???Informed Altruism??? and ???Partner Restriction??? in the Reduction of HIV Infection in Injecting Drug Users Entering Detoxification Treatment in New York City, 1990???2001

Jarlais, Don C. Des; Perlis, Theresa; Arasteh, Kamyar; Hagan, Holly; Milliken, Judith; Braine, Naomi; Yancovitz, Stanley R.; Mildvan, Donna; Perlman, David C.; Maslow, Carey B.; Friedman, Samuel R.

doi:10.1097/00126334-200402010-00010

Cited by 96 publications

(76 citation statements)

References 19 publications

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“…However, ever/never variables have recorded significant reductions in sharing in the late 1980s to early 1990s in Baltimore 30 and New York. 31 It is interesting to note no change in ever sharing of syringes was found among IDUs in a New York drug treatment facility from 1990 to 2001, 32 while HCV and HIV prevalence declined markedly. 17 The latter finding raises the possibility that the declines we observed were the delayed result of behavioral changes occurring before the beginning of the study period.…”

Section: Discussionmentioning

confidence: 99%

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Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

et al. 2007

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Injection drug users (IDUs) are at risk for infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Information on time trends in prevalence of these viruses among IDUs and in behaviors influencing their transmission can help define the status of these epidemics and of public health efforts to control them. We conducted a secondary data analysis combining crosssectional data from IDUs aged 18-30 years enrolled in four Seattle-area studies from 1994 to 2004. Participants in all four studies were tested for antibody to HIV (anti-HIV), hepatitis B core antigen (anti-HBc), and HCV (anti-HCV), and completed behavioral risk assessments. Logistic regression was used to investigate trends in prevalence over time after controlling for sociodemographic, drug use, and sexual behavior variables. Between 1994 and 2004, anti-HBc prevalence declined from 43 to 15% (p G 0.001), anti-HCV prevalence fell from 68 to 32% (p G 0.001) and anti-HIV prevalence remained constant at 2-3%. Declines in anti-HBc and anti-HCV prevalence were observed within the individual studies, although not all these declines were statistically significant. The declines in anti-HBc and anti-HCV prevalence remained significant after control for confounding. Although we did not observe coincident declines in injection equipment sharing practices, there were increases in self-reported needle-exchange use, condom use, and hepatitis B vaccination. We conclude that there has been a substantial and sustained reduction in prevalence rates for HBV and HCV infection among young Seattle IDUs, while HIV rates have remained low and stable.

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Section: Discussionmentioning

confidence: 99%

“…A finding that HIV-infected IDUs in New York were less likely than HIV-negative persons to engage in distributive needle sharing suggests they may have practiced such serosorting. 32 Further studies should evaluate the extent to which IDUs are serosorting.…”

Section: Discussionmentioning

confidence: 99%

Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

et al. 2007

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“…Infection disclosure norms and secondary prevention practices vary among Western European and North American IDUs, and may be different based on the type of infection (Van Ameijden et al 1999;Schlumberger et al 1999;Ompad et al 2002;Des Jarlais et al 2004). Disclosure and secondary prevention are rare among IDUs in some Eastern European countries (Booth et al 2004;Gore-Felton et al 2003;Amirkhanian et al 2003;Rhodes et al 2004b).…”

Section: Discussionmentioning

confidence: 99%

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Gyarmathy

Neaigus

Újhelyi

et al. 2006

Drug and Alcohol Dependence

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Ethnographic interviews and focus groups were conducted (05/2003-01/2004) among injecting drug users (IDUs; n=29) in Budapest, Hungary to assess HIV, Hepatitis B and C (HBV and HCV) related knowledge, norms, attitudes and behaviors. Participants perceived themselves at low risk for infection with HIV but high risk for hepatitis through injection but not sexual exposure. They reported strong disclosure norms for HIV and hepatitis infections, while sexual and injecting risk behaviors were influenced by trust about partners' self-report of infection status. Injecting networks were small, with infrequent syringe sharing among a few close friends. Cookers and drug filters were often shared, and filters were re-used as a backup drug supply. Most sexual relationships were monogamous, where condoms were rarely used. Although participant norms supported HIV/HBV/HCV testing, the lack of available testing facilities was a barrier to getting tested. Strong norms for infection disclosure and for getting tested coexist with engaging in risk behaviors with injecting and sex partners who are close friends. Network interventions among IDUs in Hungary should build on disclosure norms and trust to reduce injecting and sex risk. Testing services should be expanded and access increased so that IDUs can act on and reinforce their norms for testing.

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“…Risk Factors is an ongoing series of cross-sectional studies that recruits participants from one of NYC's largest detoxification facilities. 47 To be included in this analysis, Risk Factors participants had to report injecting drugs in the past 6 months; be interviewed between 1995 and 2006; be ≥18 years old; and report a valid NYC ZIP code. Homeless individuals were linked to ZIP codes via the street intersection closest to where they had slept most in the past 6 months; 4,178 Risk Factors participants met these criteria.…”

Section: Units Of Analysismentioning

confidence: 99%

“…[57][58][59][60][61][62][63] Though the Risk Factors study tested participants for HIV, we used self-reported HIV status because individuals who know they are HIV-positive engage in less injection-related risk behaviors. 47 Individual race/ethnicity and SEP participation (i.e., going to an SEP in the past 6 months) were treated as possible effect modifiers. All covariates were binary except years since first injection, which was continuous.…”

Section: District-level Measuresmentioning

confidence: 99%

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

et al. 2012

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Despite the 2010 repeal of the ban on spending federal monies to fund syringe exchange programs (SEPs) in the USA, these interventions-and specifically SEP site locations-remain controversial. To further inform discussions about the location of SEP sites, this longitudinal multilevel study investigates the relationship between spatial access to sterile syringes distributed by SEPs in New York City (NYC) United Hospital Fund (UHF) districts and injecting with an unsterile syringe among injectors over time (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). Annual measures of spatial access to syringes in each UHF district (N = 42) were created using data on SEP site locations and site-specific syringe distribution data. Individual-level data on unsterile injecting among injectors (N = 4,067) living in these districts, and on individual-level covariates, were drawn from the Risk Factors study, an ongoing cross-sectional study of NYC drug users. We used multilevel models to explore the relationship of district-level access to syringes to the odds of injecting with an unsterile syringe in 975% of injection events in the past 6 months, and to test whether this relationship varied by district-level arrest rates (per 1,000 residents) for drug and drug paraphernalia possession. The relationship between district-level access to syringes and the odds of injecting with an unsterile syringe depended on district-level arrest rates. In districts with low baseline arrest rates, better syringe access was associated with a decline in the odds of frequently injecting with an unsterile syringe (AOR, 0.95). In districts with no baseline syringe access, higher arrest rates were associated with increased odds of frequently injecting with an unsterile syringe (AOR, 1.02) When both interventions were present, arrest rates eroded the protective effects of spatial access to syringes. Spatial access to syringes in small geographic areas appears to reduce the odds of injecting with an unsterile syringe among local injectors, and arrest rates elevate these odds. Policies and practices that curtail syringe flow in geographic areas (e.g., restrictions on SEP locations or syringe distribution) or that make it difficult for injectors to use the sterile syringes they have acquired may damage local injectors' efforts to reduce HIV transmission and other injection-related harms.

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???Informed Altruism??? and ???Partner Restriction??? in the Reduction of HIV Infection in Injecting Drug Users Entering Detoxification Treatment in New York City, 1990???2001

Cited by 96 publications

References 19 publications

Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

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