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Marcellin F, Jaquet A, Lazarus JV, Molina P, Carrieri P. Alcohol Use Disorder and Hepatitis C Prevention and Care in People Who Inject Drugs: The State of Play. Semin Liver Dis 2021; 41:109-116. [PMID: 32851613 DOI: 10.1055/s-0040-1716343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Safe and effective treatment with direct-acting antivirals (DAAs) has ushered in an era in which hepatitis C virus (HCV) elimination, as set out by the World Health Organization, is possible. However, alcohol use disorder (AUD) has the potential to reduce the benefits of prevention interventions and reduce access to and continuity of HCV care in at-risk populations, such as people who inject drugs (PWID). We review the literature on the consequences of AUD on the effectiveness of HCV prevention and the cascade of care in PWID and provide recommendations for future research in the field of alcohol use and HCV.
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Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Antoine Jaquet
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France.,Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Patricia Molina
- Department of Physiology and Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
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Wolfson-Stofko B, Elliott L, Bennett AS, Curtis R, Gwadz M. Perspectives on supervised injection facilities among service industry employees in New York City: A qualitative exploration. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 62:67-73. [PMID: 30359875 PMCID: PMC6279482 DOI: 10.1016/j.drugpo.2018.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/08/2018] [Accepted: 08/21/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Approximately 100 supervised injection facilities (SIFs) operate in 66 cities around the world to reduce overdose deaths, the spread of disease and public disorder, though none legally exist in the United States. Public bathrooms are among the most common public places for injection reported by people who inject drugs in New York City (NYC) and service industry employees (SIEs) inadvertently become first-responders when overdoses occur in business bathrooms. The goal of this study was to assess SIE acceptability of SIFs and the perceived effects that SIFs would have on them, their colleagues, their businesses and communities. METHODS Semi-structured qualitative interviews were conducted with 15 SIEs recruited through convenience sampling throughout NYC. Participants were provided with peer-reviewed scientific evidence prior to discussing SIFs. Data were analysed using a hybrid deductive and inductive approach. RESULTS Most SIEs had encountered drug use (93%, n = 14/15) and syringes (73%, n = 11/15) in their business bathrooms and three had encountered unresponsive individuals. Nearly all workers (93%, n = 14/15) were supportive of SIFs and believed SIFs would reduce injection drug use in their business bathrooms. Participants also believed that 'not in my backyard' arguments from community boards may impede SIF operation. CONCLUSIONS Service industry employees are critical stakeholders due to their exposure to occupational health hazards related to public injection. Those interviewed were amenable to SIF operation as a form of occupational harm reduction and their experiences provide an important dimension to the political debate surrounding SIFs.
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Affiliation(s)
- Brett Wolfson-Stofko
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, United States; National Development & Research Institute, Center on Community and Health Disparities Research, 71 W. 23rd St, 4th Fl, New York, NY, 10010, United States.
| | - Luther Elliott
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, United States; National Development & Research Institute, Center on Community and Health Disparities Research, 71 W. 23rd St, 4th Fl, New York, NY, 10010, United States
| | - Alex S Bennett
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, United States; National Development & Research Institute, Center on Community and Health Disparities Research, 71 W. 23rd St, 4th Fl, New York, NY, 10010, United States
| | - Ric Curtis
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, United States; John Jay College of Criminal Justice, City University of New York, Department of Law, Police Science and Criminal Justice Administration, Department of Anthropology, 524 W. 59th St, New York, NY, 10019, United States
| | - Marya Gwadz
- Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, United States
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Wolfson-Stofko B, Bennett AS, Elliott L, Curtis R. Drug use in business bathrooms: An exploratory study of manager encounters in New York City. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 39:69-77. [PMID: 27768996 DOI: 10.1016/j.drugpo.2016.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 08/16/2016] [Accepted: 08/29/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Though public bathroom drug injection has been documented from the perspective of people who inject drugs, no research has explored the experiences of the business managers who oversee their business bathrooms and respond to drug use. These managers, by default, are first-responders in the event of a drug overdose and thus of intrinsic interest during the current epidemic of opioid-related overdoses in the United States. This exploratory study assists in elucidating the experiences that New York City business managers have with people who inject drugs, their paraphernalia, and their overdoses. METHODS A survey instrument was designed to collect data on manager encounters with drug use occurring in their business bathrooms. Recruitment was guided by convenience and purposive approaches. RESULTS More than half of managers interviewed (58%, n=50/86) encountered drug use in their business bathrooms, more than a third (34%) of these managers also found syringes, and the vast majority (90%) of managers had received no overdose recognition or naloxone training. Seven managers encountered unresponsive individuals who required emergency assistance. CONCLUSION The results from this study underscore the need for additional research on the experiences that community stakeholders have with public injection as well as educational outreach efforts among business managers. This research also suggests that there is need for a national dialogue about potential interventions, including expanded overdose recognition and naloxone training and supervised injection facilities (SIF)/drug consumption rooms (DCR), that could reduce public injection and its associated health risks.
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Affiliation(s)
- Brett Wolfson-Stofko
- National Development & Research Institute, Institute for Special Populations Research, 71 W. 23rd St., 4th Fl., New York, NY 10100, United States of America; Center for Drug Use and HIV/HCV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10100, United States of America.
| | - Alex S Bennett
- National Development & Research Institute, Institute for Special Populations Research, 71 W. 23rd St., 4th Fl., New York, NY 10100, United States of America; Center for Drug Use and HIV/HCV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10100, United States of America
| | - Luther Elliott
- National Development & Research Institute, Institute for Special Populations Research, 71 W. 23rd St., 4th Fl., New York, NY 10100, United States of America; Center for Drug Use and HIV/HCV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10100, United States of America
| | - Ric Curtis
- John Jay College of Criminal Justice, City University of New York, Department of Law, Police Science and Criminal Justice Administration, and Department of Anthropology, 524 W. 59th St., New York, NY 10019, United States of America; Center for Drug Use and HIV/HCV Research, Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10100, United States of America
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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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Smith ME, Robinowitz N, Chaulk P, Johnson KE. Self-care and risk reduction habits in older injection drug users with chronic wounds: a cross-sectional study. Harm Reduct J 2014; 11:28. [PMID: 25326686 PMCID: PMC4213493 DOI: 10.1186/1477-7517-11-28] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/22/2014] [Indexed: 11/25/2022] Open
Abstract
Background We surveyed a population of injection drug users (IDUs) frequenting the mobile Baltimore City Needle Exchange Program (BNEP) to investigate self-care factors associated with chronic wounds, a significant cause of morbidity especially among older IDUs. Methods Participants ≥18 years old completed a survey regarding chronic wounds (duration ≥8 weeks), injection and hygiene practices. Study staff visually verified the presence of wounds. Participants were categorized into four groups by age and wound status. Factors associated with the presence of chronic wounds in participants ≥45 years were analyzed using logistic regression. Results Of the 152 participants, 19.7% had a chronic wound. Of those with chronic wounds, 18 were ≥45 years old (60.0%). Individuals ≥45 years old with chronic wounds were more likely to be enrolled in a drug treatment program (Odds ratio (OR) 3.4, 95% Confidence interval (CI) 1.0–10.8) and less likely to use cigarette filters when drawing up prepared drug (OR 0.2, 95% CI 0.03–0.7) compared to the same age group without chronic wounds. Compared to individuals <45 years old without chronic wounds, individuals ≥45 with a chronic wound were more likely to report cleaning reused needles with bleach (OR 10.7, 95% CI 1.2–93.9) and to use the clinic, rather than an emergency room, as a primary source of medical care (OR 3.4, 95% CI 1.1–10.4). Conclusions Older IDUs with chronic wounds have different, and perhaps less risky, injection and hygiene behaviors than their peers and younger IDUs without wounds in Baltimore City. Because of these differences, older IDUs with wounds may be more receptive to community-based healthcare and substance abuse treatment messages.
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Affiliation(s)
| | | | | | - Kristine E Johnson
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, 5200 Eastern Avenue, MFL Building, Center Tower, 3rd Floor, Baltimore, MD 21224, USA.
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Crabtree A, Mercer G, Horan R, Grant S, Tan T, Buxton JA. A qualitative study of the perceived effects of blue lights in washrooms on people who use injection drugs. Harm Reduct J 2013; 10:22. [PMID: 24099145 PMCID: PMC3853159 DOI: 10.1186/1477-7517-10-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 09/28/2013] [Indexed: 12/01/2022] Open
Abstract
Background Blue lights are sometimes placed in public washrooms to discourage injection drug use. Their effectiveness has been questioned and concerns raised that they are harmful but formal research on the issue is limited to a single study. We gathered perceptions of people who use injection drugs on the effects of blue lights with the aim of informing harm reduction practice. Methods We interviewed 18 people in two Canadian cities who currently or previously used injection drugs to better understand their perceptions of the rationale for and consequences of blue lights in public washrooms. Results Participants described a preference for private places to use injection drugs, but explained that the need for an immediate solution would often override other considerations. While public washrooms were in many cases not preferred, their accessibility and relative privacy appear to make them reasonable compromises in situations involving urgent injecting. Participants understood the aim of blue lights to be to deter drug use. The majority had attempted to inject in a blue-lit washroom. While there was general agreement that blue lights do make injecting more difficult, a small number of participants were entirely undeterred by them, and half would use a blue-lit washroom if they needed somewhere to inject urgently. Participants perceived that, by making veins less visible, blue lights make injecting more dangerous. By dispersing public injection drug use to places where it is more visible, they also make it more stigmatizing. Despite recognizing these harms, more than half of the participants were not opposed to the continued use of blue lights. Conclusions Blue lights are unlikely to deter injection drugs use in public washrooms, and may increase drug use-related harms. Despite recognizing these negative effects, people who use injection drugs may be reluctant to advocate against their use. We attempt to reconcile this apparent contradiction by interpreting blue lights as a form of symbolic violence and suggest a parallel with other emancipatory movements for inspiration in advocating against this and other oppressive interventions.
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Linton SL, Celentano DD, Kirk GD, Mehta SH. The longitudinal association between homelessness, injection drug use, and injection-related risk behavior among persons with a history of injection drug use in Baltimore, MD. Drug Alcohol Depend 2013; 132:457-65. [PMID: 23578590 PMCID: PMC3926693 DOI: 10.1016/j.drugalcdep.2013.03.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 03/04/2013] [Accepted: 03/09/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Few studies have assessed the temporal association between homelessness and injection drug use, and injection-related risk behavior. METHODS Among a cohort of 1405 current and former injection drug users in follow-up from 2005 to 2009, we used random intercept models to assess the temporal association between homelessness and subsequent injection drug use, and to determine whether the association between homelessness and sustained injection drug use among active injectors differed from the association between homelessness and relapse among those who stopped injecting. We also assessed the association between homelessness and subsequent injection-related risk behavior among participants who injected drugs consecutively across two visits. Homelessness was categorized by duration: none, <1 month, and ≥1 month. RESULTS Homelessness was reported on at least one occasion by 532 (38%) participants. The relationship between homelessness and subsequent injection drug use was different for active injectors and those who stopped injecting. Among those who stopped injecting, homelessness was associated with relapse [<1 month: AOR=1.67, 95% CI (1.01, 2.74); ≥1 month: AOR=1.34 95% CI (0.77, 2.33)]. Among active injectors, homelessness was not associated with sustained injection drug use [<1 month: AOR=1.03, 95% CI (0.71, 1.49); ≥1 month: AOR=0.81 95% CI (0.56, 1.17)]. Among those injecting drugs across two consecutive visits, homelessness ≥1 month was associated with subsequent injection-related risk behavior [AOR=1.61, 95% CI (1.06, 2.45)]. CONCLUSION Homelessness appears to be associated with relapse and injection-related risk behavior. Strengthening policies and interventions that prevent homelessness may reduce injection drug use and injection-related risk behaviors.
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Affiliation(s)
- Sabriya L. Linton
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - David D. Celentano
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Gregory D. Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Shruti H. Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA
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High prevalence of HIV, syphilis and HCV, and low methadone maintenance treatment in a migrant population in Beijing. J Addict Med 2013; 6:311-7. [PMID: 23041679 DOI: 10.1097/adm.0b013e31826c1135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To provide evidence for policy makers for human immunodeficiency virus (HIV) prevention and control, we investigated HIV, syphilis, and hepatitis C virus (HCV) infection and the availability of methadone maintenance treatment (MMT) among migrant drug users in Beijing. METHODS A total of 222 participants from 3 main communities where drug abusers reside were interviewed, completed a questionnaire, and were screened for HIV using enzyme-linked immunosorbent assay, confirmed by Western blot. Descriptive statistics, χ tests, and binary logistic regression models were used to analyze differences in HIV and sexually transmitted diseases among different subpopulations. RESULTS The prevalence of HIV and syphilis in the migrant population was much higher than in permanent residents (43.0% vs 2.1% and 13.3% vs 4.3%, respectively). The HIV-infected cases in the migrant population were 33-fold higher than in permanent residents. Compared with permanent residents, the availability of MMT was much lower in the migrant population (21.9% vs 70.2%), and they were less knowledgeable about MMT (37.0% vs 84.0%). Even for those who were knowledgeable about MMT, methadone treatment was still lower (46.8% vs 82.3%). Compared with the MMT group, higher infection rates of HIV and HCV were found in the no-MMT group (36.7% vs 10.6% and 64.8% vs 50.0%, respectively). Education and employment status contributed to the different distributions between permanent residents and the migrant population and the MMT and no-MMT groups. CONCLUSIONS The prevalence of HIV, syphilis, and HCV infection was higher, and the use of MMT was lower in the migrant population. The migrant population is a noticeable challenge for HIV prevention and control in Beijing.
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Interdisciplinary mixed methods research with structurally vulnerable populations: case studies of injection drug users in San Francisco. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:101-9. [PMID: 23312109 DOI: 10.1016/j.drugpo.2012.12.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 10/27/2012] [Accepted: 12/09/2012] [Indexed: 02/07/2023]
Abstract
Research with injection drug users (IDUs) benefits from interdisciplinary theoretical and methodological innovation because drug use is illegal, socially sanctioned and often hidden. Despite the increasing visibility of interdisciplinary, mixed methods research projects with IDUs, qualitative components are often subordinated to quantitative approaches and page restrictions in top addiction journals limit detailed reports of complex data collection and analysis logistics, thus minimizing the fuller scientific potential of genuine mixed methods. We present the methodological logistics and conceptual approaches of four mixed-methods research projects that our interdisciplinary team conducted in San Francisco with IDUs over the past two decades. These projects include combinations of participant-observation ethnography, in-depth qualitative interviewing, epidemiological surveys, photo-documentation, and geographic mapping. We adapted Greene et al.'s framework for combining methods in a single research project through: data triangulation, methodological complementarity, methodological initiation, and methodological expansion. We argue that: (1) flexible and self-reflexive methodological procedures allowed us to seize strategic opportunities to document unexpected and sometimes contradictory findings as they emerged to generate new research questions, (2) iteratively mixing methods increased the scope, reliability, and generalizability of our data, and (3) interdisciplinary collaboration contributed to a scientific "value added" that allowed for more robust theoretical and practical findings about drug use and risk-taking.
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