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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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Gholami J, Rostam-Abadi Y, Rahimi J, Fotouhi A, Amin-Esmaeili M, Rahimi-Movaghar A. HIV prevalence among non-injecting people who use drugs and related factors in Iran: A systematic review and meta-analysis. Drug Alcohol Rev 2021; 41:666-676. [PMID: 34783411 DOI: 10.1111/dar.13407] [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: 03/05/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
ISSUES This systematic review aimed to provide an updated estimate on the prevalence of human immunodeficiency virus (HIV) infection among non-injecting people who use drugs (PWUD) and the various subgroups and the odds of HIV infection in the injecting compared to non-injecting PWUD. APPROACH A comprehensive search of international, regional and national databases was performed from January 2005 to May 2020. We conducted backward citation tracking of the included studies and contacted experts for unpublished studies. Studies providing HIV prevalence among non-injecting PWUD were included. Data were also drawn from a previous systematic review, covering 10 years from 1998 to 2007, and was added to the new database. The HIV prevalence was pooled for non-injecting PWUD and other subgroups using the random-effects model. KEY FINDINGS Seventeen studies with a total sample of 9912 non-injecting PWUD were found. The prevalence of HIV infection was 1.9% (95% confidence interval 0.9, 3.1) for 2007 and afterward (nine studies). It was not significantly different from the estimate for the years before 2007 (0.5%; 95% confidence interval 0.0, 2.0; eight studies). No significant difference was found among gender subgroups. The overall estimate of odds of HIV infection among injecting PWUD was 5.7 (95% confidence interval 3.2, 10.0) times higher than non-injecting PWUD. IMPLICATIONS AND CONCLUSIONS The HIV prevalence among the non-injecting PWUD was higher than the general population in Iran. Targeting non-injection PWUD by preventive measures such as harm reduction, drug and psychoeducation, and surveillance seem to be crucial in reducing HIV prevalence in this group.
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Affiliation(s)
- Jaleh Gholami
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasna Rostam-Abadi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamileh Rahimi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Amin-Esmaeili
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
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Oliveira-Filho AB, Silva FQ, Santos FJA, Cardoso YMN, Di Miceli JFF, Resque RL, Silva-Oliveira GC, Martins LC, Pinheiro LML, Machado LFA, Pinto AR, Lemos JAR, Fischer B, Kupek E. Prevalence and risk factors for HIV-1 infection in people who use illicit drugs in northern Brazil. Trans R Soc Trop Med Hyg 2021; 114:213-221. [PMID: 31746322 DOI: 10.1093/trstmh/trz106] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/09/2019] [Accepted: 10/01/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND People who use illicit drugs (PWUDs) have a high risk of viral infections. To date, there is a paucity of information on HIV infection among PWUDs in remote Brazilian regions. This study determined the prevalence and factors associated with HIV-1 infection among PWUDs in northern Brazil. METHODS Sociodemographic, economic, drug use and health-related information were collected through interviews from a community-recruited, multi-site sample of 1753 PWUDs. The blood samples collected were tested for the presence of HIV-1 using chemiluminescence immunoassay and PCR or western blotting. Logistic regressions identified factors independently associated with HIV-1 infection. RESULTS In total, 266 (15.2%) PWUDs were HIV-1 positive. Hepatitis B virus and/or hepatitis C virus nucleic acid was detected in 65 (3.7%) PWUDs infected by HIV-1. The factors associated with HIV-1 infection were male gender, older age, a lower educational level and a lower income, crack cocaine use, a longer drug use history and a history of drug injection and engagement in unsafe sex, sex work and a higher number of sexual partners. CONCLUSIONS The current study provides unique, initial insights into HIV and co-infection status and pertinent risk factors among PWUDs in northern Brazil, with clear and diverse implications for urgently improved prevention and treatment intervention needs.
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Affiliation(s)
- Aldemir B Oliveira-Filho
- Laboratório de Células e Patógenos, Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA, Brazil.,Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianopólis SC, Brazil
| | - Fabricio Quaresma Silva
- Laboratório de Células e Patógenos, Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA, Brazil
| | - Francisco Junior A Santos
- Laboratório de Células e Patógenos, Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA, Brazil
| | - Yasmin Maria N Cardoso
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá AP, Brazil
| | - Jeruza Ferraz F Di Miceli
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá AP, Brazil
| | - Rafael Lima Resque
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá AP, Brazil
| | - Gláucia C Silva-Oliveira
- Laboratório de Células e Patógenos, Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança PA, Brazil
| | - Luisa Caricio Martins
- Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém PA, Brazil
| | - Luiz Marcelo L Pinheiro
- Faculdade de Ciências Biológicas, Campus do Marajó - Soure, Universidade Federal do Pará, Soure PA, Brazil
| | - Luiz Fernando A Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém PA, Brazil
| | - Aguinaldo Roberto Pinto
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil
| | - José Alexandre R Lemos
- Programa de Pós-Graduação em Análises Clínicas, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém PA, Brazil
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, New Zealand.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Emil Kupek
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianopólis SC, Brazil.,Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis SC, Brazil
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Gordon KS, Chiasson MA, Hoover DR, Martins SS, Wilson PA, Lewis CF. Difference in HIV testing behavior by injection status, among users of illicit drugs. AIDS Care 2021; 34:776-783. [PMID: 33856945 DOI: 10.1080/09540121.2021.1913716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Human Immunodeficiency Virus (HIV) infection remains prevalent among the marginalized and drug using population in the United States. Testing for HIV is an important and cost-effective way to reduce HIV prevalence. Our objective was to determine if there is a difference in the number of HIV testing by injection status among users of illicit drugs and if a person's social network characteristics is a contributing factor. Using a cross-sectional design and negative binomial regression models, we assessed HIV testing behavior of people who use non-injected drugs (PWND) compared to people who use injected drugs (PWID). In an analytic sample of 539 participants, PWND tested for HIV 19% less compared to PWID, PR (95% CI) = 0.81 (0.66, 0.98), p = 0.03. Other contributing factors of testing were education, condomless sex, STIs, heroin use, and participant's sex network. The interaction term between PWND and emotional support in relation to HIV testing was significant, 1.33 (1.03, 1.69), p=0.03. These findings suggest HIV testing behavior differed by injection status, and this relationship may be dependent on emotional support. To exert a greater impact on the HIV epidemic, interventions and policies encouraging HIV testing in PWND, an understudied at-risk sub-population, are warranted.
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Affiliation(s)
- Kirsha S Gordon
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA.,Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA
| | - Mary Ann Chiasson
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA.,Public Health Solutions, Research and Evaluation Unit, New York, NY, USA
| | - Donald R Hoover
- Department of Statistics & Biostatistics, Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, NJ, USA
| | - Silvia S Martins
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA
| | - Patrick A Wilson
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA
| | - Crystal Fuller Lewis
- Division of Social Solutions and Services Research, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Department of Psychiatry, New York University School of Medicine, New York, NY, USA
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Dickson-Gomez J, Tarima S, Glasman LR, Lechuga J, Bodnar G, de Mendoza LR. Intervention Reach and Sexual Risk Reduction of a Multi-level, Community-Based HIV Prevention Intervention for Crack Users in San Salvador, El Salvador. AIDS Behav 2019; 23:1147-1157. [PMID: 30341555 DOI: 10.1007/s10461-018-2314-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016. The intervention consisted of three components introduced sequentially: (1) rapid HIV testing in community settings; (2) a social network HIV testing intervention; and (3) small group interventions with crack users who were members of the same social network. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3-4 month period for each assessment (total n = 1597). Results revealed a significant increase in exposure to the intervention over time with 50% of the participants reporting exposure to one or more of the three components. Getting an HIV test at the community site was associated with reductions in total times each individual had sex without a condom (p < 0.05) compared to those who had been exposed to no intervention components. Being referred by another crack user through the Social Network HIV intervention was also associated with reductions in total numbers of condomless sex (p < 0.05) The cumulative effect of being exposed to more than one intervention component was associated with reductions in total number of times individuals had condomless sex (p < 0.05). In spite of the high level of intervention reach and that self-reported exposure to intervention components was associated with lower sexual risk, reductions in sexual risk over time were not observed in the full sample, indicating that the penetration of HIV prevention components was not sufficient to produce population level change.
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Affiliation(s)
- Julia Dickson-Gomez
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Sergey Tarima
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Laura R Glasman
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julia Lechuga
- Department of Psychology, College of Education, Lehigh University, Bethlehem, PA, USA
| | - Gloria Bodnar
- Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador
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