1
|
Sekera JC, Frýbert J. Analysis of drug-related infectious diseases in people who inject drugs - Pilsen Region, 2003-2018. Cent Eur J Public Health 2022; 30:13-19. [PMID: 35421293 DOI: 10.21101/cejph.a6937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 03/04/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic. METHODS In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective. RESULTS In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine. CONCLUSIONS This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.
Collapse
Affiliation(s)
- Jan Carlos Sekera
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jiří Frýbert
- Ulice Association in Pilsen, Pilsen, Czech Republic
| |
Collapse
|
2
|
Wang JY, Zhang KG, Ruan JX, Chen W, Wang L. Shift in HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi'an, China. Curr HIV Res 2021; 18:219-226. [PMID: 32294041 PMCID: PMC7475938 DOI: 10.2174/1570162x18666200415123607] [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: 10/31/2019] [Revised: 03/16/2020] [Accepted: 03/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND In China, although quite a few bold programmes have been made for HIV/AIDS, the epidemic has still shown an increasing trend. OBJECTIVES The study was aimed to investigate the characteristics of new HIV/AIDS and the major factors of false positives (FP) for HIV testing. METHODS A retrospective review was performed in a teaching hospital in Xi'an between 2013 and 2018. The overall characteristics and trends of new HIV/AIDS were described. Moreover, the major factors of FP were determined by the Pareto analysis. RESULTS A total of 469 new HIV/AIDS were diagnosed, with an increasing prevalence of the new HIV/AIDS from 0.0626% (41/65503) in 2013 to 0.0827% (115/139046) in 2018. Of them, the majority occurred in the males (88.50%), people aged 21-50 years (76.97%), migrants (60.98%), and sexual contact route (88.70%). There was a rapid increase in the annual number of new HIV/AIDS and increasing trends in groups of young individuals, students, and homosexual mode; however, a downward trend in the percentage of injecting drug use was also observed. Over 50 years old and patients from oncology, obstetrics, hepatobiliary surgery, nephrology, cardiology, and infectious disease constituted the major factors of FP. CONCLUSION The HIV/AIDS epidemic in Xi'an is still evolving, therefore, effective strategies, appropriate education and scaling up HIV testing should be developed. In addition, old adults and specific departments were associated with FP.
Collapse
Affiliation(s)
- Jing-Yuan Wang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Kai-Ge Zhang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Jing-Xiong Ruan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wei Chen
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Linchuan Wang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| |
Collapse
|
3
|
Zhao Q, Jiang S, Li M, Yao L, Ma X, Li M, Wang C, Pan Y, Zhao H, Li B. Incidence trend and age-period-cohort analysis of reported hepatitis C among residents aged 30 to 79 in northeastern China, 2008 to 2017. Medicine (Baltimore) 2020; 99:e22005. [PMID: 32899048 PMCID: PMC7478665 DOI: 10.1097/md.0000000000022005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to acquire the epidemic trend of age-standardized reported incidence and to analyze the age effect, period effect, and cohort effect on the reported incidence of hepatitis C in Jilin Province, China.We collected the annual reported incidence data of hepatitis C by gender (2008-2017). Annual percentage change and annual average percentage change were calculated by joinpoint Poisson regression analysis. The age effect, period effect, and cohort effect on the incidence of hepatitis C were estimated by an age-period-cohort model, and the relative risk was determined.Joinpoint regression analysis showed that the age-standardized reported incidence of hepatitis C indicated a declining trend integrally. Among people aged 30 to 44 (youth), the incidence trend declined the fastest, while trends declined the slowest among women and the overall population aged over 66 (elderly people) and men aged 45 to 65 (middle-aged group). The results of the age-period-cohort model showed that the reported incidence increased first and then decreased with age. Throughout the period, the risk of hepatitis C also increased first and then decreased. Compared with the median birth cohort of the same age group, the birth cohort of the patients with the highest incidence of hepatitis C was in the 1930s, followed by the 1940s and 1950s. The birth cohort of the patients with the lowest incidence was in the 1980s, followed by the 1970s and 1960s.Although the overall reported incidence trend of hepatitis C is declining and the risk of the young birth cohort is low, many factors affecting infection and testing with hepatitis C still exist in China. We should focus on high-risk population management and formulate corresponding public health strategies to accelerate the implementation of the global health strategy to eliminate hepatitis C published by the World Health Organization.
Collapse
Affiliation(s)
- Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention
| | - Shan Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Meina Li
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Laishun Yao
- Jilin Provincial Center for Disease Control and Prevention
| | - Xiaoyu Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Meng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Hantong Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University
| |
Collapse
|
4
|
Peavy KM, Darnton J, Grekin P, Russo M, Green CJB, Merrill JO, Fotinos C, Woolworth S, Soth S, Tsui JI. Rapid Implementation of Service Delivery Changes to Mitigate COVID-19 and Maintain Access to Methadone Among Persons with and at High-Risk for HIV in an Opioid Treatment Program. AIDS Behav 2020; 24:2469-2472. [PMID: 32347404 PMCID: PMC7186943 DOI: 10.1007/s10461-020-02887-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
5
|
Liu Y, Zou X, Chen W, Gong C, Ling L. Hepatitis C Virus Treatment Status and Barriers among Patients in Methadone Maintenance Treatment Clinics in Guangdong Province, China: A Cross-Sectional, Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224436. [PMID: 31726750 PMCID: PMC6888391 DOI: 10.3390/ijerph16224436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/31/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022]
Abstract
We aimed to evaluate the status and barriers related to hepatitis C virus (HCV) treatment among Chinese methadone maintenance treatment (MMT) clients, and the willingness and barriers of patients to accept directly observed treatment (DOT) service and oral direct-acting antivirals (DAAs). We conducted a cross-sectional survey from July to October 2017 in Guangdong Province, China, involving 678 HCV antibody-positive MMT patients. If they reported being infected with HCV, then their HCV treatment experience, willingness to use DOT and DAAs, along with any barriers, were collected. Logistic regression analysis was used to identify the correlates of initiating HCV treatment. Among those reporting HCV infection (54%, 366/678), 39% (144/366) initiated treatment; however, 38% (55/144) interrupted and 55% (79/135) delayed treatment for 15 months. Seventy-five percent (273/366) and 53% (195/366) were willing to use DOT and DAAs, respectively. Unaffordable medical costs and insignificant symptoms were the major barriers to HCV treatment and accepting DOT or DAAs. The lack of a stable residence, being a woman, and having ever injected drugs were all associated with a low probability of initiating treatment (p < 0.05). This study highlights a limited uptake of HCV treatment among MMT patients, and a need to strengthen the popularity of DOT and DAAs and integrate them into Chinese MMT clinics.
Collapse
Affiliation(s)
| | | | | | | | - Li Ling
- Correspondence: ; Tel.: +86-020-873-3319
| |
Collapse
|
6
|
Zhang L, Zou X, Xu Y, Medland N, Deng L, Liu Y, Su S, Ling L. The Decade-Long Chinese Methadone Maintenance Therapy Yields Large Population and Economic Benefits for Drug Users in Reducing Harm, HIV and HCV Disease Burden. Front Public Health 2019; 7:327. [PMID: 31781529 PMCID: PMC6861367 DOI: 10.3389/fpubh.2019.00327] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives: We aimed to conduct a comprehensive evaluation of the population impact of methadone maintenance treatment (MMT) for its future program planning. Methods: We conducted a literature review of the effects of MMT in China on HIV and HCV disease burden, injecting, and sexual behaviors and drug-related harm during 2004–2015. Data synthesis and analysis were conducted to obtain the pooled estimates of parameters for a mathematical model which was constructed to evaluate the effectiveness and cost-effectiveness of the program. Results: Based on a review of 134 articles, this study demonstrated that MMT is highly effective in reducing crime-related, high risk sexual, and injecting behaviors. The model estimated US$1,037 m which was invested in MMT from 2004 to 2015 has prevented 29,463 (15,325–43,600) new HIV infections, 130,563 (91,580–169,546) new HCV infections, 10,783 (10,380–11,187) deaths related to HIV, HCV and drug-related harm, and 338,920.0 (334,596.2–343,243.7) disability-adjusted life years (DALYs). The costs for each prevented HIV infection, HCV infection, death, and DALY were $35,206.8 (33,594.8–36,981.4), $7,944.7 ($7,714.4–8,189.2), $96,193.4 (92,726.0–99,930.2), and $3,060.6 ($3,022.0–3,100.1) respectively. Conclusion: The Chinese MMT program has been effective and cost-effective in reducing injecting, injecting-related risk behaviors and adversities due to HIV/HCV infection and drug-related harm among drug users.
Collapse
Affiliation(s)
- Lei Zhang
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xia Zou
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yong Xu
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Nick Medland
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Liwei Deng
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yin Liu
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu Su
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Li Ling
- Sun Yat-sen Center for Migrant Health Policy, Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
7
|
Changes in Substance Abuse and HIV Risk Behaviors over 12-Month Methadone Maintenance Treatment among Vietnamese Patients in Mountainous Provinces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132422. [PMID: 31288440 PMCID: PMC6651144 DOI: 10.3390/ijerph16132422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/21/2019] [Accepted: 07/04/2019] [Indexed: 11/16/2022]
Abstract
Methadone maintenance treatment (MMT) programs have been used worldwide to reduce the number of drug users and for HIV prevention; however, evidence of their effectiveness in mountainous areas is limited. This study aimed to identify changes in substance abuse and sexual practices among MMT patients after treatment in three Vietnamese mountainous provinces. A survey on risk behaviors was conducted among 300 drug users in six MMT clinics prior to and following one year of MMT. Cramér's effect size of changes was extrapolated to justify the magnitude of the intervention's effectiveness. A generalized estimation equation was used to find the factors associated with respondents' substance use and sexual risk behavior. While drug-related risk behaviors were significantly reduced, alcohol and sex-related behaviors remained risk factors for HIV in this group. Additionally, condom use was common among participants at both time points, but not among those having sex with sex workers. Socio-economic characteristics of ethnic, education, occupation, as well as drug use history influenced the possibility of engaging in drug use and/or sexual risk behavior following treatment. Further emphasis on managing these among MMT patients is required, potentially by providing integrated services including smoking and drinking counseling and condom use promotion in accordance with MMT.
Collapse
|
8
|
Nguyen TMT, Tran BX, Fleming M, Pham MD, Nguyen LT, Nguyen ALT, Le HT, Nguyen TH, Hoang VH, Le XTT, Vuong QH, Ho MT, Dam VN, Vuong TT, Nguyen V, Nguyen HLT, Do HP, Doan PL, Nguyen HH, Latkin CA, Ho CSH, Ho RCM. HIV knowledge and risk behaviors among drug users in three Vietnamese mountainous provinces. Subst Abuse Treat Prev Policy 2019; 14:3. [PMID: 30646945 PMCID: PMC6334422 DOI: 10.1186/s13011-019-0191-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 01/03/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Globally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas. METHODS A cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model. RESULTS Of the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam's national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status. CONCLUSIONS This study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services.
Collapse
Affiliation(s)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Vietnam Young Physician Association, Hanoi, Vietnam
| | | | - Manh Duc Pham
- Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Long Thanh Nguyen
- Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | | | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thang Huu Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Van Hai Hoang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Xuan Thanh Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quan Hoang Vuong
- Centre for Interdisciplinary Social Research, Phenikaa University, Hanoi, Vietnam
- Université Libre de Bruxelles, B-1050 Brussels, Belgium
| | - Manh Tung Ho
- Institute of Philosophy, Vietnam Academy of Social Sciences, Hanoi, Vietnam
| | | | | | - Vu Nguyen
- Department of Neurosurgery Spine-Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam
| | | | - Huyen Phuc Do
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh city, Vietnam
| | - Phuong Linh Doan
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh city, Vietnam
| | - Hai Hong Nguyen
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh city, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Singapore
| |
Collapse
|
9
|
Reddon H, Marshall BDL, Milloy MJ. Elimination of HIV transmission through novel and established prevention strategies among people who inject drugs. Lancet HIV 2018; 6:e128-e136. [PMID: 30558843 DOI: 10.1016/s2352-3018(18)30292-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/01/2018] [Accepted: 10/12/2018] [Indexed: 11/16/2022]
Abstract
Despite the effectiveness of existing HIV prevention strategies for people who inject drugs (PWID), uncontrolled outbreaks of HIV among this group are common and occur around the world. In this Review, we summarise recent evidence for novel and established HIV prevention approaches to eliminate HIV transmission among PWID. Effective HIV prevention strategies include mobile needle and syringe programmes, pre-exposure prophylaxis, supervised injection facilities, and, to a lesser extent, some behavioural interventions. Studies have also shown the cost-effectiveness of long-standing HIV prevention strategies including needle and syringe programmes, opioid agonist therapy, and antiretroviral therapy for prevention. Although each individual intervention can reduce the risk of HIV acquisition among PWID, there is a consensus that a combination of approaches is required to achieve substantial and durable reductions in HIV transmission. Unfortunately, in many settings, the implementation of these interventions is often limited by public and political opposition that manifests as structural barriers to HIV prevention, such as the criminalisation of drug use. Given that there is ample evidence showing the effectiveness of several HIV prevention methods, social and political advocacy will be needed to overcome these barriers and integrate innovative HIV prevention approaches with addiction science to create effective drug policies.
Collapse
Affiliation(s)
- Hudson Reddon
- British Columbia Centre on Substance Use, Vancouver, BC, Canada; Canadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada.
| |
Collapse
|
10
|
Fu X, Chen K, Liao X, Shen K. Case report: surgical removal of a migrated needle in right ventricle of an intravenous drug user. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:51. [PMID: 29216882 PMCID: PMC5721468 DOI: 10.1186/s13011-017-0134-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 11/14/2017] [Indexed: 11/10/2022]
Abstract
Background Illicit drug use has become an increasing public health and social concern in the past decades worldwide. Intravenous injection has an elevated risk of infection. Needle embolism is a rare complication of intravenous drug users, Retained broken needles can lead to local complications, such as infection, but they also have the potential to embolize to heart or lung, and lead to serious complications. Method We reported a rare case of an intravenous drug user which a retained broken needle fragments in the inferior wall of the right ventricle. Results We performed a successful surgery and give our comments and recommendations for illicit drug use worldwide and in China. Conclusions Illicit Drug use becomes a global problem because of its health and social harmfulness. To help drug addicts and provide prevention and treatment services are the obligations and responsibilities of all medical workers.
Collapse
Affiliation(s)
- Xianming Fu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Kai Chen
- Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Xiaobo Liao
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Kangjun Shen
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, 139. Renmin Road, Changsha, Hunan, 410011, People's Republic of China.
| |
Collapse
|
11
|
Liu Y, Liu Y, Zou X, Chen W, Ling L. Trends and factors in human immunodeficiency virus and/or hepatitis C virus testing and infection among injection drug users newly entering methadone maintenance treatment in Guangdong Province, China 2006-2013: a consecutive cross sectional study. BMJ Open 2017; 7:e015524. [PMID: 28710214 PMCID: PMC5734580 DOI: 10.1136/bmjopen-2016-015524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To assess trends and related factors in HIV and/or hepatitis C virus (HCV) antibody testing and infection among injection drug users (IDUs) newly entering methadone maintenance treatment (MMT) in Guangdong Province, China. METHOD Consecutive cross sectional surveys were conducted in 14 MMT clinics from July 2006 to December 2013 in Guangdong Province, China. IDUs were excluded if they were re-enrolled or referred from other MMT clinics. Trend tests were used to examine HIV and/or HCV testing and infection, sociodemographic characteristics, drug use related behaviours and the past 3 month sexual behaviours on enrolment. Multivariate logistic regression was used to identify correlates of HIV and/or HCV testing and infection. RESULTS 7539 IDUs with an average age of 35.6±6.2 years were newly enrolled with a history of injection for an average of 11.8±4.9 years. The average frequency of injection before enrolment had been increasing. HIV, HCV and HIV/HCV dual testing increased from 2006 to 2013 (ptrend<0.001). However, all three types of infections remained stable (ptrend>0.05) until reaching a peak in 2011, excluding the first year. Associating with fellow drug users 1-4 times during the past month, injecting for 15+ years and having multiple sexual partners during the past 3 months predicted higher percentages for HIV and/or HCV testing (p<0.05), while those injecting 4+ times per day in the past month and those who had ever shared needles were less likely to take both tests (p<0.05). Having multiple sexual partners, a longer duration of injection drug use and sharing needles or sharing more frequently were major risk factors for HIV, HCV and HIV/HCV co-infection (p<0.05). CONCLUSIONS The prevalence of HIV and HCV were high and quite stable among new IDU entrants in MMT. Publicising MMT, routine screening, and behavioural and structural interventions is needed.
Collapse
Affiliation(s)
- Yin Liu
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Xia Zou
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
12
|
Wu Q, Kamphuis C, Duo L, Luo J, Chen Y, Richardus JH. Coverage of harm reduction services and HIV infection: a multilevel analysis of five Chinese cities. Harm Reduct J 2017; 14:10. [PMID: 28193236 PMCID: PMC5307648 DOI: 10.1186/s12954-017-0137-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/02/2017] [Indexed: 02/04/2023] Open
Abstract
Background Since 2003, a harm reduction program for injecting drug users has been rolled out countrywide in China. It entails services for condom promotion, a needle and syringe program (NSP), and methadone maintenance treatment (MMT). However, it remains unknown if and to what extent the coverage of these services at city level is related to a reduced risk of HIV infection among drug users. Methods We wished to quantify the extent to which city-level characteristics (such as NSP and MMT service coverage) and individual-level determinants (e.g., self-reported exposure to NSP and MMT services, knowledge, motivation, and skills) were associated with the risk of HIV infection among drug users. In 2006, we conducted an integrated serological and behavioral survey among drug users in five cities of Yunnan Province, China (N = 685), constructing a multilevel logistic regression model with drug users clustered within these cities. Results Drug users who reported having received NSP or MMT services were about 50% less likely to be infected with HIV than those who reported not having received them (OR 0.45, 95% CI, 0.26–0.83 for NSP and 0.48, 95% CI, 0.31–0.73 for MMT). Despite a between-city variation of HIV infection risk (ICC 0.24, 95% CI 0.08–0.54), none of the city-level factors could explain this difference. Individual-level determinants such as perceived risk of infection and use of condoms were not associated with HIV infection. Conclusions Although people who had used NSP or MMT services were less likely to be HIV infected, this study found no relationship between city-level coverage of HIV prevention programs and variations in HIV infection between cities. This may have been due to the low number of cities in the analysis. Future research should include the analysis of data from a larger number of cities, which are collected widely in China through integrated behavioral and serological surveys. Electronic supplementary material The online version of this article (doi:10.1186/s12954-017-0137-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Qing Wu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,School of Public Health, Kunming Medical University, Yunnan, People's Republic of China.
| | - Carlijn Kamphuis
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Lin Duo
- Department of Research and Development, Yunnan Provincial Red Cross Hospital, Kunming, People's Republic of China
| | - Jiahong Luo
- School of Public Health, Kunming Medical University, Yunnan, People's Republic of China
| | - Ying Chen
- School of Public Health, Kunming Medical University, Yunnan, People's Republic of China
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| |
Collapse
|
13
|
Getting to 90-90-90 targets for children and adolescents HIV in low and concentrated epidemics: bottlenecks, opportunities, and solutions. Curr Opin HIV AIDS 2016; 11 Suppl 1:S1-5. [PMID: 26945141 PMCID: PMC4787107 DOI: 10.1097/coh.0000000000000264] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Wang C, Shi CX, Zhang B, Chen H, Wang H, Zhang N, Rou K, Cao X, Luo W, Wu Z. HIV seroconversion and risk factors among drug users receiving methadone maintenance treatment in China: A qualitative study. Drug Alcohol Depend 2016; 167:169-74. [PMID: 27567967 PMCID: PMC6625317 DOI: 10.1016/j.drugalcdep.2016.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We sought to explore the experiences of drug users in China who were recently diagnosed with HIV infection while engaged in methadone maintenance treatment (MMT) and to better understand their perceptions of MMT, HIV risk, and HIV prevention. METHODS We recruited clients of MMT clinics in Chongqing and Kunming who had a baseline HIV-negative test result upon entry to MMT and had been diagnosed with HIV within the past 12 months. We conducted semi-structured qualitative interviews and thematic data analysis to identify situations and factors that increased HIV risk. RESULTS Among the 27 participants who were interviewed, 15 believed their infection was due to injection drug use, 7 attributed their infection to sexual contact, and 5 were unsure as to how they became infected. High risk behaviors were common; 18 participants continued to use drugs during treatment, and 10 engaged in unprotected sex. Common themes were the difficulty of drug abstinence despite receiving MMT, social pressure to continue using drugs, and low knowledge of effective HIV prevention measures. CONCLUSION While MMT is effective in reducing drug usage and needle sharing, many clients remain at risk of HIV infection due to continued injection drug use and unprotected sex. Clients may benefit from additional counseling on HIV prevention methods as well as structural interventions to increase the availability of clean injection equipment.
Collapse
Affiliation(s)
- Changhe Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China
| | - Cynthia X Shi
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China,Department of Epidemiology of Microbial Diseases and Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College Street, New Haven, CT 06511, USA
| | - Bo Zhang
- Yunnan Institute for Drug Abuse, 471 Xifu Road, Kunming 650228, China
| | - Hong Chen
- Chongqing Center for Disease Control and Prevention, 8 Changjiang 2nd Road, Chongqing 400016, China
| | - Hua Wang
- Yunnan Institute for Drug Abuse, 471 Xifu Road, Kunming 650228, China
| | - Nanci Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China
| | - Keming Rou
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China
| | - Xiaobin Cao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China
| | - Wei Luo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Beijing 102206, China.
| |
Collapse
|
15
|
Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners. PLoS One 2016; 11:e0152804. [PMID: 27046029 PMCID: PMC4821610 DOI: 10.1371/journal.pone.0152804] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 02/25/2016] [Indexed: 11/30/2022] Open
Abstract
Background Methadone maintenance treatment (MMT) reduces HIV risk behaviors and improves access to HIV-related services among drug users. In this study, we assessed the uptake and willingness of MMT patients to refer HIV testing and counseling (HTC) service to their sexual partners and relatives. Methods Health status, HIV-related risk behaviors, and HTC uptake and referrals of 1,016 MMT patients in Hanoi and Nam Dinh were investigated. Willingness to pay (WTP) for HTC was elicited using a contingent valuation technique. Interval and logistic regression models were employed to determine associated factors. Results Most of the patients (94.2%) had received HTC, 6.6 times on average. The proportion of respondents willing to refer their partners, their relatives and to be voluntary peer educators was 45.7%, 35.3%, and 33.3%, respectively. Attending MMT integrated with HTC was a facilitative factor for HTC uptake, greater WTP, and volunteering as peer educators. Older age, higher education and income, and HIV positive status were positively related to willingness to refer partners or relatives, while having health problems (mobility, usual care, pain/discomfort) was associated with lower likelihood of referring others or being a volunteer. Over 90% patients were willing to pay an average of US $17.9 for HTC service. Conclusion The results highlighted the potential role of MMT patients as referrers to HTC and voluntary peer educators. Integrating HIV testing with MMT services and applying users’ fee are potential strategies to mobilize resources and encourage HIV testing among MMT patients and their partners.
Collapse
|