study's limitations and directions for future research.
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Morina N, Ewers SM, Passardi S, Schnyder U, Knaevelsrud C, Müller J, Bryant RA, Nickerson A, Schick M. Mental health assessments in refugees and asylum seekers: evaluation of a tablet-assisted screening software. Confl Health 2017; 11:18. [PMID: 29026438 PMCID: PMC5623980 DOI: 10.1186/s13031-017-0120-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/22/2017] [Indexed: 11/12/2022] Open
Abstract
Background Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge in hosting societies. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. Methods In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface. Results Results showed no differences between the two assessment modalities with regard to symptom scores. The findings suggest good feasibility and usability of MAPSS in traumatized refugees. The administration via MAPSS was significantly shorter than the paper-pencil interview. Conclusion MAPSS may be a cost-effective, flexible and valid alternative to interpreter-based psychometric screening and assessment.
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Affiliation(s)
- Naser Morina
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Simon M Ewers
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Sandra Passardi
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
| | - Christine Knaevelsrud
- Department of Clinical Psychological Intervention, Freie Universität, Berlin, Germany
| | - Julia Müller
- Psychiatric Services Thurgau, CH-8596 Münsterlingen, Switzerland
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, N.S.W. 2052 Australia
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, N.S.W. 2052 Australia
| | - Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
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Ahmad FA, Jeffe DB, Plax K, Schechtman KB, Doerhoff DE, Garbutt JM, Jaffe DM. Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department. Emerg Med J 2017; 35:46-51. [PMID: 28801483 DOI: 10.1136/emermed-2016-206199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 06/20/2017] [Accepted: 07/12/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Adolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested. METHODS This was a prospective study conducted in a paediatric ED between April and December 2011. After triage, eligible patients between 15 and 21 years presenting with non-life-threatening conditions were asked to participate in the study. Consenting participants used an ACASI to provide their demographic data and answer questions about their sexual history and willingness to be tested. Our primary outcome was the association of demographics, chief complaint and ACASI recommendation with the participant's willingness to be tested. RESULTS We approached 1337 patients, of whom 800 (59%) enrolled and completed the ACASI. Eleven who did not answer questions related to their sexual history were excluded from analysis. Of 789 participants, 461 (58.4%) were female and median age was 16.9 years (IQR 16.0-17.8); 509 (64.5%) endorsed a history of anal, oral and/or vaginal intercourse. Disclosing a sexual history and willingness to be tested did not differ significantly by gender. 131 (16.6%) had a chief complaint potentially referable to an STI; among the 658 participants with non-STI-related complaints, 412 (62.6%) were sexually active, many of whom disclosed risky behaviours, including multiple partners (46.4%) and inconsistent condom use (43.7%). The ACASI identified 419 patients as needing immediate STI testing; the majority (81%) did not have a chief complaint potentially related to STIs. 697 (88.3%) participants were willing to receive STI testing. Most (94.6%) of the patients with STI-related complaints were willing to be tested, and 92.1% of patients with a recommendation for immediate testing by the ACASI indicated a willingness to be tested. CONCLUSIONS Adolescents were willing to disclose sexual activity via electronic questionnaires and were willing to receive STI testing, even when their chief complaint was not STI related. The ACASI facilitated identification of adolescent ED patients needing STI testing regardless of chief complaint.
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Affiliation(s)
- Fahd A Ahmad
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Donna B Jeffe
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katie Plax
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Jane M Garbutt
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David M Jaffe
- American Academy of Pediatrics, Chicago, Illinois, USA
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Eyrich-Garg KM, Moss SL. How Feasible is Multiple Time Point Web-Based Data Collection with Individuals Experiencing Street Homelessness? J Urban Health 2017; 94:64-74. [PMID: 28105585 PMCID: PMC5359169 DOI: 10.1007/s11524-016-0109-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Three barriers investigators often encounter when conducting longitudinal work with homeless or other marginalized populations are difficulty tracking participants, high rates of no-shows for follow-up interviews, and high rates of loss to follow-up. Recent research has shown that homeless populations have substantial access to information technologies, including mobile devices and computers. These technologies have the potential both to make longitudinal data collection with homeless populations easier and to minimize some of these methodological challenges. This pilot study's purpose was to test whether individuals who were homeless and sleeping on the streets-the "street homeless"-would answer questions remotely through a web-based data collection system at regular "follow-up" intervals. We attempted to simulate longitudinal data collection in a condensed time period. Participants (N = 21) completed an in-person baseline interview. Each participant was given a remotely reloadable gift card. Subsequently, weekly for 8 weeks, participants were sent an email with a link to a SurveyMonkey questionnaire. Participants were given 48 h to complete each questionnaire. Data were collected about life on the streets, service use, community inclusion, substance use, and high-risk sexual behaviors. Ten dollars was remotely loaded onto each participant's gift card when they completed the questionnaire within the completion window. A substantial number of participants (67% of the total sample and 86% of the adjusted sample) completed at least seven out of the eight follow-up questionnaires. Most questionnaires were completed at public libraries, but several were completed at other types of locations (social service agencies, places of employment, relative/friend/acquaintance's domiciles, or via mobile phone). Although some of the questions were quite sensitive, very few participants skipped any questions. The only variables associated with questionnaire completion were frequency of computer use and education-both positive associations. This pilot study suggests that collecting longitudinal data online may be feasible with a subpopulation of persons experiencing homelessness. We suspect that participant follow-up rates using web-based data collection methods have the potential to exceed follow-up rates using traditional in-person interviews. If this population of persons experiencing street homelessness can be successful with this method of data collection, perhaps other disenfranchised, difficult-to-track, or difficult-to-reach populations could be followed using web-based data collection methods. Local governments are striving to decrease the "digital divide," providing free or greatly discounted wi-fi connectivity as well as mobile computer lab access to low-income geographic areas. These actions, in combination with increased smart phone ownership, may permit vulnerable populations to connect and communicate with investigators.
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Affiliation(s)
- Karin M Eyrich-Garg
- College of Public Health, School of Social Work, Temple University, Philadelphia, PA, USA.
| | - Shadiya L Moss
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Latkin CA, Mai NVT, Ha TV, Sripaipan T, Zelaya C, Le Minh N, Morales G, Go VF. Social Desirability Response Bias and Other Factors That May Influence Self-Reports of Substance Use and HIV Risk Behaviors: A Qualitative Study of Drug Users in Vietnam. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:417-425. [PMID: 27710083 PMCID: PMC5268760 DOI: 10.1521/aeap.2016.28.5.417] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The accuracy of self-report data may be marred by a range of cognitive and motivational biases, including social desirability response bias. The current study used qualitative interviews to examine self-report response biases among participants in a large randomized clinical trial in Vietnam. A sample of study participants was reinterviewed. The vast majority reported being truthful and emphasized the importance of rapport with the study staff for achieving veridical data. However, some stated that rapport may lead to under reporting of risk behaviors in order not to disappoint study staff. Other factors that appeared to influence accuracy of self-reports include fear that the information may be divulged, desire to enroll in the study, length of the survey, and memory. There are several methods that can be employed to reduce response biases, and future studies should systematically address response bias and include methods to assess whether approaches and survey items are effective in improving accuracy of self-report data.
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Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nguyen Vu Tuyet Mai
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Tran Viet Ha
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Teerada Sripaipan
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Carla Zelaya
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nguyen Le Minh
- Thai Nguyen Center for Preventive Medicine, Thai Nguyen, Vietnam
| | - Giuliana Morales
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Vivian F Go
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
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HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa. AIDS Behav 2016; 20:2387-2397. [PMID: 26873492 DOI: 10.1007/s10461-016-1333-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.
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Delker E, Aharonovich E, Hasin D. Interviewer-administered TLFB vs. self-administered computerized (A-CASI) drug use frequency questions: a comparison in HIV-infected drug users. Drug Alcohol Depend 2016; 161:29-35. [PMID: 26880593 PMCID: PMC5036518 DOI: 10.1016/j.drugalcdep.2016.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/19/2015] [Accepted: 01/06/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Substance use can have major consequences among HIV patients. Interviewer- or self-administered modalities are widely used to measure drug use frequency. This often involves Timeline Follow-Back (TLFB) interviewer-administered measures, or self-administered computerized questions assessing similar information via Audio Computer-Assisted Self Interview (A-CASI). Little is known about agreement between these two modalities on drug use frequency in HIV-infected samples. METHODS Prior to randomization into a trial of brief interventions to reduce drug use, 240 HIV patients completed a baseline A-CASI assessment battery that included questions on drug use frequency, followed by an interviewer-administered TLFB. Each measure generated number of days patients used their primary drug in the prior 30 days. Agreement between TLFB and A-CASI modalities on days using primary drug was determined using intraclass correlation coefficients (ICC). Regression analysis tested the association of patient characteristics with discrepancies between TLFB and A-CASI modalities. RESULTS Overall agreement was excellent (ICC=.80), with little variation by primary drug, education, race, current drug treatment, binge drinking or years since HIV diagnosis. Gender, ethnicity (Hispanic vs. non-Hispanic) and age predicted differences in days used (p<0.05); the A-CASI modality reflected more days used than TLFB. CONCLUSIONS Measures of days used primary drug showed high agreement whether assessed by interviewer-administered TLFB or by questions self-administered via the A-CASI modality. Differences by gender, ethnicity and age suggest some caution in using the TLFB, although additional studies are needed. However, findings generally indicate that studies based on one assessment method or the other can be compared with reasonable confidence.
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Affiliation(s)
- Erin Delker
- New York State Psychiatric Institute, New York, NY
10032, San Diego State University/University of California, San
Diego Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA
92093
| | - Efrat Aharonovich
- New York State Psychiatric Institute, New York, NY
10032, Columbia University Medical Center, New York, NY
10032
| | - Deborah Hasin
- New York State Psychiatric Institute, New York, NY 10032, United States; Columbia University Medical Center, New York, NY 10032, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, United States.
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Linas BS, Genz A, Westergaard RP, Chang LW, Bollinger RC, Latkin C, Kirk GD. Ecological Momentary Assessment of Illicit Drug Use Compared to Biological and Self-Reported Methods. JMIR Mhealth Uhealth 2016; 4:e27. [PMID: 26980400 PMCID: PMC4812047 DOI: 10.2196/mhealth.4470] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 10/17/2015] [Accepted: 11/10/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The use of mHealth methods for capturing illicit drug use and associated behaviors have become more widely used in research settings, yet there is little research as to how valid these methods are compared to known measures of capturing and quantifying drug use. OBJECTIVE We examined the concordance of ecological momentary assessment (EMA) of drug use to previously validated biological and audio-computer assisted self-interview (ACASI) methods. METHODS The Exposure Assessment in Current Time (EXACT) study utilized EMA methods to assess drug use in real-time in participants' natural environments. Utilizing mobile devices, participants self-reported each time they used heroin or cocaine over a 4-week period. Each week, PharmChek sweat patch samples were collected for measurement of heroin and cocaine and participants answered an ACASI-based questionnaire to report behaviors and drug using events during the prior week. Reports of cocaine and heroin use captured through EMA were compared to weekly biological or self-report measures through percent agreement and concordance correlation coefficients to account for repeated measures. Correlates of discordance were obtained from logistic regression models. RESULTS A total of 109 participants were a median of 48.5 years old, 90% African American, and 52% male. During 436 person-weeks of observation, we recorded 212 (49%) cocaine and 103 (24%) heroin sweat patches, 192 (44%) cocaine and 161 (37%) heroin ACASI surveys, and 163 (37%) cocaine and 145 (33%) heroin EMA reports. The percent agreement between EMA and sweat patch methods was 70% for cocaine use and 72% for heroin use, while the percent agreement between EMA and ACASI methods was 77% for cocaine use and 79% for heroin use. Misreporting of drug use by EMA compared to sweat patch and ACASI methods were different by illicit drug type. CONCLUSIONS Our work demonstrates moderate to good agreement of EMA to biological and standard self-report methods in capturing illicit drug use. Limitations occur with each method and accuracy may differ by type of illicit drugs used.
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Affiliation(s)
- Beth S Linas
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA.
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Palinkas LA, Bazzi AR, Syvertsen JL, Ulibarri MD, Hernandez D, Rangel MG, Martinez G, Strathdee SA. Measuring Current Drug Use in Female Sex Workers and Their Noncommercial Male Partners in Mexico: Concordance Between Data Collected From Surveys Versus Semi-Structured Interviews. Subst Use Misuse 2016; 51:23-33. [PMID: 26683591 PMCID: PMC4802973 DOI: 10.3109/10826084.2015.1073326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Self-reports are commonly used to assess prevalence and frequency of drug use, but it is unclear whether qualitative methods like semi-structured interviews are as useful at obtaining such information as quantitative surveys. OBJECTIVES This study compared drug use occurrence and frequency using data collected from quantitative surveys and qualitative interviews. We also examined whether combining data from both sources could result in significant increases in percentages of current users and whether the concordance between the two sets of data was associated with the type of drug use, age, gender and socioeconomic status. METHODS Self- reports of recent marijuana, heroin, crack, cocaine, crystal/methamphetamine, inhalant, and tranquilizer use were collected using both methods from a cohort of Mexican female sex workers and their non-commercial male partners (n = 82). RESULTS Participants were significantly less likely to report marijuana, cocaine and tranquilizer use and frequency of use during the qualitative interviews than during the quantitative surveys. Agreement on frequency of drug use was excellent for crystal/methamphetamine, heroin and inhalant use, and weak for cocaine, tranquilizers and marijuana use. Older participants exhibited significantly higher concordance than younger participants in reports of marijuana and methamphetamine use. Higher monthly income was significantly associated with higher concordance in crack use but lower concordance with marijuana use. CONCLUSIONS Although use of such data can result in an underreporting of drug use, qualitative data can be quantified in certain circumstances to triangulate and confirm the results from quantitative analyses and provide a more comprehensive view of drug use.
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Affiliation(s)
- Lawrence A Palinkas
- a School of Social Work , University of Southern California , Los Angeles , California , USA
| | | | | | - Monica D Ulibarri
- d Psychiatry, University of California , San Diego, La Jolla , California , USA
| | - Daniel Hernandez
- e School of Medicine , University of California , Davis, Sacramento , California , USA
| | | | - Gustavo Martinez
- g Federacion Mexicana de Asociaciones Privadas , Cuidad Juarez , Mexico
| | - Steffanie A Strathdee
- h Division of Global Public Health , University of California , San Diego, La Jolla , California , USA
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Development of immunity following financial incentives for hepatitis B vaccination among people who inject drugs: A randomized controlled trial. J Clin Virol 2015; 74:66-72. [PMID: 26679830 DOI: 10.1016/j.jcv.2015.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 10/21/2015] [Accepted: 11/25/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND People who inject drugs (PWID) are at risk of hepatitis B virus (HBV) but have low rates of vaccination completion. The provision of modest financial incentives increases vaccination schedule completion, but their association with serological protection has yet to be determined. OBJECTIVE To investigate factors associated with vaccine-induced immunity among a sample of PWID randomly allocated to receive AUD$30 cash following receipt of doses two and three ('incentive condition') or standard care ('control condition') using an accelerated 3-dose (0,7,21 days) HBV vaccination schedule. STUDY DESIGN A randomised controlled trial among PWID attending two inner-city health services and a field site in Sydney, Australia, assessing vaccine-induced immunity measured by hepatitis B surface antibodies (HBsAb ≥ 10 mIU/ml) at 12 weeks. The cost of the financial incentives and the provision of the vaccine program are also reported. RESULTS Just over three-quarters of participants - 107/139 (77%)--completed the vaccination schedule and 79/139 (57%) were HBsAb ≥ 10 mIU/ml at 12 weeks. Vaccine series completion was the only variable significantly associated with vaccine-induced immunity in univariate analysis (62% vs 41%, p<0.035) but was not significant in multivariate analysis. There was no statistically discernible association between group allocation and series completion (62% vs 53%). The mean costs were AUD$150.5, (95% confidence interval [CI]: 142.7-158.3) and AUD$76.9 (95% CI: 72.6-81.3) for the intervention and control groups respectively. CONCLUSION Despite increasing HBV vaccination completion, provision of financial incentives was not associated with enhanced serological protection. Further research into factors which affect response rates and the optimal vaccination regimen and incentive schemes for this population are needed.
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