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Kim IS, Kim HH, Chang CL. Genetic Variants and Haplotypes in the IL10 Gene and Their Association with Opportunistic Infections among HIV-Infected Patients in Korea in the Era of Highly Active Antiretroviral Therapy. ANNALS OF CLINICAL MICROBIOLOGY 2019. [DOI: 10.5145/acm.2019.22.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- In-Suk Kim
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyung-Hoi Kim
- Department of Laboratory Medicine and Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Chulhun L. Chang
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea
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Giorgi Rossi P, Riccardo F, Pezzarossi A, Ballotari P, Dente MG, Napoli C, Chiarenza A, Velasco Munoz C, Noori T, Declich S. Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070720. [PMID: 28678172 PMCID: PMC5551158 DOI: 10.3390/ijerph14070720] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/22/2017] [Accepted: 06/30/2017] [Indexed: 02/07/2023]
Abstract
We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.
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Affiliation(s)
- Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Flavia Riccardo
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Annamaria Pezzarossi
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Paola Ballotari
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Maria Grazia Dente
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Christian Napoli
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Antonio Chiarenza
- Research and Innovation Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
| | - Cesar Velasco Munoz
- European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
- IS Global, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, 08036 Barcelona, Spain.
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
| | - Silvia Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
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Black-White and Country of Birth Disparities in Retention in HIV Care and Viral Suppression among Latinos with HIV in Florida, 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020120. [PMID: 28134795 PMCID: PMC5334674 DOI: 10.3390/ijerph14020120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 11/16/2022]
Abstract
The study's purpose was to identify HIV, Black-White race, and birth country disparities in retention in HIV care and HIV viral load (VL) suppression among Latinos, in 2015. Florida's surveillance data for Latinos diagnosed with HIV (2000-2014) were merged with American Community Survey data. Multi-level (random effects) models were used to estimate adjusted odds ratios (aOR) for non-retention in care and non-viral load suppression. Blacks and Whites experienced similar odds of non-retention in care. Racial differences in VL suppression disappeared after controlling for neighborhood factors. Compared to U.S.-born Latinos, those born in Mexico (retention aOR 2.00, 95% CI 1.70-2.36; VL 1.85, 95% CI 1.57-2.17) and Central America (retention aOR 1.33, 95% CI 1.16-1.53; VL 1.28, 95% CI 1.12-2.47) were at an increased risk after controlling for individual and neighborhood factors. Among Central Americans, those born in Guatemala (retention aOR 2.39, 95% CI 1.80-3.18; VL 2.20, 95% CI 1.66-2.92) and Honduras (retention aOR 1.39, 95% CI 1.13-1.72; VL 1.42, 95% CI 1.16-1.74) experienced the largest disparities, when compared to U.S.-born Latinos. Disparities in care and treatment exist within the Latino population. Cultural and other factors, unique to Latino Black-White racial and birth country subgroups, should be further studied and considered for intervention.
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Rubaihayo J, Tumwesigye NM, Konde-Lule J. Trends in prevalence of selected opportunistic infections associated with HIV/AIDS in Uganda. BMC Infect Dis 2015; 15:187. [PMID: 25879621 PMCID: PMC4408591 DOI: 10.1186/s12879-015-0927-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 04/08/2015] [Indexed: 11/12/2022] Open
Abstract
Background After more than a decade of establishing and expanding access to highly active antiretroviral therapy (HAART), empirical evidence on its impact on trends of opportunistic infections (OIs) associated with the deadly human immunodeficiency virus (HIV) in resource poor settings is scarce. The primary objective of this study was to assess the effect of HAART coverage on trends of five most common OIs in Uganda. Methods Observational data from January 2002 to December 2013 for 5972 HIV positive individuals attending the AIDS Support Organisation (TASO) HIV/AIDS care programme in Uganda were extracted and analysed. Trends were analysed using autoregressive moving average time series and mixed effects linear regression models adjusting for all available potential confounders. Results A total of 204,871 monthly medical reports were retrieved and analysed. Majority of the participants were female (73%) with a median age of 32 years (inter-quartile range 26–39). Overall, significant decreasing mean annual prevalence trends were observed for Mycobacterium tuberculosis, herpes zoster, genital ulcer and oral candidiasis (p < 0.05, X2trend). Non-significant declining mean annual prevalence trend was observed for cryptococcal meningitis (p = 0.181, X2trend). The largest impact of HAART was observed in Oral candidiasis and TB whose average annual prevalence reduced by 61% and 43% respectively following the introduction of HAART. Monthly series for TB, Herpes zoster and genital ulcers differed significantly by age and clinic but only genital ulcer series differed significantly by sex (p < 0.05, kruskal wallis). After controlling for the effects of age, sex and clinic (fixed) and monthly clustering (random effect) in a mixed effects linear regression model, all the five OIs showed a significant monthly change in prevalence (p < 0.001). Conclusion Overall, prevalence of most OIs declined especially after the introduction of HAART. However significant variations exist in the trends of different OIs in different geographical areas in Uganda. It is therefore important that site specific factors are properly identified to enable the development of targeted interventions.
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Affiliation(s)
- John Rubaihayo
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. .,Department of Public Health, School of Health Sciences, Mountains of the Moon University, Fort Portal, Uganda.
| | - Nazarius M Tumwesigye
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Joseph Konde-Lule
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
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Sheehan DM, Trepka MJ, Dillon FR. Latinos in the United States on the HIV/AIDS care continuum by birth country/region: a systematic review of the literature. Int J STD AIDS 2014; 26:1-12. [PMID: 24810215 DOI: 10.1177/0956462414532242] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Twenty percent of Latinos with HIV in the US are unaware of their HIV status, 33% are linked to care late, and 74% do not reach viral suppression. Disparities along this HIV/AIDS care continuum may be present between various ethnic groups historically categorised as Latino. To identify differences along the HIV/AIDS care continuum between US Latinos of varying birth countries/regions a systematic review of articles published in English between 2002 and 2013 was conducted using MEDLINE, PsycINFO, and Web of Science. Studies that reported on one or more steps of the HIV/AIDS care continuum and reported results by birth country/region for Latinos were included. Latinos born in Mexico and Central America were found to be at increased risk of late diagnosis compared with US-born Latinos. No studies were found that reported on linkage to HIV care or viral load suppression by country/region of birth. Lower survival was found among Latinos born in Puerto Rico compared with Latinos born in mainland US. Inconsistent differences in survival were found among Latinos born in Mexico, Cuba, and Central America. Socio/cultural context, immigration factors, and documentation status are discussed as partial explanations for disparities along the HIV/AIDS care continuum.
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Affiliation(s)
- Diana M Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Frank R Dillon
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA School of Social Welfare, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Trends in overall opportunistic illnesses, Pneumocystis carinii pneumonia, cerebral toxoplasmosis and Mycobacterium avium complex incidence rates over the 30 years of the HIV epidemic: a systematic review. Braz J Infect Dis 2013; 18:196-210. [PMID: 24275372 PMCID: PMC9427509 DOI: 10.1016/j.bjid.2013.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 09/13/2013] [Accepted: 10/12/2013] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The natural history of HIV infection has changed dramatically after the introduction of highly active antiretroviral therapy. Currently, opportunistic illnesses still represent a major cause of death and hospitalization in this population. In this study, we review the trends in opportunistic illnesses incidence rates and compare the results observed in high-income settings with that for low/middle-income settings, with special attention given to studies from Brazil. METHODS We systematically searched Pubmed, Web of Science, Lilacs and Google scholar for publications on HIV associated opportunistic illness. Studies reporting rates based on person-time for all opportunistic illnesses and/or the three opportunistic infections of interest, namely, Pneumocystis carinii pneumonia, cerebral toxoplasmosis, and Mycobacterium avium complex were included. RESULTS Significant reductions in the incidence rates were demonstrated for opportunistic illnesses overall and also for the specific opportunistic infections included in the present study, both in high and low/middle-income settings. Out of the 37 studies included in the present review, almost 70% were from high-income settings. All the studies conducted in low/middle-income settings were single center studies and four were from Brazil. We found no study from Brazil reporting annual incidence rates of opportunistic illnesses. CONCLUSIONS Opportunistic illnesses remain an important public health problem. To better guide health policies in low/middle-income settings, multicenter cohort studies should be encouraged. Studies from Brazil are urgently needed to assess the current burden of opportunistic illnesses in our population and to support the planning of HIV/AIDS health care services organization.
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Vissman AT, Young AM, Wilkin AM, Rhodes SD. Correlates of HAART adherence among immigrant Latinos in the Southeastern United States. AIDS Care 2012; 25:356-63. [PMID: 22835082 DOI: 10.1080/09540121.2012.701722] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We explored the relationships between sociocultural and psychological constructs and adherence to antiretroviral therapy among predominantly Spanish-speaking immigrant Latinos in the southeastern United States. A cross-sectional clinic-based sample of immigrant Latino men and women participated in an interviewer-administered assessment. Self-reported prevalence of adherence was assessed along with demographic characteristics, acculturation, physician trust, social support, and theory of planned behavior (TPB) constructs: attitude, subjective norm (SN), and perceived behavioral control (PBC). A total of 66 respondents met inclusion criteria. Average age was 38 years old, 74% of respondents were male, 71% heterosexual, and 86% reported being from Mexico or Central America. Prevalence of "complete" adherence (i.e., not missing a single dose) in the past 30 days was 71%. Social support was significantly and inversely associated with adherence, PBC, and attitude. Positive correlates of adherence included attitude, PBC, and employment status. In multivariable analysis, SN and PBC were significantly associated with social support, controlling for acculturation, physician trust, and number of behavioral referents. TPB constructs have utility in explaining ART adherence among immigrant Latinos in the "Deep South." Further research is necessary to understand the complex relationships between social support, attribution processes, and ART adherence outcomes.
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Affiliation(s)
- Aaron T Vissman
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA.
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Wohl AR, Garland WH, Wu J, Au CW, Boger A, Dierst-Davies R, Carter J, Carpio F, Jordan W. A youth-focused case management intervention to engage and retain young gay men of color in HIV care. AIDS Care 2011; 23:988-97. [PMID: 21390879 DOI: 10.1080/09540121.2010.542125] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HIV-positive Latino and African-American young men who have sex with men (YMSM) have low rates of engagement and retention in HIV care. An evaluation of a youth-focused case management intervention (YCM) designed to improve retention in HIV care is presented. HIV-positive Latino and African-American YMSM, ages 18-24, who were newly diagnosed with HIV or in intermittent HIV care, were enrolled into a psychosocial case management intervention administered by Bachelor-level peer case managers at two HIV clinics in Los Angeles County, California. Participants met weekly with a case manager for the first two months and monthly for the next 22 months. Retention in HIV primary care at three and six months of follow-up was evaluated as were factors associated with retention in care. From April 2006 to April 2009, 61 HIV-positive participants were enrolled into the intervention (54% African-American, 46% Latino; mean age 21 years). At the time of enrollment into the intervention, 78% of the YMSM had a critical or immediate need for stable housing, nutrition support, substance abuse treatment, or mental health services. Among intervention participants (n=61), 90% were retained in primary HIV care at three months and 70% at six months. Among those who had previously been in intermittent care (n=33), the proportion attending all HIV primary care visits in the previous six months increased from 7% to 73% following participation in the intervention (p<0.0001). Retention in HIV care at six months was associated with increased number of intervention visits (p=0.05), more hours in the intervention (p=0.02), and prescription of HAART. These data highlight the critical needs of HIV-positive African-American and Latino YMSM and demonstrate that a clinic-based YCM can be effective in stabilizing hard-to-reach clients and retaining them in consistent HIV care.
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Affiliation(s)
- Amy Rock Wohl
- Los Angeles County Department of Public Health, HIV Epidemiology Program, CA, USA.
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Crawford T, Caldwell G, Bush HM, Browning S, Thornton A. Foreign Born Status and HIV/AIDS: A Comparative Analysis of HIV/AIDS Characteristics Among Foreign and U.S. Born Individuals. J Immigr Minor Health 2011; 14:82-8. [DOI: 10.1007/s10903-011-9455-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wohl AR, Galvan FH, Myers HF, Garland W, George S, Witt M, Cadden J, Operskalski E, Jordan W, Carpio F. Social support, stress and social network characteristics among HIV-positive Latino and African American women and men who have sex with men. AIDS Behav 2010; 14:1149-58. [PMID: 20107888 DOI: 10.1007/s10461-010-9666-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Social support and stress have been poorly characterized for persons with HIV, particularly for racial/ethnic minorities. To address this gap, data on general and HIV-specific support and stress and social network characteristics were collected for 399 African American and Latino women and men who have sex with men (MSM) in Los Angeles County. African American (mean = 41; SD = 17) and Latina (mean = 40; SD = 19) women reported the highest general support. Stress was also highest for Latina women (mean = 18; SD = 11) and higher compared to Latino and African American MSM. African American and Latina women reported receiving most of their social support and stress from family members, while African American and Latino MSM received their support and stress from friends and providers. Finally, Latina and African American women disclosed their HIV status to more network members and received more HIV-specific support compared to MSM. Interventions are needed to help Latino and African American MSM enhance their support networks to manage a stigmatized illness.
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Affiliation(s)
- Amy Rock Wohl
- HIV Epidemiology Program, Los Angeles County Department of Public Health, Los Angeles, CA 90005, USA.
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Carabin H, Keesee MS, Machado LJ, Brittingham T, Williams L, Sonleitner NK, Anderson KG, Cajina A, Foster MW. Estimation of the prevalence of AIDS, opportunistic infections, and standard of care among patients with HIV/AIDS receiving care along the U.S.-Mexico border through the Special Projects of National Significance: a cross-sectional study. AIDS Patient Care STDS 2008; 22:887-95. [PMID: 19025483 DOI: 10.1089/apc.2007.0176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is high demand for care among the Hispanic population in states along the U.S.-Mexico border. The objective is to describe the standard of care received by people living with HIV/AIDS (PLWH/A) at enrollment into one of five Special Projects of National Significance (SPNS) Sites located along the U.S.-Mexico border. This cross-sectional study describes the presence of opportunistic infections (OIs), AIDS status and two types of standard of care received by 707 PLWH/A participating in SPNS. Patients receiving care through SPNS in one of the five sites between June 1, 2002 and December 31, 2003 were invited to participate to the medical chart review component of the study. The association between sociodemographic variables and the prevalence of OIs and AIDS at enrollment was estimated using multivariate hierarchical logistic models. More than one quarter of the 707 participants had at least one OI recorded and 58% of new and 60% of existing patients had AIDS at enrollment in SPNS. The association between being Hispanic and having higher prevalence of OI and AIDS at entry varied by SPNS site. Standard of care was well followed overall. This is the first study describing HIV stage and OI prevalences and standard of care in PLWH/A in all U.S.-Mexico bordering states. Being of Hispanic ethnicity may not fully explain discrepancy in access to care along the border.
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Affiliation(s)
- Hélène Carabin
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Marguerite S. Keesee
- K20 Center for Educational and Community Renewal, University of Oklahoma, Norman, Oklahoma
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
| | - Linda J. Machado
- Section of Infectious Disease, Department of Internal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Timothy Brittingham
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
| | - Lynda Williams
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
| | - Nancy K. Sonleitner
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
- Department of Sociology, Anthropology, Social Work, and Criminal Justice. The University of Tennessee at Martin, Martin, Tennessee
| | - Kermyt G. Anderson
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
| | - Adan Cajina
- Health Resources and Services Administration, HIV/AIDS Bureau, Special Projects of National Significance, Rockville, Maryland
| | - Morris W. Foster
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma
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Maxwell JC, Cravioto P, Galván F, Ramírez MC, Wallisch LS, Spence RT. Drug use and risk of HIV/AIDS on the Mexico-USA border: a comparison of treatment admissions in both countries. Drug Alcohol Depend 2006; 82 Suppl 1:S85-93. [PMID: 16769452 DOI: 10.1016/s0376-8716(06)80014-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2005] [Revised: 07/27/2005] [Accepted: 09/20/2005] [Indexed: 11/20/2022]
Abstract
This study analyzes trends in treatment admissions and summarizes HIV/AIDS risk factors along the US-Mexican border. Data are presented at the national level and at the state level for states along the border. Client data also are compared for treatment programs located in sister cities on the Texas-Mexico border. These data show that methamphetamine admissions are increasing nationally and methamphetamine use is a major problem in the western states on both sides of the border. Use of Ice (smoked methamphetamine) has increased significantly. Use of crack (smoked cocaine) is a growing problem on the border, and injection is the primary route for using black tar heroin in this area. Each of these drugs is a risk factor, either from drug-influenced risky sexual behaviors or from sharing injection equipment. In addition, the availability of drugs on the border and patterns of risky behaviors among migrants mean that drug users on the border are at risk of HIV/AIDS, and this risk is expected to increase with the spreading methamphetamine epidemic and smoking of crack cocaine. Comparable data on HIV/AIDS are needed for further studies of the relationship of drug use and HIV/AIDS on the border.
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Affiliation(s)
- Jane Carlisle Maxwell
- School of Social Work, The University of Texas at Austin, 1717 West 6th Street, Suite 335, Austin, TX 78703, USA.
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