1
|
Lankenau SE, Sanders B, Bloom JJ, Hathazi DS, Alarcon E, Tortu S, Clatts M. Prevalence and Patterns of Prescription Drug Misuse among Young Ketamine Injectors. Journal of Drug Issues 2016; 37:717-736. [DOI: 10.1177/002204260703700311] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In recent years, epidemiological monitoring data has indicated sharp increases in prescription drug misuse. Despite these increases, little is known about the context or patterns associated with prescription drug misuse, particularly among youth or young injection drug users (IDUs). A three-city study of 213 young IDUs found prescription drug misuse to be pervasive, specifically the use of opioids and benzodiazepines. Particular practices not commonly associated with prescription drugs were reported, such as sniffing, smoking, and injection. Associated health risks included initiation into injection drug use, polydrug use, drug overdose, and drug dependency. A greater awareness of the potential health risks associated with prescription drug misuse should be incorporated into services that target IDUs, including street outreach, syringe exchanges, and drug treatment.
Collapse
|
2
|
Colón-López V, Ortiz AP, Del Toro-Mejías L, Clatts M, Durán-Guzmán G, Pérez N, DaCosta M, Palefsky J. Prevalence and Correlates of Penile HPV Infection in a Clinic-Based Sample of Hispanic Males. P R Health Sci J 2015; 34:128-134. [PMID: 26356736] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV infection and the behavioral risk factors associated with penile HPV infection (any HPV type, high-oncogenic-risk [HR] types, low-oncogenic-risk [LR] types, and of multiple HPV types) in a group of sexually active males who went to an STI clinic in San Juan, Puerto Rico. METHODS After providing informed consent, the participants, underwent a detailed behavioral interview and a clinical examination. Frequency distributions and descriptive statistics were used to characterize the study samples. Prevalence estimates and 95% confidence intervals (CI) were calculated for any type of HPV, HR types, LR types, or multiple types. Logistic regression analyses was performed to determine factors associated with each of the HPV types. RESULTS Two hundred and six participants were enrolled in this study. The mean age of the participants was 37.8±13.1 years. Close to 80% of the sample were infected with at least one HPV type; 73.5% were infected with one or more LR-HPV types; 32.4%, with one or more HR-HPV types; and 46.0%, with multiple HPV types. The most prevalent HR types were HPV-35, -31, and -16; the most prevalent LR types were HPV 6/11, and -84. After adjusting for age, having a high number of lifetime female sexual partners was highly associated with having multiple types of HPV infection (estimated OR=2.86; 95% CI=1.41, 5.80). CONCLUSION HPV infection is common among sexually active males frequenting this STI clinic. HPV types not covered by the current quadrivalent HPV vaccine were identified. Multiple HPV types in the penis are significantly related to the lifetime number of female sexual partners. The high prevalence of HPV at this particular STI clinic evidences that males need to be targeted in primary care settings if the available vaccine is to be effectively promoted. In addition, opportunities for secondary prevention of HPV in STI settings are recommended, because of the burden of anal and penile cancer documented in the island.
Collapse
Affiliation(s)
- Vivian Colón-López
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Ana Patricia Ortiz
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | | | - Michael Clatts
- Center for Research on Global Health, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | | | - Naydi Pérez
- Puerto Rico Central Cancer Registry, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR
| | - Maria DaCosta
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA
| | - Joel Palefsky
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA
| |
Collapse
|
3
|
Clatts M, Giang LM, Goldsamt L, Colón-López V. Nonmedical use of promethazine hydrochloride among heroin injectors in Vietnam: unrecognized risks and unintended consequences. Subst Use Misuse 2010; 45:515-27. [PMID: 20141462 DOI: 10.3109/10826080903452520] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Surveillance studies have noted intravenous injection of promethazine hydrochloride (PHC) among populations that use heroin in south and southeast Asia. However, little is known about onset and initiation of PHC use and its relationship to habitual heroin use. METHODS As part of a longitudinal study of heroin initiation, a sample of 179 new heroin users, aged 15-27 years, were interviewed between October 2005 and December 2006 in Hanoi, Vietnam. Cox proportional hazard regression analysis was used to characterize age at promethazine initiation and its association with relevant covariates. RESULTS 76% reported lifetime use of PHC. Mean age of PHC initiation was 21.3 years, on average 6 months following onset of heroin injection. In multivariate analysis, lifetime use of diazepam [HR = 1.69 (1.17, 2.44); p-value = .01] and injecting heroin for more than 1.58 years [HR = 1.46 (1.04, 2.06); p-value = .03] were associated with PHC initiation. CONCLUSION Intravenous injection of PHC is a relatively common practice among young injection heroin users in Hanoi, Vietnam who use it on a situational basis to substitute for heroin (when heroin is not available or when heroin is too costly) or to augment the effects of an inadequate heroin dosing (delaying onset of heroin withdraw). Existing drug prevention strategies in Vietnam are focused primarily on heroin and most new heroin users initiate PHC use without prior knowledge of its high risk for serious vein damage. Future research is needed on the PHC use among heroin users, including long-term medical consequences of PHC exposure.
Collapse
Affiliation(s)
- Michael Clatts
- Medical Science Campus, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | | | | | | |
Collapse
|
4
|
Abstract
"Ruby" was out on the street and out in the open, when the first mailman passed us she got nervous and started rushing her injection, first dropping her water bottle and then her cooker. While she injected another mailman passed making her even more tense and she spilled blood down her arm. She looked at me and said "these damn mailmen are everywhere…You see when I have a little privacy it's so much easier." (Fieldnotes)
Collapse
Affiliation(s)
| | - Jo Sotheran
- Mailman School of Public Health, Columbia University
| | | |
Collapse
|
5
|
Aaron S, McMahon JM, Milano D, Torres L, Clatts M, Tortu S, Mildvan D, Simm M. Intranasal transmission of hepatitis C virus: virological and clinical evidence. Clin Infect Dis 2009; 47:931-4. [PMID: 18764772 DOI: 10.1086/591699] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Intranasal transmission of hepatitis C virus (HCV) via contaminated drug-sniffing implements is a potential but unconfirmed source of viral infection. We demonstrate the virological plausibility of intranasal transmission by confirming that blood and HCV RNA are present in the nasal secretions and drug-sniffing implements of HCV-infected intranasal drug users recruited from a community health clinic in New York City.
Collapse
Affiliation(s)
- Sagiv Aaron
- Molecular Virology Division, St. Luke's-Roosevelt Institute for Health Sciences/Columbia University
| | | | | | | | | | | | | | | |
Collapse
|
6
|
West SG, Duan N, Pequegnat W, Gaist P, Des Jarlais DC, Holtgrave D, Szapocznik J, Fishbein M, Rapkin B, Clatts M, Mullen PD. Alternatives to the randomized controlled trial. Am J Public Health 2008; 98:1359-66. [PMID: 18556609 DOI: 10.2105/ajph.2007.124446] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Public health researchers are addressing new research questions (e.g., effects of environmental tobacco smoke, Hurricane Katrina) for which the randomized controlled trial (RCT) may not be a feasible option. Drawing on the potential outcomes framework (Rubin Causal Model) and Campbellian perspectives, we consider alternative research designs that permit relatively strong causal inferences. In randomized encouragement designs, participants are randomly invited to participate in one of the treatment conditions, but are allowed to decide whether to receive treatment. In quantitative assignment designs, treatment is assigned on the basis of a quantitative measure (e.g., need, merit, risk). In observational studies, treatment assignment is unknown and presumed to be nonrandom. Major threats to the validity of each design and statistical strategies for mitigating those threats are presented.
Collapse
Affiliation(s)
- Stephen G West
- Psychology Department, Arizona State University, Tempe, AZ 85287-1104, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Prado G, Schwartz SJ, Pattatucci-Aragón A, Clatts M, Pantin H, Fernández MI, Lopez B, Briones E, Amaro H, Szapocznik J. The prevention of HIV transmission in Hispanic adolescents. Drug Alcohol Depend 2006; 84 Suppl 1:S43-53. [PMID: 16764997 DOI: 10.1016/j.drugalcdep.2006.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article reviews the state of the science in HIV prevention for Hispanic adolescents. The article discusses the importance of preventing HIV in Hispanic adolescents. Literature is reviewed in three broad areas: (1) the prevalence rates of drug and alcohol misuse, sexual practices, and HIV infection; (2) risk and protective factors for drug and alcohol misuse and unprotected sex (in general and specifically for Hispanics); and (3) the state of HIV prevention intervention development and evaluation targeting Hispanic youth. Seven specific recommendations are advanced in areas that have the potential to further the field of HIV prevention for Hispanic adolescents.
Collapse
Affiliation(s)
- Guillermo Prado
- Department of Epidemiology and Biostatistics, Stempel School of Public Health, Florida International University, 11200 SW 8th Street HLS-II 597, Miami, FL 33199, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
McMahon JM, Simm M, Milano D, Clatts M. Detection of hepatitis C virus in the nasal secretions of an intranasal drug-user. Ann Clin Microbiol Antimicrob 2004; 3:6. [PMID: 15132748 PMCID: PMC421742 DOI: 10.1186/1476-0711-3-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Accepted: 05/07/2004] [Indexed: 11/25/2022] Open
Abstract
Background One controversial source of infection for hepatitis C virus (HCV) involves the sharing of contaminated implements, such as straws or spoons, used to nasally inhale cocaine and other powdered drugs. An essential precondition for this mode of transmission is the presence of HCV in the nasal secretions of intranasal drug users. Methods Blood and nasal secretion samples were collected from five plasma-positive chronic intranasal drug users and tested for HCV RNA using RT-PCR. Results HCV was detected in all five blood samples and in the nasal secretions of the subject with the highest serum viral load. Conclusions This study is the first to demonstrate the presence of HCV in nasal secretions. This finding has implications for potential transmission of HCV through contact with contaminated nasal secretions.
Collapse
Affiliation(s)
- James M McMahon
- National Development and Research Institutes, 71 West 23rd Street, New York, NY, USA
| | - Malgorzata Simm
- Molecular Virology Division, St. Luke's-Roosevelt Hospital Center, 432 West 58th Street, New York, NY, USA
| | - Danielle Milano
- Boriken Neighborhood Health Center, 2253 Third Avenue, New York, NY, USA
| | - Michael Clatts
- National Development and Research Institutes, 71 West 23rd Street, New York, NY, USA
| |
Collapse
|
9
|
Montgomery SB, Hyde J, De Rosa CJ, Rohrbach LA, Ennett S, Harvey SM, Clatts M, Iverson E, Kipke MD. Gender differences in HIV risk behaviors among young injectors and their social network members. Am J Drug Alcohol Abuse 2003; 28:453-75. [PMID: 12211360 DOI: 10.1081/ada-120006736] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Using epidemiological and social network research methods, this study examines gender differences in HIV risk and protective behaviors and social network characteristics among 193 young injection drug users (IDUs) and 127 referred members of their social networks. Respondents reported on their drug use, sexual behavior, and relationships within three types of social networks: hang out (i.e., friendship); drug use; and sexual networks. Most respondents were homeless and had experienced numerous life stressors. Females' social networks consisted more predominantly of drug injectors, and members more frequently appeared multiple networks. Females reported needle sharing more frequently than males, but also reported more protective behaviors such as needle exchange use and carrying clean syringes. Young female IDUs may compound their risk by having sex and injecting with higher risk partners. However, their propensity to practice protective behaviors may provide an opening for interventions to reduce their HIV risk and that of their social network members.
Collapse
|
10
|
Young RM, Friedman SR, Case P, Asencio MW, Clatts M. Women Injection Drug Users Who Have Sex with Women Exhibit Increased HIV Infection and Risk Behaviors. Journal of Drug Issues 2000. [DOI: 10.1177/002204260003000302] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article is a comprehensive review of published research on HIV seroprevalence and HIV-related risk behaviors among women injection drug users (IDUs) who have sex with women (WSW). At least 14 studies since the late 1980s converge into a consistent pattern: compared to other IDUs, WSW IDUs report higher levels of HIV-related risk behaviors and in many cases exhibit higher rates of HIV seroconversion or seroprevalence. Data from these and additional studies also indicate that large numbers of women IDUs are WSWs. Since information regarding WSW IDUs are widely collected but infrequently analyzed and reported, we suggest promising research and analysis strategies for exploring the meaning behind this pattern of increased vulnerability to HIV. Finally, we assert that enough is currently known to warrant significant investment in targeted prevention and intervention programs to address the critical HIV-related needs of lesbian, bisexual, and other WSW IDUs.
Collapse
|
11
|
Needle RH, Coyle S, Cesari H, Trotter R, Clatts M, Koester S, Price L, McLellan E, Finlinson A, Bluthenthal RN, Pierce T, Johnson J, Jones TS, Williams M. HIV risk behaviors associated with the injection process: multiperson use of drug injection equipment and paraphernalia in injection drug user networks. Subst Use Misuse 1998; 33:2403-23. [PMID: 9781822 DOI: 10.3109/10826089809059332] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examines drug acquisition and multiperson use of paraphernalia, drugs, and needles/syringes. Ethnographers observed 54 injection episodes in which IDUs were linked by HIV risk behaviors, and developed a typology of higher-risk, lower-risk, and nonsharing-risk networks. Multiperson use of injection paraphernalia or drug solution occurred in most injection events (94%). Serial use of syringes/needles occurred infrequently (14%) relative to "backloading" (37%) and reuse of paraphernalia (cookers 84%, cotton 77%, water 77%). Higher-risk injection networks were characterized by larger size and pooling of resources for drugs. Prevention messages must include avoiding reuse of injection paraphernalia and transfer of drug solution.
Collapse
Affiliation(s)
- R H Needle
- National Institute on Drug Abuse, Rockville, Maryland 20857, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Anderson JE, Cheney R, Clatts M, Faruque S, Kipke M, Long A, Mills S, Toomey K, Wiebel W. HIV risk behavior, street outreach, and condom use in eight high-risk populations. AIDS Educ Prev 1996; 8:191-204. [PMID: 8806949] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In this paper we examine risk behavior, exposure to street outreach, and condom use in samples of injecting drug users (IDUs) and high-risk youth. We used systematic sampling methods to produce representative samples of injecting drug users IDUs (five sites) and high-risk youth (three sites). The populations surveyed engaged in high levels of sexual risk behavior: 20% to 46% reported two or more sex partners in the last month. The majority (62% to 97%) knew someone infected with HIV. Condom use rates approached national health promotion goals for nonsteady partners but not for steady or main partners. Having a condom at time of interview was the most consistent predictor of condom use at last intercourse. Many of the respondents have been in contact with street outreach programs and many acknowledged some personal risk for HIV infection. However, most of the injecting drug users and high-risk youth interviewed (and their sex partners) were still at risk through unprotected sex.
Collapse
Affiliation(s)
- J E Anderson
- Behavioral and Intervention Research Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Deren S, Davis WR, Beardsley M, Tortu S, Clatts M. Outcomes of a risk-reduction intervention with high-risk populations: the Harlem AIDS project. AIDS Educ Prev 1995; 7:379-390. [PMID: 8672391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Many studies of interventions with high-risk populations have reported reductions in risk behaviors. To assess effectiveness of interventions, data are also needed on the characteristics of subjects lost to follow-up, and on follow-up risk behaviors for subjects who were not participants in the intervention. This paper reports on a study conducted in Harlem, New York, recruiting 1,770 injection drug users (IDUs) and sex partners of IDUs, randomly assigned to two interventions. Repeated-measures analyses for the two intervention groups and those who participated in no intervention indicated that all groups reported significant reductions in risk behaviors, with no group effect. Comparisons of those followed-up and not followed-up indicate that those followed-up were less likely to: be homeless, be Latinos, and to use "shooting galleries." The discussion focuses on the need to assess outcomes for all types of participants, and to distinguish the impact of interventions from other explanations for behavior changes.
Collapse
Affiliation(s)
- S Deren
- National Development and Research Institutes, Inc., New York, USA
| | | | | | | | | |
Collapse
|