scholarly journals The Prevalence and Incidence of Sexually Transmitted Infections in a Prospective Cohort of Injection Drug Users in Vancouver, British Columbia

2005 ◽  
Vol 16 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Laura M Kuyper ◽  
Courtney LC Collins ◽  
Thomas Kerr ◽  
Robert S Hogg ◽  
Kathy Li ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Injection Drug Users ◽  
Drug Users ◽  
Unprotected Sex ◽  
Relative Hazard ◽  
Sex Trade ◽  
Sexually Transmitted ◽  
Cumulative Rate ◽  
History Of

BACKGROUND: While several studies have reported on sexual risk behaviours and the prevalence of sexually transmitted infections (STIs) among injection drug users (IDUs), there are fewer prospective studies that have been able to examine populations of IDUs with no history of STIs. Therefore, the authors examined prevalence, correlates and factors associated with time to first STI infection in a prospective cohort of IDUs in Vancouver, British Columbia.METHODS: The authors examined the prevalence and correlates of STIs among IDUs at the time of recruitment into a prospective cohort study. The authors also evaluated the cumulative rate of time to first STI among IDUs with no history of STIs at baseline using the Kaplan-Meier method, and modelled factors independently associated with first STI using Cox regression.RESULTS: Between May 1996 and November 2003, 1560 individuals were recruited into the cohort; of these individuals, 745 reported a history of STI at baseline. Among the 815 who did not report an STI at baseline, 671 (82%) had at least one follow-up visit and were eligible for the analysis of time to first STI. After 36 months of follow-up, the cumulative rate of first STI was 8.2% for men and 15.9% for women (log-rank P<0.001), whereas the cumulative rate of first STI was 8.0% for IDUs who did not report sex trade involvement versus 19.8% for IDUs who reported sex trade involvement (log-rank P<0.001). In multivariate analyses, the risk of first STI remained independently associated with unprotected sex with regular partners (relative hazard=2.04, 95% CI 1.29 to 3.23; P=0.001) and unprotected sex with sex trade clients (relative hazard=2.36, 95% CI 1.46 to 3.82; P=0.005).CONCLUSIONS: In the present study, the authors found that STIs were associated with both regular sex partnerships and sex trade involvement. These findings are of particular concern because both unprotected sex with regular partners and sex trade involvement is common among IDUs. Interventions to encourage condom use among IDUs, particularly those with regular sex partners and those involved in the sex trade, should be further developed.

scholarly journals 699. A Retrospective Review of the Progression of Cardiac Vegetations with treatment

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Roomana Khan ◽  
Saleeha Asghar ◽  
Vivek Kak
Keyword(s):  
Successful Treatment ◽  
Retrospective Review ◽  
Injection Drug Users ◽  
Drug Users ◽  
Primary Outcome ◽  
P Value ◽  
Initial Size ◽  
Adequate Treatment ◽  
History Of

Abstract Background The purpose of our study was to assess the natural history of cardiac vegetations in native valves(NVIE) including changes in size and/or resolution with adequate treatment, as well as analyze factors that influence initial size. Methods We did a retrospective review of 102 patients discharged with a diagnosis NVIE at a community hospital. These patients were then screened to see if they received an adequate course of antimicrobial therapy and had follow up echocardiograms. The primary outcome measured was the change in vegetation size. We also assessed secondary measures including pathogen identified, the valve involved, complications, and associated IDU and any co-infections. Results 31 patients fulfilled the study criteria and showed an initial mean vegetation size of 170mm upon initial echocardiography. The follow-up size after antibiotic treatment was 78mm suggesting a statistically significant relationship between antibiotic completion and reduction in vegetation size. (p-value 0.005). T-Test was used for subgroup analysis and showed that the initial size of vegetations was significantly larger in IDUs (311) when compared to non-IDU (92)(p-value= 0.026).Patients who had embolic phenomena had significantly larger initial vegetations than those with no embolic complication. Initial vegetation size was significantly larger for people with embolic complications (308 mm vs 82.65 mm, p-value 0.013).We also found that patients with Staphylococcal endocarditis had larger vegetations than those with non-staphylococcal endocarditis (264 vs 39, p-value 0.001). and treatment led to a larger decrease in vegetation size (152 vs 7, p value 0.007) Conclusion Our small study suggests that successful treatment of NVIE does lead to a decrease in vegetation size though resolution of the vegetation does not occur. We also found that embolic phenomenon tended to occur with larger vegetations with our study suggesting that a vegetation &gt; 3 cm was more likely to embolize. Our study also shows that vegetations in NVIE in injection drug users were larger than those in non-IDU and vegetation size is larger in patients with staphylococcal endocarditis however successful treatment in these patients also leads to a larger decrease in size of these vegetations Disclosures All Authors: No reported disclosures

scholarly journals 1027. Outpatient Parenteral Antimicrobial Therapy (OPAT) in Injection Drug Users (IDUs): Is It Safe?

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S306-S306
Author(s):  
Hira Rizvi ◽  
Nathalie Baratz ◽  
Hind Hadid ◽  
Ana C Bardossy ◽  
Erica Herc ◽  
...  
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Illicit Drugs ◽  
Patient Characteristics ◽  
The United States ◽  
Emergency Department Visits ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Improved Outcomes ◽  
History Of

Abstract Background OPAT is widely implemented in the United States. However, there are concerns surrounding discharge of IDU with a peripherally inserted central catheter (PICC). The objective of this study was to evaluate the characteristics and treatment outcomes of IDUs discharged on OPAT. Methods This is a retrospective observational study conducted on patients discharged from an Infectious Diseases unit at a quaternary academic healthcare center in Detroit. Charts of all IDUs discharged on OPAT between 2011 and 2017 were reviewed. Current or former IDU were discharged on OPAT if they met the following criteria: self-reported history of IDU, stable living conditions, controlled psychiatric illness (if present), and willingness to sign a discharge agreement to refrain from using the PICC as a route for illicit drugs. Patients were categorized based on clinic follow-up vs. no clinic follow-up. Outcomes evaluated were: cured (completed treatment and symptom free for 1 month after completion), improved (symptoms were improved but there was no confirmation of treatment completion); and relapsed (readmitted within 30 days for the same infection or sequela). Outcomes of patients with no clinic follow-up were based on chart review of subsequent emergency department visits or admissions. Results Patient characteristics are shown in Table 1. Of the 61 patients evaluated, 33 (54.1%) attended clinic follow-up and 28 (45.9%) did not. Outcomes based on clinic follow-up are shown in Table 2. Of the 18 patients who were cured, 16 attended clinic follow-up vs. two who did not. Conclusion This study demonstrates that some IDUs can be discharged safely on OPAT. Patients with clinic follow-up had improved outcomes compared with those who did not. Further studies are needed to look at other predictors of outcome in this patient population. Disclosures All authors: No reported disclosures.

scholarly journals DEMOGRAPHIC AND CLINICAL PROFILES OF HIV POSITIVE CASES : A TWO-YEAR STUDY REPORT FROM A TERTIARY TEACHING HOSPITAL

2004 ◽  
Vol 43 (153) ◽  
Author(s):  
Tapas Kumar Aich ◽  
M Dhungana ◽  
A Kumar ◽  
V K Pawha
Keyword(s):  
Teaching Hospital ◽  
Injection Drug Users ◽  
Drug Users ◽  
Significant Loss ◽  
Injection Drug ◽  
Hiv Positive ◽  
Sexually Transmitted ◽  
Tertiary Teaching ◽  
History Of ◽  
Clinical Profiles

The report on the pattern of demographic and clinical profiles of HIV positive persons in Nepal are scarce.Present study was carried out at the Universal College of Medical Sciences Teaching Hospital at Bhairahawa(UCMS-TH). Following group of patients, who attended our different OPDs for a period of two years(January 2001 to December 2002) were subjected to HIV tests: History of exposure to Commercial SexWorkers (CSW), history of travelling and working India/abroad, living single, driver/cleaner by profession,history of injection drug use (IDU), unexplained fever, diarrhoea and significant loss of weight for over amonth, all cases of Sexually Transmitted Diseases (STDs), etc. A total of 43 HIV positive cases were detectedduring the period. Mode of transmission was as follows: 6 (13.9%) patients were injection drug users (IDU),one case (2.3%) transmitted through blood transfusion (BT), one patient (2.3%) was homosexual whileheterosexual transmission was noted in 34 (79.1%) patients. Out of 23 injection drug users (IDUs) admittedduring the period, 6 cases were detected positive for HIV infection. Applying ‘Expanded WHO Case Definitionfor AIDS Surveillance’, out of total 43 cases at least 28 (65%) cases could be detected as having sufferingfrom clinical AIDS; 12 (27.7%) of them were suffering from pulmonary or extra-pulmonary tuberculosis. Asignificant percentage of these patients belonged to lower socio-economic class and many of them weremobile worker and contacted their illness while working in Indian metropolis in the past.ABSTRACTKey Words: HIV positive, Clinical AIDS, Nepal.

scholarly journals Correlates of Knowledge of HIV Transmission Among Incident Cases of HIV in a Cohort of Injection Drug Users Receiving Harm Reduction Services at Karachi, Pakistan

2014 ◽  
Vol 16 (3) ◽  
pp. 286-289 ◽  
Author(s):  
Rab Nawaz Samo ◽  
Arshad Altaf ◽  
Sharaf Ali Shah
Keyword(s):  
Harm Reduction ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hiv Transmission ◽  
Critical Role ◽  
Unprotected Sex ◽  
Injection Drug ◽  
P Value ◽  
High Risk Population ◽  
Incident Cases

Background: Knowledge of risk factors for HIV transmission in high-risk population plays a critical role in averting the risk of HIV transmission. In Pakistan, injection drug users (IDUs) constitute the core risk group of HIV prevalence, where the epidemic has transitioned to a “concentrated level.” Still nothing is known about the role of knowledge in HIV transmission and HIV sero-conversion among IDUs in Pakistan. Methods: From 2009 to 2011, a nested case–control study was conducted in a cohort of 636 IDUs receiving harm reduction services in the mega city of Karachi. Results: In multivariable regression analysis, 3 factors, namely HIV does not spread through unprotected sex (adjusted odds ratio [AOR]: 3.1, 95% confidence interval [CI] 1.39-6.90, P value .01), HIV does not transmit by sharing syringes (AOR: 3.5, 95% CI 1.97-6.40, P value <.00), and the risk of HIV cannot be minimized by using new syringe every time (AOR: 2.0, 95% CI 1.16-3.60, P value .01), were significantly associated with the incident cases of HIV. Conclusion: The study findings suggest the association between knowledge of HIV transmission and HIV sero-incident cases.

scholarly journals Discordant Zika Virus Findings in Twin Pregnancies Complicated by Antenatal Zika Virus Exposure: A Prospective Cohort

2019 ◽  
Vol 221 (11) ◽  
pp. 1838-1845 ◽  
Author(s):  
Nasim C Sobhani ◽  
Elyzabeth Avvad-Portari ◽  
Aline C M Nascimento ◽  
Heloisa N Machado ◽  
Daniel S S Lobato ◽  
...  
Keyword(s):  
Zika Virus ◽  
Prospective Cohort ◽  
Neonatal Outcome ◽  
Infant Outcomes ◽  
Long Term Follow Up ◽  
History Of ◽  
Virus Exposure ◽  
Twin Pregnancies

Abstract Background There are limited data on the natural history of antenatal Zika virus (ZIKV) exposure in twin pregnancies, especially regarding intertwin concordance of prenatal, placental, and infant outcomes. Methods This prospective cohort study included twin pregnancies referred to a single institution from September 2015 to June 2016 with maternal ZIKV. Polymerase chain reaction (PCR) testing of maternal, placental, and neonatal samples was performed. Prenatal ultrasounds were completed for each twin, and histomorphologic analysis was performed for each placenta. Abnormal neonatal outcome was defined as abnormal exam and/or abnormal imaging. Two- to three-year follow-up of infants included physical exams, neuroimaging, and Bayley-III developmental assessment. Results Among 244 pregnancies, 4 twin gestations without coinfection were identified. Zika virus infection occurred at 16–33 weeks gestation. Zika virus PCR testing revealed discordance between dichorionic twins, between placentas in a dichorionic pair, between portions of a monochorionic placenta, and between a neonate and its associated placenta. Of the 8 infants, 3 (38%) had an abnormal neonatal outcome. Of 6 infants with long-term follow-up, 3 (50%) have demonstrated ZIKV-related abnormalities. Conclusions Neonatal PCR testing, placental findings, and infant outcomes can be discordant between co-twins with antenatal ZIKV exposure. These findings demonstrate that each twin should be evaluated independently for vertical transmission.

Predictors of Positive Outcomes for Out-of-Treatment Opiate Injectors Recruited into Methadone Maintenance through Street Outreach

2002 ◽  
Vol 32 (3) ◽  
pp. 999-1016 ◽  
Author(s):  
Karen Fortuin Corsi ◽  
Carol F. Kwiatkowski ◽  
Robert E. Booth
Keyword(s):  
Drug Use ◽  
Behavior Change ◽  
Hiv Risk ◽  
Methadone Maintenance Treatment ◽  
Injection Drug Users ◽  
Drug Users ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Positive Outcomes

This study was conducted to assess behavior change in the areas of drug use, productivity, criminal activity, and HIV risk among street-recruited injection drug users who entered methadone maintenance treatment. In addition, the study examined a number of variables that could account for these changes, including demographics, intervention effects, and treatment-related measures. A total of 168 participants were interviewed at baseline, received outreach interventions, entered methadone maintenance treatment, and were reinterviewed 5–9 months later. Significant (p<.001) improvements were seen in the areas of drug use, productivity, criminality, and HIV risk behaviors. The only variables significantly associated with behavior change were related to drug treatment. In particular, being in treatment at the time of the follow-up assessment had the strongest relationship to positive outcomes, including length of treatment. Having no prior treatment experience was associated with fewer injections at follow-up. These findings emphasize the importance of retaining clients, given the likelihood that positive change is likely to be evidenced while they remain in treatment

Mortality Among Injection Drug Users in Northern Thailand: A Prospective Cohort Study

2010 ◽  
Vol 4 (4) ◽  
pp. 217-222 ◽  
Author(s):  
Vu Minh Quan ◽  
Apinun Aramrattana ◽  
Tasanai Vongchak ◽  
Carl Latkin ◽  
Deborah Donnell ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Northern Thailand

scholarly journals Recent Incarceration Independently Associated with Syringe Sharing by Injection Drug Users

2005 ◽  
Vol 120 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Evan Wood ◽  
Kathy Li ◽  
Will Small ◽  
Julio S. Montaner ◽  
Martin T. Schechter ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hiv Risk Behavior ◽  
Injection Drug ◽  
Syringe Sharing ◽  
Binary Outcomes ◽  
History Of ◽  
The Relationship ◽  
Hiv Negative

Objectives. Few prospective studies are available on the relationship between incarceration and HIV risk among injection drug users (IDUs). The authors evaluated self-reported rates of syringe sharing and incarceration among a cohort of IDUs. Methods. This study analyzed syringe lending by HIV-infected IDUs and syringe borrowing by HIV-negative IDUs among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS). Since serial measures for each individual were available, variables potentially associated with each outcome (syringe lending and borrowing) were evaluated using generalized estimating equations for binary outcomes. Results. The study sample consisted of 1,475 IDUs who were enrolled into the VIDUS cohort from May 1996 through May 2002. At baseline, 1,123 (76%) reported a history of incarceration since they first began injecting drugs. Of these individuals, 351 (31%) reported at baseline that they had injected drugs while incarcerated. Among 318 baseline HIV-infected IDUs, having been incarcerated in the six months prior to each interview remained independently associated with syringe lending during the same period (adjusted odds ratio [OR] = 1.33; 95% confidence interval [CI] 1.06, 1.69; p=0.015). Similarly, among the 1,157 baseline HIV-negative IDUs, having been incarcerated in the six months prior to each interview remained independently associated with reporting syringe borrowing during the same period (adjusted OR=1.26; 95% CI 1.12, 1.44; p<0.001). Conclusions. Incarceration was independently associated with risky needle sharing for HIV-infected and HIV-negative IDUs. This evidence of HIV risk behavior should reinforce public health concerns about the high rates of incarceration among IDUs.

Sign in / Sign up

Export Citation Format

Share Document