The Methamphetamine Treatment Project (MTP) offers the opportunity to examine co-occurring psychiatric conditions in a sample of 1016 methamphetamine users participating in a multisite outpatient treatment study between 1999-2001. Participants reported high levels of psychiatric symptoms, particularly depression and attempted suicide, but also anxiety and psychotic symptoms. They also reported high levels of problems controlling anger and violent behavior, with a correspondingly high frequency of assault and weapons charges. Findings continue to support the value of integrated treatment for co-occurring conditions, especially the importance of training counseling staff to handle psychotic symptoms when needed.

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A study of coronary heart disease (CHD) among Japanese migrants compared with Japanese living in Japan provided the opportunity to study factors possibly responsible for the high rates of CHD in America as compared with Japan. Comparable methods were employed in examining 11,900 men of Japanese ancestry aged 45--69 living in Japan, Hawaii and California. The age-adjusted prevalence rates for definite CHD as determined by ECG were: Japan 5.3, Hawaii 5.2 and California 10.8/1000. For definite plus possible CHD the rates were 25.4, 34.7 and 44.6. The prevalence of angina pectoris and pain of possible myocardial infarction, determined by questionnaire, showed a similar gradient. Elevated serum cholesterol showed a Japan-Hawaii-California gradient, but the prevalence of hypertension in Japan was intermediate between the prevalence in Hawaii and the higher prevalence in California. The three geographic locations were compared as to prevalence of CHD at comparable levels of blood pressure and cholesterol. At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted. These facts, plus the near universality of smoking in Japan, suggest that conventional risk factors only partly explain the observed gradient in CHD.

A B S T R A C TObjectives. The purpose of this study was to determine the prevalence and effect of domestic violence and childhood sexual abuse in women with HIV or at risk for HIV infection.Methods. Participants with HIV or at risk for HIV infection enrolled in the Women's Interagency HIV Study. Childhood sexual abuse; all physical, sexual, and coercive violence by a partner; HIV serostatus; demographic data; and substance use and sexual habits were assessed.Results. The lifetime prevalence of domestic violence was 66% and 67%, respectively, in 1288 women with HIV and 357 uninfected women. One quarter of the women reported recent abuse, and 31% of the HIV-seropositive women and 27% of the HIV-seronegative women reported childhood sexual abuse. Childhood sexual abuse was strongly associated with a lifetime history of domestic violence and high-risk behaviors, including using drugs, having more than 10 male sexual partners and having male partners at risk for HIV infection, and exchanging sex for drugs, money, or shelter.Conclusions. Our data support the hypothesis of a continuum of risk, with early childhood abuse leading to later domestic violence, which may increase the risk of behaviors leading to HIV infection. (Am J Public Health. 2000; 90:560-565) Mardge Cohen, MD, Catherine Deamant, MD, Susan Barkan, PhD, Jean Richardson, PhD, Mary Young, MD, Susan Holman, RN, MS, Kathryn Anastos, MD, Judith Cohen, PhD, and Sandra Melnick, DrPH Domestic Violence and Childhood Sexual Abuse in HIV-Infected Women and Women at Risk for HIV Violence and abuse toward women are widespread. Studies suggest that one fifth to one third of all women in the United States (more than 12 million women) will be physically assaulted during their lifetime by a partner or ex-partner.1 Reassault rates are high, and between 8% and 29% of pregnant women are physically abused.2-6 One half of the women murdered in the United States and England are killed by a current or former partner. 7,8 In studies of emergency department visits, one third of the women reported symptoms related to partner abuse regardless of their presenting complaint.

The Methamphetamine Treatment Project offers the opportunity to examine the history of abuse and violence in a sample of 1016 methamphetamine users participating in a multisite study between 1999-2001. Reporting of abuse and violence was extensive, with 80% of women reporting abuse or violence from a partner. Men were more likely to report experiencing violence from friends and others. A high percentage of study participants reported a variety of threatening or coercive experiences with their partners. Past and current interpersonal violence is a characteristic of the lifestyles of the majority entering treatment for methamphetamine dependence.