1
|
Hatch MA, Laschober TC, Paschen-Wolff M, Ertl MM, Nelson CM, Wright L, Lancaster C, Feaster DJ, Forrest D, Hankey C, Monger M, Fegley JP, Irving R, Young C, Rose J, Spector A, Dresser L, Moran L, Jelstrom E, Tross S. PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern U.S. cities where HIV incidence is high. Drug Alcohol Depend 2024; 257:111133. [PMID: 38447393 DOI: 10.1016/j.drugalcdep.2024.111133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND People who use opioids (PWUO) are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective but underutilized as HIV prevention among PWUO. This study examined predictors of willingness to take daily oral PrEP and long-acting injectable (LAI) PrEP among PWUO across eight Southern urban cities with high HIV incidence. METHODS HIV-negative PWUO (N = 308) seeking services in community-based programs participated in this cross-sectional survey study. Measures included demographics, sexual risk behavior, substance use frequency, and awareness of and willingness to take oral and injectable PrEP. Data were analyzed using mixed-effects models. RESULTS Willingness to take daily oral and LAI PrEP was moderately high (69.16% and 62.02%, respectively). Half had heard of PrEP, but only 4% had ever taken it. Only education and condomless vaginal sex predicted willingness to take oral PrEP. Only education predicted willingness to take LAI PrEP. Polysubstance use was prevalent, with substantial proportions of PWUO reporting frequent use of injection drugs (opioids or stimulants, 79.5%), non-injection opioids (73.3%), non-injection stimulants (71.1%), cannabis (62.6%), and hazardous drinking (29.6%). About 20% reported past-year condomless anal sex, and one-third reported past-year condomless vaginal sex. CONCLUSIONS PWUO in this study were amenable to PrEP, particularly in light of education and condomless vaginal sex. Careful consideration for matching PrEP messaging to the PWUO audience is needed. PrEP promotion should expand beyond men who have sex with men to include groups such as these predominantly heterosexual, polysubstance-using PWUO with HIV risk who were open to both formulations of PrEP.
Collapse
Affiliation(s)
- Mary A Hatch
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA.
| | - Tanja C Laschober
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Margaret Paschen-Wolff
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melissa M Ertl
- University of Minnesota-Twin Cities, Department of Psychology, Minneapolis, MN 55455, USA
| | - C Mindy Nelson
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - Lynette Wright
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Chloe Lancaster
- University of South Florida, Department of Leadership, Policy, and Lifelong Learning, Tampa, FL 33620, USA
| | - Daniel J Feaster
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - David Forrest
- University of Miami, Department of Anthropology, Coral Gables, FL, USA
| | - Colby Hankey
- Aspire Health Partners, HIV Services, Orlando, FL 32804, USA
| | - Mauda Monger
- My Brother's Keeper, 710 Avignon Dr, Ridgeland, MS 39157, USA
| | - Joshua P Fegley
- CrescentCare, 330 Tulane Ave, 1st Floor, New Orleans, LA 70119, USA
| | - Rhonda Irving
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Cynthia Young
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Juliana Rose
- Gateway Community Services, Research Department, Jacksonville, FL, USA
| | - Anya Spector
- Stella and Charles Guttman Community College, City University of New York, New York, NY, USA
| | | | - Landhing Moran
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY 10032, USA
| |
Collapse
|
2
|
Harris L, Hankey C, Jones N, Murray H, Pert C, Tobin J, Boyle S, Shearer R, Melville CA. Process evaluation of a cluster-randomised controlled trial of multi-component weight management programme in adults with intellectual disabilities and obesity. J Intellect Disabil Res 2019; 63:49-63. [PMID: 30417575 DOI: 10.1111/jir.12563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/10/2018] [Accepted: 09/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Providing effective weight management to adults with intellectual disabilities is necessary to challenge the high rates of obesity. The aim of this process evaluation was to explore the feasibility of conducting a full-scale clinical trial of the TAKE 5 multi-component weight management programme. METHODS The study was a 12-month pilot cluster-randomised controlled trial. Adults with intellectual disabilities and obesity were randomised to either TAKE 5, which included an energy deficit diet (EDD) or Waist Winners Too, based on health education principles. A mixed-methods process evaluation was conducted focussing on the reach, recruitment, fidelity, implementation, dose (delivered/received) and context. RESULTS The study successfully recruited adults with intellectual disabilities. Both weight management programmes were delivered with high fidelity and implemented as intended. Only one weight management programme, TAKE 5, demonstrated potential efficacy in reducing body weight and body composition. The effectiveness was largely attributed to the EDD and social support from carers. CONCLUSIONS The extensive process evaluation illustrated that a full-scale trial of a multi-component programme including an EDD is feasible and an acceptable approach to weight management for adults with intellectual disabilities and obesity.
Collapse
Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jones
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - H Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Pert
- Learning Disability Psychology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Tobin
- Glasgow City CHP North East Sector, Eastbank Conference Training Centre, Glasgow, UK
| | - S Boyle
- Consultant Clinical Psychologist NHS Greater, Glasgow, UK
| | - R Shearer
- Glasgow and Clyde Specialist Weight Management Service, Glasgow, UK
| | - C A Melville
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
3
|
Harris L, McGarty A, Hutchison L, Ells L, Hankey C. Short-term intermittent energy restriction interventions for weight management: a systematic review and meta-analysis. Obes Rev 2018; 19:1-13. [PMID: 28975722 DOI: 10.1111/obr.12593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Abstract
This systematic review synthesized the available evidence on the effect of short-term periods of intermittent energy restriction (weekly intermittent energy restriction; ≥7-d energy restriction) in comparison with usual care (daily continuous energy restriction), in the treatment of overweight and obesity in adults. Six electronic databases were searched from inception to October 2016. Only randomized controlled trials of interventions (≥12 weeks) in adults with overweight and obesity were included. Five studies were included in this review. Weekly intermittent energy restriction periods ranged from an energy intake between 1757 and 6276 kJ/d-1 . The mean duration of the interventions was 26 (range 14 to 48) weeks. Meta-analysis demonstrated no significant difference in weight loss between weekly intermittent energy restriction and continuous energy restriction post-intervention (weighted mean difference: -1.36 [-3.23, 0.51], p = 0.15) and at follow-up (weighted mean difference: -0.82 [-3.76, 2.11], p = 0.58). Both interventions achieved comparable weight loss of >5 kg and therefore were associated with clinical benefits to health. The findings support the use of weekly intermittent energy restriction as an alternative option for the treatment of obesity. Currently, there is insufficient evidence to support the long-term sustainable effects of weekly intermittent energy restriction on weight management.
Collapse
Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A McGarty
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Hutchison
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Health and Social Care Institute, Teesside University, United Kingdom Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Middlesbrough, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
4
|
Harris L, Hankey C, Murray H, Melville C. The effects of physical activity interventions on preventing weight gain and the effects on body composition in young adults with intellectual disabilities: systematic review and meta-analysis of randomized controlled trials. Clin Obes 2015; 5:198-210. [PMID: 26126951 DOI: 10.1111/cob.12103] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/31/2015] [Accepted: 05/08/2015] [Indexed: 01/19/2023]
Abstract
The aim of this study was to examine the literature on randomized controlled trials examining the efficacy of physical activity interventions to prevent weight gain and the effects on body composition in young adults with intellectual disabilities.A systematic search of Medline, Emabse, CINHAL, PsychINFO, Cochrane library and ERIC was conducted from 1946 to September 2014. Eligibility criteria included; randomized controlled trials of a physical activity intervention: objective measure of body weight and body composition; young adults (age range 16-24 years) with intellectual disabilities. Six studies met the eligibility criteria. The interventions varied in their prescription of physical activity including aerobic and strength-based activities. The mean duration of the interventions was 15.3 (range 10-21 weeks). There was no significant effect of physical activity interventions on body weight (weighted mean difference: -0.17 kg, 95% confidence interval, -1.04 kg to 0.72 kg) and body composition outcomes. The meta-analysis showed that physical activity interventions did not prevent weight gain in young adults with intellectual disabilities. Published studies are inadequate to form firm conclusions. Future longer term studies of interventions specifically designed for this population group are required to elucidate the effects of physical activity interventions on body composition and the prevention of weight gain in young adults with intellectual disabilities.
Collapse
Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hankey
- Human Nutrition, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - H Murray
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - C Melville
- College of Medical Veterinary and Life Sciences, Institute of Mental Health & Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
5
|
Hutch A, He M, Reilly A, Lean M, Leslie W, Hankey C. The stigmata of obesity. Thoughts and attitudes of adolescent school pupils. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Nikolau CK, Hankey C, Lean MEJ. A randomised controlled trial for weight gain prevention in young adults. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku163.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
7
|
Spanos D, Hankey C, Boyle S, Melville C. Comparing the effectiveness of a multi‐component weight loss intervention in adults with and without intellectual disabilities. J Hum Nutr Diet 2013; 27:22-9. [DOI: 10.1111/jhn.12051] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- D. Spanos
- College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK
| | - C. Hankey
- College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK
| | - S. Boyle
- Glasgow and Clyde Weight Management Service NHS Greater Glasgow and Clyde Glasgow UK
| | - C. Melville
- College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK
| |
Collapse
|
8
|
Abstract
Abstract
The objectives of the study were to determine whether, by providing caffeine-free tea and coffee, plasma caffeine concentrations would fall in elderly hospitalised patients, and whether, as a result, sleep profiles and urinary incontinence would be altered.
Twenty-eight patients in two wards of an elderly care hospital received caffeine-containing or caffeine-free tea and coffee for consecutive three week periods in a study which was blinded to patients, nurses and investigator. Median caffeine concentration (μg/ml) was stable between the run in period at 2.3 (range 0–5.8) and the caffeine-containing period at 1.6 (range 0.4–6.0), but fell significantly to 0 (range 0–0.7), during the caffeine-free period (P<0.001). In spite of significantly lowered caffeine concentrations, no change in sleep patterns or urinary incontinence was noted. Of 12 patients with sleep problems a benefit to sleep quality was reported by two individuals, one of whom was prescribed hypnotics from which she subsequently successfully withdrew.
Collapse
Affiliation(s)
- C M Stephens
- Department of Medicine (Geriatrics), Medical School, University of Newcastle upon Tyne
| | - C Hankey
- Department of Medicine (Geriatrics), Medical School, University of Newcastle upon Tyne
| | - H A Wynne
- Department of Medicine (Geriatrics), Medical School, University of Newcastle upon Tyne
| |
Collapse
|
9
|
Khan T, Wynne H, Wood P, Torrance A, Hankey C, Avery P, Kesteven P, Kamali F. Dietary vitamin K influences intra-individual variability in anticoagulant response to warfarin. Br J Haematol 2004; 124:348-54. [PMID: 14717783 DOI: 10.1046/j.1365-2141.2003.04787.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The relationship between dietary intake of vitamin K, fat, plasma vitamin K concentrations and anticoagulation response to warfarin within individuals, as well as the contribution of dietary vitamin K to differences in warfarin dose requirements between individuals were investigated in 53 patients on warfarin therapy who had stably controlled anticoagulation. Each patient completed a dietary record of all foods consumed on a daily basis for 4 weeks. Each week a blood sample was taken for measurement of the international normalized ratio (INR), plasma vitamin K, triglycerides and warfarin enantiomer concentrations. The patients' genotype for CYP2C9 was also determined. Regression analysis of the data showed that, for each increase of 100 microg in the daily dietary intake of vitamin K averaged over 4 d, the INR was reduced by 0.2. There was no correlation between warfarin daily dose and average daily dietary vitamin K intake when calculated over 28 d. The regression model for warfarin dose showed that, while dietary vitamin K had no effect, CYP2C9 genotype (P = 2%) and age (P < 1%) significantly contributed to inter-patient variability in warfarin dose requirements. A consistent intake of vitamin K could reduce intrapatient variability in anticoagulation response and thus improve the safety of warfarin therapy.
Collapse
Affiliation(s)
- T Khan
- Department of Clinical Pharmacology, School of Clinical and Laboratory Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | | | | | | | | | | | | | | |
Collapse
|