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Menezes NP, Mehta SH, Wesolowski A, Clipman SJ, Srikrishnan AK, Kumar MS, Zook KJ, Lucas GM, Latkin C, Solomon SS. Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India. Addiction 2024; 119:570-581. [PMID: 37967827 PMCID: PMC11003398 DOI: 10.1111/add.16379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND AND AIMS Network centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual-level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as peer navigators or change agents in network-based interventions in settings where sociometric data are unavailable. We assessed the relationship between network centrality and HIV prevention service engagement to determine whether centrally-positioned PWID share measurable commonalities. DESIGN Observational study and survey using baseline data from a sociometric network cohort of PWID, enumerated using network software and biometric data (2017-2020). Network ties corresponded to direct injection partnerships in the prior month. SETTING New Delhi, India. PARTICIPANTS A total of 2512 PWID who were ≥18 years, provided written informed consent, and reported illicit injection drug use within the 24 months before study enrollment. MEASUREMENTS Interviewer-administered questionnaires measured demographics and substance use behaviors. Central versus peripheral network position was categorized using betweenness centrality 75th%ile . Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) between network position and HIV testing, medication for opioid use disorder (MOUD), or syringe service use. Lasso models selected predictors of central network position among 20 covariates detailing demographic, biologic, and substance use information. Predictive accuracy was evaluated using model performance metrics. FINDINGS Overall, median age was 26 years (interquartile range 22-34); 99% were male; 628 were classified as central. Compared with PWID at the periphery, central PWID were more likely to use MOUD (aOR: 1.59, 95%CI: 1.30-1.94) and syringe services (aOR: 2.91, 95%CI: 2.25, 3.76) in the prior six months. Findings for HIV testing were inconclusive (aOR: 1.30, 95%CI: 1.00-1.69). The lasso variable selector identified several predictors of network centrality: HIV and hepatitis C infection, number of PWID seen in the prior month, injecting heroin and buprenorphine (vs. heroin only) six months prior, sharing injection equipment six months prior, experiencing drug overdose in the past year, and moderate/severe depression (vs. none/mild). Average agreement between model-predicted vs. observed values was 0.75; area under the receiver operator curve was 0.69. CONCLUSIONS In a socioeconomic network of people who inject drugs (PWID) in New Delhi, India, there are common characteristics among individuals based on their network position (central vs. peripheral) but individual-level predictors have only moderate predictive accuracy. Although central network members appear to be more likely to use HIV prevention services than peripheral network members, their potential as change agents may be limited by other factors that impede their ability to adopt or promote HIV prevention service use.
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Affiliation(s)
- Neia Prata Menezes
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Steven J. Clipman
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | | | | | - Katie J.C. Zook
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Gregory M. Lucas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Carl Latkin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
- Department of Health, Behaviour and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Sunil S. Solomon
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
- Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India
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Wiginton JM, Booth R, Smith LR, Shakya S, da Silva CE, Patterson TL, Pitpitan EV. Effects of a social network intervention on HIV seroconversion among people who inject drugs in Ukraine: moderation by network gender composition. Harm Reduct J 2023; 20:165. [PMID: 37940947 PMCID: PMC10631017 DOI: 10.1186/s12954-023-00899-3] [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: 03/31/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Women who inject drugs in Ukraine are disproportionately burdened by HIV. To help address the needs of this population, a greater understanding of how interventions may uniquely benefit women who inject drugs is needed. METHODS Data come from a randomized controlled trial of a social network intervention targeting people who inject drugs in Ukraine (N = 1195). Indexes, plus two of their injection network members, received HIV testing and counseling (control arm) or HIV testing and counseling plus a social network intervention (intervention arm), in which indexes were trained to influence network members' risk behaviors. We used Cox regressions with interaction terms to assess differences in time to HIV seroconversion between arms by network gender composition and gender of the index. For significant interaction terms, we calculated simple effects, generated survival functions using Kaplan-Meier methods, and compared survival curves using log-rank tests. RESULTS At 12 months, there were 45 seroconversions among women (40.0 [28.3, 51.7] per 100 person years) and 111 among men (28.4 [23.1, 33.6] per 100 person years) in the control arm; there were 27 seroconversions among women (17.1 [10.7, 23.6] per 100 person years) and 77 among men (18.7 [14.5, 22.9] per 100 person years) in the intervention arm. Network gender composition (but not gender of the index) moderated the intervention effect on HIV incidence (p < 0.05). Specifically, the intervention appeared to be even more protective against HIV acquisition as female gender composition increased. In the intervention arm, the HIV seroconversion hazard rate was 44% lower with 1 network female; 61% lower with 2 network females; and 72% lower with 3 network females. CONCLUSIONS A greater number of women in an injection network, coupled with the provision of risk-reduction strategies, is associated with HIV risk-mitigation, though the mechanisms through which this occurs remain unclear. Findings can support new research and practice directions that prioritize women who inject drugs and more thoughtfully support their health and wellbeing.
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Affiliation(s)
- John Mark Wiginton
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, USA
- School of Social Work, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Robert Booth
- Department of Psychiatry, University of Colorado School of Medicine, Denver, USA
| | - Laramie R Smith
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, USA
| | - Sajina Shakya
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, USA
| | - Cristina Espinosa da Silva
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, San Diego, USA
- School of Public Health, San Diego State University, San Diego, USA
| | - Thomas L Patterson
- Departments of Psychiatry, University of California San Diego, San Diego, USA
| | - Eileen V Pitpitan
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, USA.
- School of Social Work, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA.
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Shivaprakash P, Patel V, Shadakshari D, Verma R, Shukla L, Mahadevan J, Kandasamy A, Chand PK, Benegal V, Sethuraman L, Sharma P, Murthy P. A descriptive study of hepatitis C in people who inject drugs. Indian J Med Res 2023; 158:559-564. [PMID: 38084934 PMCID: PMC10878480 DOI: 10.4103/ijmr.ijmr_2634_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND OBJECTIVES The seroprevalence of the hepatitis C virus (HCV) in general population is higher than that of human immunodeficiency virus (HIV) in India. People who inject drugs (PWIDs) constitute a high-risk group for all blood-borne infections. Multiple behavioural surveillance surveys have provided a rich typology of HIV-infected PWIDs, but this information is missing for HCV infection. We describe awareness, transmission risk factors and the treatment continuum for HCV infection among PWID. We also report spatial clustering of HCV infection in PWIDs residing in Bengaluru. METHODS Information from clinical records was collected and telephonic interviews of retrospectively identified PWIDs who received treatment at a tertiary-level addiction treatment facility between 2016 and 2021 were conducted. RESULTS We identified 391 PWIDs; 220 (56.26%) received an anti-HCV antibody test (4 th Generation HCV-Tridot). Individuals reporting unsafe injection practices were more often tested than those who did not ( χ2 =44.9, df=1, P <0.01). Almost half of the tested and more than a quarter of the whole sample (109/220, 49.9%; 109/391, 27.9%) were seropositive for HCV infection. The projected seropositivity in this group was between 27.9 per cent (best case scenario, all untested assumed negative) and 71.6 per cent (worst case scenario, all untested assumed positive). Only a minority of participants interviewed were aware of HCV (27/183, 14.7%). HCV infection and its associated risk behaviour (PWID) were clustered in certain localities (Diggle and Chetwynd Test; P =0.001) in Bengaluru in the southern district of Karnataka. INTERPRETATION CONCLUSIONS Undetected HCV infection is common in PWIDs; awareness and treatment uptake is poor in this group. Spatial clustering of infections in a district shows transmission in close networks and provides opportunities for targeted interventions.
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Affiliation(s)
- Prakrithi Shivaprakash
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vinit Patel
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Darshan Shadakshari
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rahul Verma
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lekhansh Shukla
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Prabhat Kumar Chand
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lakshmanan Sethuraman
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Priyamvada Sharma
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Doan LP, Nguyen LH, Auquier P, Boyer L, Fond G, Nguyen HT, Latkin CA, Vu GT, Hall BJ, Ho CSH, Ho RCM. Social network and HIV/AIDS: A bibliometric analysis of global literature. Front Public Health 2022; 10:1015023. [PMID: 36408016 PMCID: PMC9666395 DOI: 10.3389/fpubh.2022.1015023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Social networks (SN) shape HIV risk behaviors and transmission. This study was performed to quantify research development, patterns, and trends in the use of SN in the field of HIV/AIDS, and used Global publications extracted from the Web of Science Core Collection database. Networks of countries, research disciplines, and most frequently used terms were visualized. The Latent Dirichlet Allocation method was used for topic modeling. A linear regression model was utilized to identify the trend of research development. During the period 1991-2019, in a total of 5,698 publications, topics with the highest volume of publications consisted of (1) mental disorders (16.1%); (2) HIV/sexually transmitted infections prevalence in key populations (9.9%); and (3) HIV-related stigma (9.3%). Discrepancies in the geographical distribution of publications were also observed. This study highlighted (1) the rapid growth of publications on a wide range of topics regarding SN in the field of HIV/AIDS, and (2) the importance of SN in HIV prevention, treatment, and care. The findings of this study suggest the need for interventions using SN and the improvement of research capacity via regional collaborations to reduce the HIV burden in low- and middle-income countries.
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Affiliation(s)
- Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam,*Correspondence: Linh Phuong Doan
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Pascal Auquier
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Laurent Boyer
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Giang Thu Vu
- Center of Excellence in Health Services and System Research, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Brian J. Hall
- School of Global Public Health, New York University, New York, NY, United States
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Pachuau LN, Tannous C, Dhami MV, Agho KE. HIV among people who inject drugs in India: a systematic review. BMC Public Health 2022; 22:1529. [PMID: 35948967 PMCID: PMC9367073 DOI: 10.1186/s12889-022-13922-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Little is known about the epidemiology of HIV infection among HIV positive people who inject drugs (PWID) in India. Injecting drug use has emerged as an important route of HIV transmission in India. The objective of this study was to conduct a systematic review on the risk behaviours associated with HIV infection among HIV positive PWID and assess the data reported. Methods A systematic search of six electronic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase and Ovid Medline was conducted. These databases were searched for published studies on injecting risk behaviours, sexual risk behaviours and socio-demographic factors associated with HIV infection among HIV positive PWID in India. Results A total of 15 studies were included in the review of which 3 studies evaluated HIV/HCV coinfection among HIV positive PWID. Older age, low educational level and employment status were significantly associated with HIV infection. Sharing of syringe and needle, frequency of injection, early initiation of injecting practice, inconsistent condom use and having multiple sexual partners were all commonly associated with HIV infection among HIV positive PWID. Conclusion Our study identified significant injecting and sexual risk behaviours among HIV positive PWID in India. There is an increasing HIV transmission among PWID in different states, more so in the northeastern states and in metropolitan cities in India. More studies need to be conducted in other regions of the country to understand the true burden of the disease. The lack of sufficient data among HIV positive female PWID does not preclude the possibility of a hidden epidemic among female PWID. The need of the hour is for the prevention of further transmission by this high-risk group through the provision of comprehensive programs, surveillance and robust continuation of harm reduction services. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13922-2.
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Affiliation(s)
- Lucy Ngaihbanglovi Pachuau
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia.
| | - Caterina Tannous
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia
| | - Mansi Vijaybhai Dhami
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia.,Belmont Hospital, 16 Croudace Bay Road, Belmont, NSW, 2280, Australia
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, NSW, DC1797, Penrith, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia.,African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629, South Africa
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6
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Starks TJ, Skeen SJ, Scott Jones S, Gurung S, Millar BM, Ferraris C, Ventuneac A, Parsons JT, Sparks MA. Effectiveness of a Combined Motivational Interviewing and Cognitive Behavioral Intervention to Reduce Substance Use and Improve HIV-Related Immune Functioning. AIDS Behav 2022; 26:1138-1152. [PMID: 34537912 DOI: 10.1007/s10461-021-03467-7] [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: 09/10/2021] [Indexed: 12/01/2022]
Abstract
This study evaluated the effectiveness of Project PLUS, a 6-session Motivational Interviewing and Cognitive Behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence among PLWH. In a quasi-experimental design, 84 participants from a network of three comprehensive care clinics in New York City received the intervention immediately post-baseline (the Immediate condition) and 90 were assigned to a Waitlist control. Viral load and CD4 data were extracted from electronic medical records (EMR) for a No-Intervention comparison cohort (n = 120). Latent growth curve analyses did not show a consistent pattern of significant between-group differences post-intervention or across time in ART adherence or substance use severity between Immediate and Waitlist participants. Additionally, Immediate intervention participants did not differ significantly from the Waitlist or No-Treatment groups on viral load or CD4 post-intervention or across time. The potential to detect intervention effects may have been limited by the use of a quasi-experimental design, the high quality of standard care at these clinics, or inadequate intervention dose.Trial Registration: ClinicalTrials.gov (NIH U.S. National Library of Medicine) Identifier: NCT02390908; https://clinicaltrials.gov/ct2/show/NCT02390908.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, USA.
| | - Simone J Skeen
- PRIDE Health Research Consortium, Hunter College of CUNY, New York, NY, USA
| | - S Scott Jones
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Sitaji Gurung
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Brett M Millar
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Christopher Ferraris
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Ana Ventuneac
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Martha A Sparks
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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7
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Falade-Nwulia O, Ward KM, McCormick S, Mehta SH, Pitts SR, Katz S, Chander G, Thomas DL, Sulkowski M, Latkin CA. Network-based recruitment of people who inject drugs for hepatitis C testing and linkage to care. J Viral Hepat 2020; 27:663-670. [PMID: 32045086 PMCID: PMC7299737 DOI: 10.1111/jvh.13274] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/15/2020] [Accepted: 01/22/2020] [Indexed: 12/13/2022]
Abstract
Although oral direct-acting agent (DAA) therapies have the potential to reduce the burden of hepatitis C virus (HCV) infection, treatment uptake remains low, particularly among people who inject drugs (PWID). This study examined the feasibility of an innovative peer-based recruitment strategy to engage PWID in HCV testing and treatment. We interviewed an initial set of HCV antibody-positive PWID as 'primary indexes' to gather demographic, drug use, health information and drug network characteristics. Primary indexes were then briefly educated on HCV and its treatment and encouraged to recruit their injection drug 'network members' for HCV testing and linkage to care. Eligible network members were enrolled as 'secondary indexes' and completed the same index study procedures. In sum, 17 of 36 primary indexes initiated the recruitment of 64 network members who were HCV antibody positive and eligible to become indexes. In multivariable analysis, successful recruitment of at least one network member was positively associated with prior HCV treatment (OR 2.80; CI [1.01, 7.72]), daily or more injection drug use (OR 2.38; CI [1.04, 5.47]), and a higher number of injection drug network members (OR 1.20; CI [1.01, 1.42]). Among the 69 participants with chronic HCV not previously linked to HCV care at enrolment, 91% (n = 63) completed a linkage to HCV care appointment, 45% (n = 31) scheduled an appointment with an HCV provider, and 20% (n = 14) initiated HCV therapy. These findings suggest a potential benefit for peer-driven, network-based interventions focused on HCV treatment-experienced PWID as a mechanism to increase HCV linkage to care.
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Affiliation(s)
| | | | - Sean McCormick
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shruti H. Mehta
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Stephanie Katz
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - David L. Thomas
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mark Sulkowski
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carl A. Latkin
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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8
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Yang X, Fang T, Mobarak SA, Wang J, Wang C, Huang S, Jiang L, Chen X, Li H, Chang W, Zhang L, Mo J, Ning C. Social network strategy as a promising intervention to better reach key populations for promoting HIV prevention: a systematic review and meta-analysis. Sex Transm Infect 2020; 96:485-491. [PMID: 32209639 DOI: 10.1136/sextrans-2019-054349] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/11/2020] [Accepted: 02/19/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Key populations such as men who have sex with men (MSM), drug users and sex workers are at high risk of HIV infection, but they are marginalised and hidden. Social network strategy (SNS) is purposeful to use social networks to generate social influence, accelerate behaviour change and achieve desirable outcomes among individuals or communities and have been increasingly used for HIV interventions. This study aims to investigate the effects of SNS on HIV prevention among key populations. METHODS We searched six databases, including PubMed, Web of Science, Embase, Cochrane Library, ScienceDirect and Wiley for randomised controlled trials published between January 1999 and May 2019. Eligibility criteria included SNS conducted among key populations for HIV interventions, with a comparator group. Outcomes included changes in HIV high-risk behaviour, HIV seroconversion and other HIV outcomes. We used the risk ratio (RR) or mean difference with associated 95% confidence interval (CI) to assess the comparative efficacy between SNS and control methods on the selected outcomes. The GRADE system was used to assess the quality of evidence for the studies. RESULTS Of 2818 citations identified, 28 trails from 24 papers met the inclusion criteria. The results showed that SNS was associated with less unprotected intercourse (RR 0.79, 95% CI 0.72 to 0.86) and sex with multiple partners (0.46, 95% CI 0.33 to 0.65). Additionally, relative to the control methods, SNS significantly reduced HIV seroconversion (0.65, 95% CI 0.53 to 0.81), improved HIV testing uptake (1.11, 95% CI 1.07 to 1.15) and promoted participant retention (1.03, 95% CI 1.00 to 1.06) among key populations. The Grading of Recommendations Assessment, Development and Evaluation system showed that trails were of moderate quality. CONCLUSIONS This review provides evidence that SNS can reach key populations who are currently not being reached by existing programmes and deliver HIV interventions through social networks, which decreases HIV sexual risk behaviour and HIV incidence and increases HIV testing uptake and participant retention. TRIAL REGISTRATION NUMBER CRD42019140533.
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Affiliation(s)
- Xing Yang
- Nursing College, Guangxi Medical University, Nanning, China
| | - Ting Fang
- Nursing College, Guangxi Medical University, Nanning, China
| | - Siam Ai Mobarak
- The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jing Wang
- Institute of Acute Communicable Disease Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Can Wang
- The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Shan Huang
- The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Jiang
- Nursing College, Guangxi Medical University, Nanning, China
| | - Xi Chen
- Nursing College, Guangxi Medical University, Nanning, China
| | - Hongzhan Li
- Nursing College, Guangxi Medical University, Nanning, China
| | - Weiwei Chang
- Nursing College, Guangxi Medical University, Nanning, China
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Jieling Mo
- Nursing College, Guangxi Medical University, Nanning, China
| | - Chuanyi Ning
- Nursing College, Guangxi Medical University, Nanning, China .,Key Lab of AIDS Prevention and Treatment, BSL-3 Lab, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
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9
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Ganapathi L, McFall AM, Srikrishnan AK, Kumar MS, Anand S, Lucas GM, Mehta SH, Harris SK, Solomon SS. Young people who inject drugs in India have high HIV incidence and behavioural risk: a cross-sectional study. J Int AIDS Soc 2019; 22:e25287. [PMID: 31116005 PMCID: PMC6530044 DOI: 10.1002/jia2.25287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/29/2019] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION There are limited data on young people who inject drugs (PWID) from low- and middle-income countries where injection drug use remains a key driver of new HIV infections. India has a diverse injection drug use epidemic and estimates suggest that at least half of PWID are ≤30 years of age. We compared injection and sexual risk behaviours and HIV incidence between younger and older PWID and characterized uptake of HIV testing and harm reduction services to inform targeted HIV prevention efforts. METHODS We analysed cross-sectional data from 14,381 PWID recruited from cities in the Northeast and North/Central regions of India in 2013 using respondent driven sampling (RDS). We compared "emerging-adult" (18 to 24 years, 26% of sample) and "young-adult" PWID (25 to 30 years, 30% of sample) to older PWID (>30 years, 44% of sample) using logistic regression to evaluate factors associated with three recent risk behaviours: needle-sharing, multiple sexual partners and unprotected sex. We estimated age-stratified cross-sectional HIV incidence using a validated multi-assay algorithm. RESULTS Compared to older adults, emerging-adults in the Northeastern states were significantly more likely to share needles (males adjusted odds ratio [aOR] 1.82; females aOR 2.29, p < 0.01), have multiple sexual partners (males aOR 1.56; females aOR 3.75, p < 0.01), and engage in unprotected sex (males aOR 2.29, p < 0.01). In the North/Central states, young-adult males were significantly more likely to needle-share (aOR 1.23, p < 0.05) while emerging-adult males were significantly more likely to have multiple sexual partners (aOR 1.74, p < 0.05). In both regions, emerging-adults had the lowest HIV testing. Participation in harm reduction services was low across all age groups. Annual HIV incidence was higher in emerging- and young-adult PWID in the North/Central region: emerging-adults: 4.3% (95% confidence interval [CI] 3.0, 5.6); young-adults: 4.9% (95% CI 3.7, 6.2); older adults: 2.1% (95% CI 1.4, 2.8). CONCLUSIONS Higher HIV incidence and engagement in risky behaviours among younger PWID compared to older PWID, coupled with low utilization of harm reduction services highlight the importance of targeting this population in HIV programming. Age-specific interventions focused on addressing the needs of young PWID are urgently needed to curb the HIV epidemic in this vulnerable population.
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Affiliation(s)
- Lakshmi Ganapathi
- Division of Infectious DiseasesBoston Children's Hospital and Harvard Medical SchoolBostonMAUSA
| | - Allison M McFall
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | | | | | - Santhanam Anand
- YR Gaitonde Center for AIDS Research and EducationChennaiIndia
| | - Gregory M Lucas
- Division of Infectious DiseasesThe Johns Hopkins University School of MedicineBaltimoreMDUSA
| | - Shruti H Mehta
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Sion K Harris
- Center for Adolescent Substance Abuse ResearchBoston Children's Hospital and Harvard Medical SchoolBostonMAUSA
| | - Sunil S Solomon
- Division of Infectious DiseasesThe Johns Hopkins University School of MedicineBaltimoreMDUSA
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10
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West BS. Social Networks of Substance-Using Populations: Key Issues and Promising New Approaches for HIV. Curr HIV/AIDS Rep 2019; 16:48-56. [PMID: 30659477 PMCID: PMC6420834 DOI: 10.1007/s11904-019-00425-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW This paper presents recent literature on substance using networks and HIV, highlighting renewed and emerging themes in the field. The goal is to draw attention to research that holds considerable promise for advancing our understanding of the role of networks in shaping behaviors, while also providing critical information for the development of interventions, programs, and policies to reduce HIV and other drug-related harms. RECENT FINDINGS Recent research advances our understanding of networks and HIV, including among understudied populations, and provides new insight into how risk environments shape the networks and health of substance-using populations. In particular, the integration of network approaches with molecular epidemiology, research on space and place, and intervention methods provides exciting new avenues of investigation. Continued advances in network research are critical to supporting the health and rights of substance-using populations and ensuring the development of high-impact HIV programs and policies.
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Affiliation(s)
- Brooke S West
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
- Division of Infectious Diseases and Global Public Health in the School of Medicine, University of California San Diego, San Diego, CA, USA.
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11
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Safe sex norm questionnaire for female sex workers: development and validation study in Iran. Public Health 2018; 164:82-90. [PMID: 30218915 DOI: 10.1016/j.puhe.2018.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/22/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of the present study was to develop and validate a safe sex norm questionnaire as an appropriate instrument which would be adaptable to the female sex worker (FSW) population. STUDY DESIGN A mixed method study. METHODS Appropriate content was prepared through a literature review. Content validation indices were assessed using interviews with content experts and lay experts. A conservative approach was used to assess the inter-rater agreement among the participants about the instrument relevance and clarity. The scale content validity index was computed using the average method. Non-parametric Mokken scale analysis was used for assessing scalability and unidimensionality of the questionnaire in a sample of 170 FSWs in Tehran. To evaluate the reliability and internal consistency of the questionnaire intra-class correlation and Cronbach's alpha were employed. RESULTS A list of 34 items was finalized, with subscales for actual behavioral norms and for perceived norms. The relevance of the actual and perceived norms subscales in the final questionnaire was higher than 96%; clarity of the subtests was 99% and higher. The comprehensiveness of the actual and perceived norms subscales was 85% for both. Mokken scale analysis showed that the two subscales were distinct constructs, and all items are good indicators for the constructs. CONCLUSION Our findings support that the safe sex norm questionnaire is a valid and reliable measure that would be useful to harm reduction programs and help effective HIV prevention among female sex workers.
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Shushtari ZJ, Hosseini SA, Sajjadi H, Salimi Y, Latkin C, Snijders TAB. Social network and HIV risk behaviors in female sex workers: a systematic review. BMC Public Health 2018; 18:1020. [PMID: 30115056 PMCID: PMC6097207 DOI: 10.1186/s12889-018-5944-1] [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: 10/09/2017] [Accepted: 08/09/2018] [Indexed: 12/12/2022] Open
Abstract
Background Social network characteristics have an important role in understanding HIV transmission among female sex workers. The purpose of this systematic review was to summarize and critically appraise the existing studies on the social network characteristics and HIV risk behaviors among female sex workers. Method A systematic review was performed using predefined eligibility criteria through searching electronic databases. Two independent reviewers assessed the methodological quality of studies. Results Nineteen papers met the eligible review criteria. The synthesized evidence suggests that characteristics of social networks, especially functional characteristics such as social support and social capital, are important constructs for understanding the HIV risk behaviors. Conclusions The findings of the present review enhance our understanding of the role of social network characteristics in HIV risk behaviors among female sex workers. However, the findings also highlighted a dearth of knowledge about the association of structural characteristics of social networks with HIV risk behaviors among female sex workers.
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Affiliation(s)
- Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran
| | - Seyed Ali Hosseini
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran.
| | - Homeira Sajjadi
- Social welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Carl Latkin
- Department of Health, Behavior and Society, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tom A B Snijders
- Department of Sociology, University of Groningen, 9712, TG Groningen, Netherlands.,Nuffield College, University of Oxford, Oxford, OX1 1NF, UK
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Racial Inequities in HIV Prevalence and Composition of Risk Networks Among People Who Inject Drugs in HIV Prevention Trial Network 037. J Acquir Immune Defic Syndr 2018; 76:394-401. [PMID: 28816720 DOI: 10.1097/qai.0000000000001521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND HIV prevention interventions in the United States have failed to eliminate racial inequities. Here, we evaluate factors associated with racial inequities in HIV prevalence among people who inject drugs using HIV Prevention Trial Network 037 data. METHODS We measured racial homophily (ie, all members share the same race), being in an HIV+ network (network with ≥1 HIV+ member), and drug and sex risk behaviors. A 2-level logistic regression with a random intercept evaluated the association between being in an HIV+ network and race adjusting for individual-level and network-level factors. RESULTS Data from 232 index participants and 464 network members were included in the analysis. Racial homophily was high among blacks (79%) and whites (70%); 27% of all-black, 14% of all-white, and 23% of racially mixed networks included HIV+ members. Sex risk was similar across networks, but needle sharing was significantly lower in all-black (23%) compared with all-white (48%) and racially mixed (46%) networks. All-black [adjusted odds ratio (AOR), 3.6; 95% confidence interval (CI), 1.4 to 9.5] and racially mixed (AOR, 2.0; 95% CI: 1.1 to 3.7) networks were more likely to include HIV+ network members; other factors associated with being in HIV+ network included homelessness (AOR, 2.0; 95% CI, 1.2 to 3.2), recent incarceration (AOR, 0.4; 95% CI, 0.2 to 0.7), and cocaine injection (AOR, 1.7; 95% CI, 1.0 to 2.7). Risk behaviors were not associated with being in an HIV+ network. CONCLUSION Despite having lower drug risk behavior, all-black networks disproportionately included HIV+ members. HIV prevention interventions for people who inject drugs need to go beyond individual risk and consider the composition of risk networks.
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Godfrey C, Bobkova M, Boucher C, Ravasi G, Chen P, Zhang F, Wu Y, Kantor R. Regional Challenges in the Prevention of Human Immunodeficiency Virus Drug Resistance. J Infect Dis 2017; 216:S816-S819. [PMID: 28968824 DOI: 10.1093/infdis/jix408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In diverse global regions with significant human immunodeficiency virus (HIV) burden, programmatic, cultural, and provider-, patient-, and virus-related factors may result in HIV drug resistance, with global implications. This article reviews such common and unique challenges in Russia, Latin America and the Caribbean, China, and India, to suggest potential solutions.
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Affiliation(s)
- Catherine Godfrey
- Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | | | - Charles Boucher
- Erasmus Medical Center, Department of Viroscience, The Netherlands
| | | | - Ping Chen
- China Office, Office of Global Research, NIAID, NIH
| | - Fujie Zhang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University
| | - Yasong Wu
- Division of Treatment and Care, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rami Kantor
- Division of Infectious Diseases, Department of Medicine, Brown University Alpert Medical School
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