scholarly journals When and how do individuals transition from regular drug use to injection drug use in Uganda? Findings from a rapid assessment

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Matayo Baluku ◽  
Twaibu Wamala
Keyword(s):  
Drug Use ◽  
Injection Drug Use ◽  
Drug Users ◽  
Time Lag ◽  
Rapid Assessment ◽  
Injecting Drug Users ◽  
Hcv Infection ◽  
Injection Drug ◽  
Structured Interviews ◽  
Increased Risk

Abstract Background In Uganda, injection drug use is a growing but less studied problem. Preventing the transition to injection drug use may help prevent blood-borne viral transmission, but little is known about when and how people transition to injection drug use. A greater understanding of this transition process may aid in the country’s efforts to prevent the continued growth of injection drug use, HIV, and hepatitis C Virus (HCV) infection among people who inject drugs (PWID). Methods Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)—recruited through outreach and snow-ball sampling. Participants were interviewed about their experiences on when and how they transitioned into injection drug use and these issues were also discussed in 12 focus groups held with the participants. Results All the study participants started their drug use career with non-injecting forms including chewing, smoking, and sniffing before transitioning to injecting. Transitioning was generally described as a peer-driven and socially learnt behavior. The participants’ social networks and accessibility to injectable drugs on the market and among close friends influenced the time lag between first regular drug use and first injecting—which took an average of 4.5 years. By the age of 24, at least 81.6% (95.7% for females and 78.4% for males) had transitioned into injecting. Over 84.8% shared injecting equipment during their first injection, 47.2% started injecting because a close friend was already injecting, 26.4% desired to achieve a greater “high” (26.4%) which could reflect drug-tolerance, and 12% out of curiosity. Conclusions Over 81% non-injecting drug users in Kampala and Mbale districts transitioned into injecting by the age of 24; a process that reproduces a population of PWID but also puts them at increased risk of HIV and HCV infection. As Uganda makes efforts to introduce and/or strengthen harm reduction services, interventions targeting non-injecting drug users before they transition into injecting should be considered as a key component for HIV/HCV epidemic control efforts, and their evaluation considered in future researches.

scholarly journals Clinical and immunological characteristics of bacterial pneumonia associated with HIV infection coupled to drug addiction

2020 ◽  
Vol 10 (4) ◽  
pp. 775-781
Author(s):  
L. V. Puzyreva ◽  
A. V. Mordyk ◽  
M. A. Paneva
Keyword(s):  
Drug Use ◽  
Hiv Infection ◽  
Injection Drug Use ◽  
Bacterial Pneumonia ◽  
Drug Users ◽  
Clinical Manifestations ◽  
Injecting Drug Users ◽  
The Body ◽  
Injection Drug ◽  
Tract Infections

Bacterial pneumonia holds the second place after respiratory tuberculosis in patients with HIV infection. In recent years, sexual transmission of HIV was replaced by injection drug route. It seems of high relevance to advance medical aid to patients with HIV infection and bacterial pneumonia depending on psychoactive substance use.Aim of study — assessment of clinical and immunological manifestations of bacterial pneumonia coupled to HIV infection with respect to verified injection drug use.Materials and methods. Clinical and immunological data collected from 224 patients with HIV infection and pneumonia were retrospectively analyzed: group 1 group — 70 patients with HIV infection, IDU, verified bacterial pneumonia; group 2 — 16 injecting drug users (IDU) with HIV infection and pneumonia of unverified etiology; group 3 — 65 patients with HIV and bacterial pneumonia of verified etiology without injection drug use, group 4 — 73 patients with HIV infection and bacterial pneumonia of unverified etiology, without injection drug use. The data obtained were analyzed by using software Statistica 13.3. Methods of descriptive statistics with calculation of nonparametric criterion — the Kruskall—Wallis test (H-criterion) and χ2 test — were used.Results. Immunological manifestations of HIV infection and bacterial pneumonia were characterized by decreased count of CD4+ cells paralleled with increased count of CD3+ and CD8+ cells at higher magnitude without injection drug use being also featured with peak viral load upon developing pneumonia. Bacterial pneumonia coupled to HIV infection showed clinical manifestations similar both in injecting drug users and non-users, proceeding in 10% cases during normothermia. Injection drug user patients often demonstrated clinical picture of pneumonia resembling those found in sepsis such as pain in the body, muscles, bone aches untypical to HIV-sexually infected subjects. In addition, systolic murmur on a heart top was more often auscultated in this patient group.Conclusion. Subjects self-considered healthy being at risk of sexually transmitted infections should examined for HIV. All subjects manifested with symptoms of the lower airway tract infections in admission department should not be rejected to be hospitalized and undergo chest X-ray examination.

scholarly journals Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Clinical Characteristics ◽  
National Registry ◽  
Injection Drug ◽  
University Hospital ◽  
Prosthetic Heart Valves ◽  
Increased Risk ◽  
History Of

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

scholarly journals Harm reduction via online platforms for people who use drugs in Russia: a qualitative analysis of web outreach work

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Arsen Davitadze ◽  
Peter Meylakhs ◽  
Aleksey Lakhov ◽  
Elizabeth J. King
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Injection Drug Use ◽  
Injection Drug ◽  
People Who Use Drugs ◽  
Structured Interviews ◽  
Advantages And Disadvantages ◽  
Online Platforms ◽  
Outreach Work ◽  
Outreach Workers

Abstract Background Harm reduction services to people who use drugs (PWUD) in Russia are insufficient in terms of quantity, government endorsement, and accessibility. The situation has recently deteriorated even further because of social distancing measures of the COVID-19 pandemic. Several organizations have started to provide some harm reduction services via online platforms by web outreach. However, little is known on how online outreach services are organized and implemented. Drawing on the example of St. Petersburg-based NGO “Humanitarian Action,” we explored web outreach work in Telegram instant messenger. Methods Our data were comprised of 4 semi-structured interviews with the NGO staff and 301 cases of web outreach work with PWUD. We used thematic analysis to study the process of web outreach, harm reduction service provision, and needs of PWUD. Results Three stages of the process of web outreach work were identified: clients initiating communication, NGO workers addressing clients’ needs, and NGO workers receiving clients’ feedback. Communication proceeded in group chat or direct messages. Challenges in addressing clients’ needs happened when clients turned for help after hours, sent recorded voice messages, sent unclear messages, and/or were unwilling to transition to telephone communication. All web outreach workers reported receiving only positive feedback on their work. The needs of PWUD were categorized into two major themes, depending on whether they can be addressed fully or partially online. In cases of online only provision of services, web outreach workers helped PWUD treat minor injection drug use complications, obtain verified harm reduction information and receive general psychological support. In instances of partial online services provision, PWUD were assisted in getting treatment of severe injection drug use complications, overdoses, and in accessing offline medical, psychological, social, legal and harm reduction services. Conclusions Our research demonstrated that web outreach work is a convenient tool for delivering some harm reduction services to PWUD either partially or completely online and for recruiting new clients (including hard-to-reach PWUD that avoid attending brick-and-mortar facilities). Harm reduction organizations should consider incorporating online harm reduction services into their activities. However, further research is needed to explore relative advantages and disadvantages of online harm reduction services.

scholarly journals Brucella Endocarditis in Persons Who Inject Drugs

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
John M Cafardi ◽  
Douglas Haas ◽  
Thomas Lamarre ◽  
Judith Feinberg
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug Users ◽  
Drug Users ◽  
Cardiac Involvement ◽  
Injection Drug ◽  
Persons Who Inject Drugs ◽  
Brucella Infection

Abstract We report 2 cases of infective endocarditis in injection drug users due to Brucella infection. Although cardiac involvement is a frequent sequela of brucellosis and endocarditis is often seen with injection drug use, Brucella endocarditis in persons who inject drugs without zoonotic exposure has not been reported to date.

Socio-Demographic Correlates of Injection Drug Use Among Male Drug Users: A Cross Sectional Study in Nepal

2014 ◽  
Vol 39 (6) ◽  
pp. 1124-1132 ◽  
Author(s):  
Sanjeev Raj Neupane ◽  
Shiva Raj Mishra ◽  
Samaj Adhikari ◽  
Amod Kumar Poudyal
Keyword(s):  
Drug Use ◽  
Injection Drug Use ◽  
Drug Users ◽  
Cross Sectional Study ◽  
Injection Drug ◽  
Sectional Study ◽  
Cross Sectional ◽  
Demographic Correlates

scholarly journals 1215. A Mixed Methods Study on Severe Bacterial Infections in People Who Inject Drugs

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S697-S697
Author(s):  
Alexander Hrycko ◽  
Benjamin Eckhardt ◽  
Pedro Mateu-Gelabert ◽  
Courtney Ciervo
Keyword(s):  
Mixed Methods ◽  
Drug Use ◽  
Injection Drug Use ◽  
Bacterial Infections ◽  
Mixed Methods Study ◽  
Injection Drug ◽  
Daily Injection ◽  
Drug Injection ◽  
Structured Interviews ◽  
Causative Microorganism

Abstract Background Severe bacterial infections (SBI) associated with intravenous drug use have been increasing in frequency in the U.S. over the last decade. This mixed methods study aims to identify the risk factors associated with SBI in hospitalized individuals with recent injection drug use. Methods We conducted 34 quantitative and 15 qualitative interviews between August 2020 and June 2021 at Bellevue Hospital in New York City. Eligible participants were (1) &gt;/= 18 year of age, (2) admitted with a SBI, and (3) reported injection drug use within the 90 days prior to admission. Quantitative and qualitative data was obtained using a quantitative survey and in-depth, semi structured interviews of participants respectively. Analysis was performed to examine trends and explore common themes potentially contributing factors to SBI. Results Of the 34 participants included, the median age was 37.5, 85% were male, 53% white, and 65% reported being homeless within the past 3 months. Endocarditis was the most common primary diagnosis (65%). Median length of hospital stay was 24 days and 35% required ICU level care during admission. A causative microorganism was identified in 85% of participants and 50% had Staphylococcus aureus as the sole organism. Discharges against medical advice occurred in 35%. Daily injection drug use in prior 30 days was 95% with a median of 10 injections per day. In the 30 days prior to admission, 50% reported an increase in injection frequency, 80% reported reusing needles and/or syringes, 75% reused cookers, 65% reused cottons. Analysis of qualitative interview data revealed high risk injection behaviors. Participants were not practicing and unaware of strategies to reduce their risk of drug injection-related SBI. Prior hospitalizations for SBI did not impact on this knowledge deficit on what constitutes bacterial infection risk and how to prevent it. Conclusion Study findings highlight the complexity of the injection drug use process and the potential social and physiological pathways leading to SBI. Multiple domains at the structural, network, and individual level that impact drug injection practices and provide context by which these factors predispose and lead to physiological tissue damage and the development of SBI among PWID. Disclosures Benjamin Eckhardt, MD, MS, Gilead Sciences (Grant/Research Support)

scholarly journals Factors Correlating to the Development of Hepatitis C Virus Infection among Drug Users—Findings from a Systematic Review and Meta-Analysis

2019 ◽  
Vol 16 (13) ◽  
pp. 2345 ◽  
Author(s):  
Biao Zhou ◽  
Gao Feng Cai ◽  
Hua Kun Lv ◽  
Shuang Fei Xu ◽  
Zheng Ting Wang ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Use ◽  
Drug Users ◽  
Methadone Maintenance ◽  
Meta Analysis ◽  
Injecting Drug Use ◽  
Hcv Infection ◽  
Increased Risk

Hepatitis C remains a significant public health threat. However, the main routes of transmission have changed since the early 1990s. Currently, drug use is the main source of hepatitis C virus (HCV) infection, and some measures have been successively implemented and additional studies have been published. However, the factors correlating with HCV infection failed to clearly define. Our study pooled the odds ratios (ORs) with 95% confidence intervals (CIs) and analyzed sensitivity by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Publication bias was determined by Egger’s test. In our meta-analysis, HCV-infected and non-HCV-infected patients from 49 studies were analyzed. The pooled ORs with 95% CIs for study factors were as follows: Injecting drug use 10.11 (8.54, 11.97); sharing needles and syringes 2.24 (1.78, 2.83); duration of drug use >5 years 2.39 (1.54, 3.71); unemployment 1.50 (1.22, 1.85); commercial sexual behavior 1.00 (0.73, 1.38); married or cohabiting with a regular partner 0.88 (0.79, 0.98), and sexual behavior without a condom 1.72 (1.07, 2.78). This study found that drug users with histories of injecting drug use, sharing needles and syringes, drug use duration of >5 years, and unemployment, were at increased risk of HCV infection. Our findings indicate that sterile needles and syringes should be made available to ensure safe injection. In view of that, methadone maintenance treatment can reduce or put an end to risky drug-use behaviors, and should be scaled up further, thereby reducing HCV infection.

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