Outpatient Medical Care of Injection Drug Use Related HIV

1992 ◽  
Vol 3 (2) ◽  
pp. 96-100 ◽  
Author(s):  
R P Brettle ◽  
S M Gore ◽  
A McNeil
Keyword(s):  
Infectious Disease ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Hiv Positive ◽  
Initial Increase ◽  
Medical Clinic ◽  
Loss To Follow Up ◽  
Disease Unit

By the end of March 1990 470 HIV positive patients, 77% injection drug use (IDU) related, had attended the outpatient department of the Regional Infectious Disease Unit with a cumulative loss to follow-up of only 20%. Coincident with the prescribing of oral methadone and a specific all-day IDU-related HIV medical clinic the total number of appointments increased from 28/month in May 1986 to 300/month in May 1989 ( P< 0.001) and the number of defaulted appointments decreased from a maximum of 60% (17/28) to 16% (48/294, P<0.001) in these months. There was a significant initial increase in the number of defaulted appointments for the infectious disease (ID) clinics from 11% (77/726) to 16% (124/797, P<0.01) which returned to previous levels once a specific IDU-related HIV clinic was established. There was also a significant decline in the number of new patients referred which was greater for the urinary tract infection clinics (108 to 56 per 6 months, P<0.0001) than for the ID clinics (119 to 88 per 6 months, P<0.05).

scholarly journals Injection drug use, unknown HIV positive status, and self-reported current PrEP use among Black men who have sex with men attending U.S. Black pride events, 2014–2017

2020 ◽  
Vol 207 ◽  
pp. 107808 ◽  
Author(s):  
Jessica L. Maksut ◽  
Rachel E. Gicquelais ◽  
Kevon-Mark Jackman ◽  
Lisa A. Eaton ◽  
M. Revel Friedman ◽  
...  
Keyword(s):  
Drug Use ◽  
Black Men ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Hiv Positive ◽  
Sex With Men ◽  
Black Pride

scholarly journals Why the Treatment of Mental Disorders Is an Important Component of HIV Prevention among People Who Inject Drugs

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth Buckingham ◽  
Ezra Schrage ◽  
Francine Cournos
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Drug Use ◽  
Mental Disorders ◽  
Hiv Infection ◽  
Injection Drug Use ◽  
People Who Inject Drugs ◽  
Injection Drug ◽  
Hiv Care ◽  
Hiv Positive

People who inject drugs are more likely to be HIV positive and to have a mental disorder than the general population. We explore how the detection and treatment of mental illness among people who are injecting drugs are essential to primary and secondary prevention of HIV infection in this population. Aside from opioid addiction, few studies have been conducted on the links between mental disorders and injection-drug use. However, independent of the injection-drug use literature, a growing number of studies demonstrate that untreated mental illness, especially depression and alcohol/substance use disorders, is associated with HIV-related risk behaviors, acquiring HIV infection, failure to access HIV care and treatment, failure to adhere to HIV care and treatment, and increased morbidity and mortality from HIV-related diseases and comorbidities. In our review of both the published literature and gray literature we found a dearth of information on models for providing care for both opioid addiction and other mental illnesses regardless of HIV status, particularly in low- and middle-income countries. We therefore make recommendations on how to address the mental health needs of HIV-positive people who inject drugs, which include the provision of opioid substitution therapy and integrated mental health, substance abuse, and HIV services.

scholarly journals Disparity in Quality of Infectious Disease vs Addiction Care Among Patients With Injection Drug Use–Associated Staphylococcus aureus Bacteremia

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
David Phillip Serota ◽  
Emily D Niehaus ◽  
Marcos C Schechter ◽  
Jesse T Jacob ◽  
Jeb Jones ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Evidence Based ◽  
High Quality ◽  
Staphylococcus Aureus Bacteremia ◽  
Addiction Care

Abstract Evidence-based interventions for Staphylococcus aureus bacteremia (SAB) are well known, but it is unclear how they are implemented among patients with injection drug use–associated (IDU) SAB. Of 46 patients with IDU-SAB identified, all received high-quality SAB management; however, few received appropriate recognition or treatment of their underlying substance use disorder.

scholarly journals Injection and non-injection drug use and infectious disease in Baltimore City: Differences by race

2014 ◽  
Vol 39 (9) ◽  
pp. 1325-1328 ◽  
Author(s):  
Larry Keen ◽  
Maria Khan ◽  
Lisa Clifford ◽  
Paul T. Harrell ◽  
William W. Latimer
Keyword(s):  
Infectious Disease ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Baltimore City

scholarly journals 890. Bridging the Gap to Help Address the Opioid Crisis: A Novel Model of Care to Integrate Substance Use, Mental Health, and Infectious Disease Services

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S22-S22
Author(s):  
Kimberly Corace ◽  
Nicholas Schubert ◽  
Melanie Willows ◽  
Guy Herbert ◽  
Gary Garber
Keyword(s):  
Mental Health ◽  
Infectious Disease ◽  
Substance Use ◽  
Drug Use ◽  
Infectious Diseases ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Opioid Use ◽  
Care Model ◽  
Rapid Access

Abstract Background There is a converging public health crisis as the opioid epidemic and increased injection drug use is driving rates of infectious diseases. Multidisciplinary care, integrating infectious diseases, substance use, and mental health services, is crucial to address this crisis. This study evaluated a novel rapid access care model to improve treatment access for opioid use, mental health, and related infectious diseases. Methods The Rapid Access Addiction Medicine (RAAM) clinic is a multidisciplinary, walk-in care model located in a mental health center in Ottawa, Canada. RAAM provides collaborative, inter-agency care, with rapid access to care facilitated through seamless care pathways (i.e., from the emergency department). RAAM offers substance use and mental health treatment, screening and care for infectious diseases, harm reduction, and connection to community services. RAAM patients (N = 411) presenting between April 2018 and January 2019 completed substance use and mental health measures upon intake and 30-day follow-ups. Clinical information was collected via chart review. Results Of the total sample, 20% (n = 83; 66% men) had problematic opioid use. Most patients reported high opioid dependence severity (97%), injection drug use (67%), and polysubstance use (97%), including cocaine (62%), alcohol (40%), and amphetamines (35%). Most patients reported anxiety (86%) and depression (75%). The number of patients tested for HIV, HCV, HBV, and other STIs was 29%, 27%, 28%, and 24%, respectively. Most patients tested (61%) were young adults (aged 16–29). Of those tested, 15% tested positive for HCV and treatment initiation was facilitated for 66% of patients (33% resolved spontaneously). At 30-day follow-up, patients showed significantly reduced substance use and improved depression and anxiety (Ps < 0.05). Conclusion Patients with problematic opioid use have multiple comorbidities, including undiagnosed infectious diseases; thus, highlighting the need for integrated care models like RAAM. Substance use treatment is an opportune setting to identify and treat infectious diseases in order to improve outcomes and reduce disease transmission. Leadership from infectious disease specialists is key to this successful integration. Disclosures All Authors: No reported Disclosures.

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