scholarly journals Syringe sharing among people who inject drugs in Tijuana: before and after the Global Fund

Salud Mental ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. 149-156 ◽  
Author(s):  
Annick Bórquez ◽  
Daniela Abramovitz ◽  
Javier Cepeda ◽  
Gudelia Rangel ◽  
Patricia González-Zúñiga ◽  
...  
Keyword(s):  
Risk Behaviors ◽  
Global Fund ◽  
People Who Inject Drugs ◽  
Hiv Transmission ◽  
Population Level ◽  
Syringe Sharing ◽  
Middle Income ◽  
Segmented Regression Analysis ◽  
Before And After ◽  
Needle And Syringe Programs

Introduction. Needle and syringe programs (NSP) reduce syringe sharing and HIV transmission among people who inject drugs (PWID). However, their effectiveness relies on sufficient individual and population level coverage. In Tijuana, Mexico, the Global Fund (GF) supported NSP during 10/2011-12/2013, but withdrew funds at the end of 2013 following Mexico’s re-classification as an upper-middle income country. Objective. We tested the hypothesis of higher NSP access and lower receptive syringe sharing among PWID in Tijuana during the GF support period compared to pre-GF initiation and post-GF withdrawal. Method. We used data from an ongoing cohort study of PWID in Tijuana (03/2011-10/2015) to implement a segmented regression analysis investigating changes in the self-reported probability of NSP access, reported difficulty in finding sterile syringes and receptive syringe sharing before GF initiation and after GF discontinuation. Results. We found a large significant increase in the probability of NSP access (+.07) and decrease in receptive syringe sharing (-.23) right after GF initiation, which continued over the GF period. Subsequently, we found a significant decline in NSP access (-.05) and an increase in receptive syringe sharing (+.02) right after post-GF withdrawal, which continued thereafter. Discussion and conclusion. We demonstrated significant temporal changes in NSP access and receptive syringe sharing among PWID in Tijuana after GF initiation and withdrawal consistent with our hypothesis. Coordinated efforts with local authorities are needed to sustain major coverage NSP in settings receiving GF or external aid to guarantee continuity of harm reduction services and prevent reinside in risk behaviors associated with HIV transmission.

scholarly journals Antiretroviral therapy for prevention of HIV transmission: implications for Europe

2013 ◽  
Vol 18 (48) ◽  
Author(s):  
V Cambiano ◽  
J O’Connor ◽  
A N Phillips ◽  
A Rodger ◽  
R Lodwick ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Who Inject Drugs ◽  
Hiv Transmission ◽  
Controlled Trial ◽  
Population Level ◽  
Hiv Infections ◽  
Cd4 Count ◽  
Art Initiation ◽  
Sex With Men ◽  
Randomised Controlled

The aim of this review is to summarise the evidence on the population-level effect of antiretroviral therapy (ART) in preventing HIV infections, and to discuss potential implications in the European context of recommending starting ART when the CD4 count is above 350 cells/mm3. The ability of ART to reduce the risk of HIV transmission has been reported in observational studies and in a randomised controlled trial (HPTN 052), in which ART initiation reduced HIV transmission by 96% within serodiscordant couples. As yet, there is no direct evidence for such an effect among men having sex with men or people who inject drugs. HPTN 052 led international organisations to develop recommendations with a higher CD4 threshold for ART initiation. However, there remains a lack of strong evidence of clinical benefit for HIV-positive individuals starting ART with CD4 count above 350 cells/mm3. The main goal of ART provision should be to increase ART coverage for all those in need, based on the current guidelines, and the offer of ART to those who wish to reduce infectivity; increased HIV testing is therefore a key requirement. Other proven prevention means such as condom use and harm reduction for people who inject drugs remain critical.

scholarly journals Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Dahui Chen ◽  
Ganfeng Luo ◽  
Zixin Wang ◽  
Yong Cai ◽  
Xiaojun Meng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Behaviors ◽  
Hiv Transmission ◽  
Community Intervention ◽  
Peer Education ◽  
Factory Workers ◽  
Hiv Knowledge ◽  
Middle Income ◽  
Hiv Interventions ◽  
Middle Income Countries

Abstract Background Factory workers in low- and middle-income countries (LMICs) are vulnerable to HIV transmission. Interventions are needed to prevent HIV in this population. We systematically reviewed published literature on the efficacy of various HIV interventions in reducing stigma, risk behaviors and HIV transmission among factory workers.Methods A systematic review was performed using predefined inclusion and exclusion criteria. Four databases (PubMed, PsycINFO, Scopus and EMBASE) were searched for relevant publications between January 1, 1990 and December 31, 2018. Two independent reviewers assessed the methodological quality of studies.Results Thirteen articles were included, with 2 randomized controlled trials and 11 cohort studies. Five interventions and their combinations were summarized. Educational intervention increased condom use and reduced the use of recreational drugs and alcohol before sex. Community intervention indicated that workers at high risk behaviors were more likely to go to HIV counselling and testing (HCT), and proactive provision of HCT could increase the detection rate of HIV and sexually transmitted diseases (STDs). Lottery intervention increased HCT uptake and decreased HIV public stigma. Education combined with community intervention reduced the proportion of workers with casual sex and enhanced HIV knowledge. Peer education combined with community intervention increased the proportion of workers who were willing to take their partners to HCT. Policy intervention combined with peer education enhanced HIV knowledge, perceived condom accessibility and condom use with regular partners.Conclusions Various interventions improved HIV knowledge, decreased HIV stigma and reduced HIV-related risk behaviors among factory workers in LMICs. The combination of multiple interventions tended to achieve better efficacy than a single intervention. Persistent combination interventions are essential to address HIV in this population.

scholarly journals Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Dahui Chen ◽  
Ganfeng Luo ◽  
Xiaojun Meng ◽  
Zixin Wang ◽  
Bolin Cao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Behaviors ◽  
Hiv Transmission ◽  
Community Intervention ◽  
Peer Education ◽  
Factory Workers ◽  
Hiv Knowledge ◽  
Middle Income ◽  
Hiv Interventions ◽  
Middle Income Countries

Abstract Background: Factory workers in low- and middle-income countries (LMICs) are vulnerable to HIV transmission. Interventions are needed to prevent HIV in this population. We systematically reviewed published literature on the efficacy of various HIV interventions in reducing stigma, risk behaviors and HIV transmission among factory workers.Methods: A systematic review was performed using predefined inclusion and exclusion criteria. Four databases (PubMed, PsycINFO, Scopus and EMBASE) were searched for relevant publications between January 1, 1990 and December 31, 2018. Two independent reviewers assessed the methodological quality of studies.Results: Thirteen articles were included, with 2 randomized controlled trials and 11 cohort studies. Five interventions and their combinations were summarized. Educational intervention increased condom use and reduced the use of recreational drugs and alcohol before sex. Community intervention that proactively provide HIV counselling and testing (HCT) services could increase the detection rate of HIV and other sexually transmitted diseases (STDs). Lottery intervention increased HCT uptake and decreased HIV public stigma. Education combined with community intervention reduced the proportion of workers with casual sex and enhanced HIV knowledge. Peer education combined with community intervention increased the proportion of workers who were willing to take their partners to HCT. Policy intervention combined with peer education enhanced HIV knowledge, perceived condom accessibility and condom use with regular partners.Conclusions: Various interventions improved HIV knowledge, decreased HIV stigma and reduced HIV-related risk behaviors among factory workers in LMICs. The combination of multiple interventions tended to achieve better efficacy than a single intervention. Persistent combination interventions are essential to address HIV in this population.

scholarly journals Is Option B+ the best choice?

2013 ◽  
Vol 14 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Coutsoudis A ◽  
A Goga ◽  
C Desmond ◽  
P Barron ◽  
V Black ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Infant Health ◽  
Hiv Transmission ◽  
Clinical Trial Data ◽  
Population Level ◽  
Cost Effective ◽  
Economic Benefits ◽  
Middle Income ◽  
Targeted Interventions ◽  
Local Evidence

This article is reprinted from The Lancet, with permission from Elsevier: Coutsodis A, Goga A, Desmond C, Barron P, Black V, Coovadia H. Is Option B+ the best choice? Lancet 2013;381(9863):269-271. [http://dx/doi.org/10.1016/S0140-6736(12)61807-8] The success of prevention of mother-to-child transmission (PMTCT) programmes (Options A and B) in middle-income countries, together with clinical trial data on antiretroviral (ARV) treatment as prophylaxis, has emboldened UN agencies to aggressively promote lifelong ARVs for PMTCT (Option B+). Unsubstantiated claims submit that Option B+ is cost-effective at population-level, will protect HIV-negative male partners, improve maternal and infant health, and increase ARV coverage. We provide counterfactual arguments about the ethics, medical safety, programme feasibility and economic benefits of Option B+. Option B+ offers no advantage to PMTCT and there are social hazards associated with privileging pregnant woman for treatment over men and non-pregnant women, especially with the absence of data to suggest that discordant relationships are more frequent among pregnant women or that they contribute disproportionately to the horizontal HIV transmission. The benefits and safety of long-term ARVs – including adherence and resistance – in mothers who do not need treatment for their own health, need to be considered, as well as, crucially, health service costs. The assumption that a decrease in efficiency caused by inappropriate targeting is compensated for by lower recruitment costs, is untested. Lives could be saved instead with appropriately targeted interventions. Countries should make individual decisions based on their HIV epidemiology, resources, priorities and local evidence. S Afr J HIV Med 2013;14(1):8-10. DOI:10.7196/SAJHIVMED.898

scholarly journals Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Dahui Chen ◽  
Ganfeng Luo ◽  
Xiaojun Meng ◽  
Zixin Wang ◽  
Bolin Cao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Behaviors ◽  
Hiv Transmission ◽  
Community Intervention ◽  
Peer Education ◽  
Factory Workers ◽  
Hiv Knowledge ◽  
Middle Income ◽  
Hiv Interventions ◽  
Middle Income Countries

Abstract Background: Factory workers in low- and middle-income countries (LMICs) are vulnerable to HIV transmission. Interventions are needed to prevent HIV in this population. We systematically reviewed published literature on the efficacy of various HIV interventions in reducing stigma, risk behaviors and HIV transmission among factory workers.Methods: A systematic review was performed using predefined inclusion and exclusion criteria. Four databases (PubMed, PsycINFO, Scopus and EMBASE) were searched for relevant publications between January 1, 1990 and December 31, 2018. Two independent reviewers assessed the methodological quality of studies.Results: Thirteen articles were included, with 2 randomized controlled trials and 11 cohort studies. Five interventions and their combinations were summarized. An educational intervention increased condom use and reduced the use of recreational drugs and alcohol before sex. A community intervention indicated that workers at high risk behaviors were more likely to go to HIV counselling and testing (HCT), and proactive provision of HCT could increase the detection rate of HIV and sexually transmitted diseases (STDs). A lottery intervention increased HCT uptake and decreased HIV public stigma. An education combined with a community intervention reduced the proportion of workers with casual sex and enhanced HIV knowledge. A peer education combined with a community intervention increased the proportion of workers who were willing to take their partners to HCT. A policy intervention combined with a peer education enhanced HIV knowledge, perceived condom accessibility and condom use with regular partners.Conclusions: Various interventions improved HIV knowledge, decreased HIV stigma and reduced HIV-related risk behaviors among factory workers in LMICs. The combination of multiple interventions tended to achieve better efficacy than a single intervention. Persistent combination interventions are essential to address HIV in this population.

STUDY ON THE RELATIONSHIP BETWEEN PARASITIC INFECTION AND KNOWLEDGE, HYGIENIC PRACTICAL MEASURES OF PARASITIC INFECTIOUS PREVENTION IN VINH THAI COMMUNITY

2017 ◽  
pp. 119-124
Author(s):  
Keyword(s):  
Health Education ◽  
Risk Behaviors ◽  
Ascaris Lumbricoides ◽  
Intestinal Parasite ◽  
Parasitic Infection ◽  
Parasite Infection ◽  
Intestinal Parasite Infection ◽  
Before And After ◽  
Parasite Infections ◽  
The Relationship

Introduction: Intestinal parasite infections werecommonintropical country such as Vietnam. Having good knowledge of parasitic infectious prevention and changing risk behaviors can decrease the infection rate. Objective: To evaluate the parasitic infectious rate in Vinh Thai community before and after being health education and the changing of knowledge of parasitic infectious prevention and risk behaviors. Materials and methods: 60 households in Vinh Thai commune were interviewed their knowledge of parasitic infectious prevention and examined intestinal parasite infection by Kato technique and then trained the knowledge of parasitic infectious prevention. The interview and examination parasite infectiousrate were carried out after 6 months to evaluating their knowledge. Result: Before health education, the rate of intestinal parasite infection was 17.4% with the prevalence of Ascaris lumbricoides, hookworm, whipworm, pinworm, small fluke worm and co-infection with A. lumbricoides - whipworm, hookworm-whipworm were 0.1%; 8.0%; 5.8%; 0.6%; 0.3%; 1.2% and 3.0% respectively. Six months later the rate of intestinal parasite infection was decreased in 12.6% even though not statistical significantly. However, there were no case of small fluke worm and co-infection with hookworm-whipworm. Receiving health education, their knowledge of parasitic infectious prevention was higher significantly but their risk behaviors were not changed so much. Conclusion: Health education can change the rate of parasite infection with higher knowledge of parasitic infectious prevention but it was necessary continuous study to change the risk behaviors. Key words: intestinal parasite, health education

scholarly journals High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lisa J. Messersmith ◽  
Rose Adjei ◽  
Jennifer Beard ◽  
Angela R. Bazzi ◽  
Joel J. Earlywine ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Sex Workers ◽  
People Who Inject Drugs ◽  
Syringe Sharing ◽  
Unsafe Sex ◽  
Lack Of Information ◽  
Sex With Men ◽  
Major Drug

Abstract Background Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana’s National Strategic Plan for HIV/AIDS 2016–2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

scholarly journals Examining the Effects of the Sacramento Dockless E-Bike Share on Bicycling and Driving

2021 ◽  
Vol 13 (1) ◽  
pp. 368
Author(s):  
Dillon T. Fitch ◽  
Hossain Mohiuddin ◽  
Susan L. Handy
Keyword(s):  
Travel Behavior ◽  
Regression Models ◽  
Population Level ◽  
Panel Survey ◽  
Multilevel Regression ◽  
Combine Data ◽  
Cross Sectional ◽  
Individual Level ◽  
Before And After ◽  
Bike Share

One way cities are looking to promote bicycling is by providing publicly or privately operated bike-share services, which enable individuals to rent bicycles for one-way trips. Although many studies have examined the use of bike-share services, little is known about how these services influence individual-level travel behavior more generally. In this study, we examine the behavior of users and non-users of a dockless, electric-assisted bike-share service in the Sacramento region of California. This service, operated by Jump until suspended due to the coronavirus pandemic, was one of the largest of its kind in the U.S., and spanned three California cities: Sacramento, West Sacramento, and Davis. We combine data from a repeat cross-sectional before-and-after survey of residents and a longitudinal panel survey of bike-share users with the goal of examining how the service influenced individual-level bicycling and driving. Results from multilevel regression models suggest that the effect of bike-share on average bicycling and driving at the population level is likely small. However, our results indicate that people who have used-bike share are likely to have increased their bicycling because of bike-share.

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