scholarly journals Gender matters? How does gender shape risk environment for syringe sharing among people who inject drugsin northern Mexico. Results from a cross-sectional survey

Salud Mental ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. 165-172
Author(s):  
Angélica Ospina-Escobar ◽  
Fátima Juárez
Keyword(s):  
Harm Reduction ◽  
Hiv Prevalence ◽  
Syringe Sharing ◽  
Significant Variable ◽  
Drug Injection ◽  
Risk Environment ◽  
Cross Sectional Survey ◽  
Men And Women ◽  
Northern Mexico ◽  
Women Who Inject Drugs

Introduction. HIV prevalence among people who inject drugs (PWID) is 5%. Studies have found a HIV prevalence around 10% among women who inject drugs (WWID) and 5% among men. Objective. To describe characteristics of risk environment that play different roles among men and women who inject drugs in Mexico that could be associated with those differentials. Method. In 2012 were interviewed in Hermosillo and Ciudad Juarez in places where population gathered. From them, 824 PWID 74.0% were men and 26.0% were women. Using chi-square test we analyzed associations of gender with demographics characteristics, drug use dynamics, and injecting behaviors. We fitted different generalized linear mixed models with random effects to test the hypothesis that predictors of receptive needle sharing have different effects on men and women. Results. Descriptive analysis showed that women live in conditions of higher vulnerability than men in terms of migration, educational attainment, occupation, and income. Women also reported a higher frequency of drug injection, a higher number of drugs used, and a higher prevalence of sharing needles. Variables significantly associated with the likelihood of sharing needles were: having being injected for someone else at first drug injection (adjusted odds ratio [AOR] = 1.60, 95% confidence interval CI [1.11, 2.25], p < .05); injecting once a day or more (AOR = 1.80, 95% CI [1.17, 2.70], p < .05), using alcohol or drugs at least half of the time at their sexual encounters (AOR = 1.64, 95% CI [1.16, 2.47], p < .05), experience of syringe confiscation by police (AOR = 1.54, 95% CI [1.13, 2.19], p < .05), and perceiving syringe availability as hard or very hard (AOR = 2.29, 95% CI [1.49, 3.32], p < .01). For women the most significant variable associated with syringe sharing was perception of syringe availability (AOR = 3.15, 95% CI [1.25, 7.91], p < .05), while for men was syringe confiscation by police (AOR = 1.74, 95% CI [1.20, 2.50], p < .05). Discussion and conclusion. Results suggests the need to design and implement harm reduction programs that tackle the specific need of WID. Enhancing syringe availability through permanent harm reduction programs, implemented in coordination between public health authorities and community-based organizations, is a basic action to stop HIV spreading among PWID in northern Mexico, along with the decriminalization policies towards these population.

A syndemic examination of injecting drug use, incarceration and multiple drug-related harms in French opioid users

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Salim Mezaache ◽  
Laélia Briand-Madrid ◽  
Virginie Laporte ◽  
Daniela Rojas Castro ◽  
Patrizia Carrieri ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Viral Infections ◽  
Multinomial Logistic Regression ◽  
Logistic Models ◽  
Multiple Drug ◽  
Drug Injection ◽  
Risk Environment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type

Purpose People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this paper aims to examine the co-occurrence and clustering of drug-related harms and their association with incarceration experience with or without in-prison drug injection. Design/methodology/approach The authors used data from a cross-sectional survey conducted in 2015 among 557 active opioid injectors. Self-reported data were collected through face-to-face or online questionnaires. They distinguished three harm categories, namely, viral infections, bacterial infections and overdoses, and built an index variable by summing the number of harm categories experienced, yielding a score from 0 to 3. Association between incarceration experience and co-occurrence of harms was modelled using a multinomial logistic regression. Findings Of the 557 participants, 30% reported lifetime experience of drug-related viral infection, 46% bacterial infection and 22% drug overdose. Multinomial logistic models showed that those who injected drugs during incarceration were more likely to report two (aOR = 2.35, 95% CI: 1.03–5.36) and three (aOR = 9.72, 95% CI: 3.23–29.22) harm categories than those who had never been incarcerated. They were also more likely to report three harm categories than formerly incarcerated respondents who did not inject drugs in prison (aOR = 5.14, 95% CI: 1.71–15.48). Originality/value This study provides insights of the syndemic nature of drug-related harms and highlights that drug injection during incarceration is associated with co-occurring harms. Public health interventions and policy changes are needed to limit the deleterious impact of prison on PWID.

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 Service providers’ use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donna Goodridge ◽  
Kerstin Stieber Roger ◽  
Christine A. Walsh ◽  
Elliot PausJenssen ◽  
Marina Cewick ◽  
...  
Keyword(s):  
Older Adults ◽  
Harm Reduction ◽  
Professional Practice ◽  
Service Provision ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Risk Environment ◽  
Intervention Process ◽  
Process Enactment ◽  
Humanistic Approach

Abstract Background Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. Methods Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. Results Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers’ description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult’s autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. Conclusions Harm reduction approaches are evident in service providers’ accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.

scholarly journals Adherence to Self-Administered Tuberculosis Treatment in a High HIV-Prevalence Setting: A Cross-Sectional Survey in Homa Bay, Kenya

PLoS ONE ◽  
2012 ◽  
Vol 7 (3) ◽  
pp. e32140 ◽  
Author(s):  
Fabienne Nackers ◽  
Helena Huerga ◽  
Emmanuelle Espié ◽  
Apollo Odongo Aloo ◽  
Mathieu Bastard ◽  
...  
Keyword(s):  
Hiv Prevalence ◽  
Tuberculosis Treatment ◽  
Cross Sectional Survey ◽  
Cross Sectional

HCV Communication Within Ego-centric Networks of Men and Women who Inject drugs

2021 ◽  
pp. 109157
Author(s):  
Marisa Felsher ◽  
Karin E. Tobin ◽  
Mark Sulkowski ◽  
Carl Latkin ◽  
Oluwaseun Falade-Nwulia
Keyword(s):  
Men And Women ◽  
Women Who Inject Drugs

scholarly journals Gender and Transaction Costs in Use of Zero Grazing Net for Tsetse Fly and Trypanosomiasis Control in Stall Feeding Systems in Kenya

2017 ◽  
Vol 7 (3) ◽  
pp. 96
Author(s):  
Jared Isaboke Mose
Keyword(s):  
Transaction Costs ◽  
Institutional Economics ◽  
Survey Design ◽  
Sampling Technique ◽  
New Institutional Economics ◽  
Tsetse Fly ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Men And Women ◽  
Zero Grazing

Trypanosomiasis is a widespread constraint in livestock production, mixed farming and human health in Africa. Several technologies have been developed to ameliorate the effects of the disease but delivery of these technologies to farmers has been undertaken on trial and error basis without a proper strategy leading to more failure than success and wastage of scarce resources. The purpose of this paper was to carry out an analysis of transaction costs incurred in accessing and using insecticide treated net in tsetse and trypanosomiasis control among smallholder cattle farms in Busia County, Kenya. The study utilized cross–sectional survey design and was guided by the New Institutional Economics approach and utilized stratified and simple random sampling technique to get 211 respondents for the study. Data was collected by use of structured questionnaires and analyzed using descriptive and inferential statistics. Conjoint analysis results for zero grazing net showed that cost was the most important factor influencing farmers’ decision, accounting for 38.52% of the total while durability and availability each accounted for 25% and retreatability accounted for 10% of the decisions. Further t-test results showed that there were significant differences between men and women with respect to attribute scores (at 99 d.f. and alpha = 0.05%) suggesting that men and women face different transaction costs in accessing T&T control technologies. Therefore there is need for gender sensitive strategies in T&T technology design and dissemination. Tsetse fly and Trypanosomiasis control by use of low cost technologies such as insecticide treated zero grazing net should be promoted by government and other development partners. The net should be affordable, available at supply outlets close to farmers, long lasting and re-treatable for famers to take it up.

The association between sexual orientation and screening of prevalent gender-specific cancers.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 198-198
Author(s):  
Michael Joseph Herriges ◽  
Ruben Pinkhasov ◽  
Keren Lehavot ◽  
Oleg Shapiro ◽  
Joseph M Jacob ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sexual Orientation ◽  
Cancer Screening ◽  
Bisexual Men ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Men And Women ◽  
Multivariable Logistic Regression ◽  
Gender Specific ◽  
Screening And Diagnosis

198 Background: Data on heterogeneity in cancer screening and diagnosis rates among sexual minorities (SMs) is lacking. Recent studies have shown SMs are more likely to engage in risky health behavior and have decreased healthcare utilization. However, few studies have examined how sexual orientation impacts cancer screening and prevalence. We therefore investigated whether sexual orientation affects prevalent gender-specific cancer including prostate (PCa), breast (BC), and cervical cancer (CC). Methods: This was a cross-sectional survey-based US study, including men and women aged 18+ from the Health Information National Trends Survey (HINTS) database (part of the National Cancer Institute’s division of cancer control and population sciences) between 2017-2019. The primary endpoint was individual-reported PCa, BC, and CC screening and prevalence rates among heterosexuals and homosexuals/bisexuals. Multivariable logistic regression analyses assessed association of various covariates with undergoing screening and diagnosis of these cancers. Results: Overall, 4,441 and 6,333 heterosexual men and women, respectively, were compared to 225 and 213 homosexual/bisexual men and women, respectively. Homosexuals/bisexuals were younger and less likely to be screened for PCa (34.7% vs 41.3%, p=0.013), BC (54.5% vs 80.7%, p=<0.001), and CC (88.3% vs 95.4%, p=<0.001). While rates of PCa and BC diagnosis were similar, more than twice as many homosexual/bisexual women were diagnosed with CC (4.2% vs 1.9%, p=0.023). Multivariable logistic regression models (Table) showed homosexuals/bisexuals were less likely to be screened for cancer with ORs of 0.61 (95% CI 0.39-0.95) for PCa, 0.52 (95% CI 0.30-0.92) for BC, and 0.21 (95% CI 0.09-0.46) for CC. Homosexuals/bisexuals were more likely to be diagnosed with any cancer with ORs of 1.64 (95% CI 1.06-2.54) in women only and 1.50 (95% CI 1.11-2.03) in men and women combined. Conclusions: Homosexuals/bisexuals in the US may be less likely to undergo screening of gender-specific prevalent malignancies, including PCa, BC, and CC. The implementation of cancer screening among SMs should be improved. [Table: see text]

How Different Health Literacy Dimensions Influences Health Status and Well-being among Men and Women: The Mediating Role of Health Behaviors

2020 ◽  
Author(s):  
Fan Zhang ◽  
Peggy Pui-Lai Or ◽  
Joanne Wai-Yee Chung
Keyword(s):  
Health Literacy ◽  
Health Behaviors ◽  
Health Knowledge ◽  
Well Being ◽  
Physical Symptoms ◽  
Literacy Skills ◽  
Subjective Well Being ◽  
Positive Health ◽  
Cross Sectional Survey ◽  
Men And Women

Abstract Background. Health literacy, the ability to access, understand, evaluate, and apply health information, was found to contribute to positive health outcomes, possibly via promoting healthy behaviors. However, the specific pathways linking different health literacy skills to health and well-being has remained unclear. Methods. A cross-sectional survey with structural questionnaires was administered among 2236 community-based adults in Hong Kong (mean age = 46.10 ±19.05). Health literacy was measured by HLS-Asian-47. Participants' health behavior, physical conditions, and subjective well-being were reported.Results. With structural modeling path analysis, health literacy in finding and understanding information showed a direct effect on enhancing physical health. While applying information capacity had an indirect positive effect via promoting health behaviors, which was moderated by sex. Only among women, this indirect effect predicting fewer physical symptoms and better well-being was significant.Conclusions. Although similar patterns were found in physical condition and well-being, distinct direct and indirect pathways were found of different health literacy dimensions for men and women. Based on the findings, by targeting specific health literacy skills, education programs should be developed to enhance women’s health knowledge, and men's application of the knowledge in healthy lifestyle.

High HIV prevalence among transgender women in Paraguay

2020 ◽  
Vol 31 (13) ◽  
pp. 1308-1314
Author(s):  
Gloria Aguilar ◽  
Tania Samudio ◽  
Gladys Lopez ◽  
Liliana Jimenez ◽  
Erin C Wilson ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Odds Ratio ◽  
Transgender Women ◽  
Hiv Prevalence ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cocaine Use ◽  
Related Risk ◽  
Trans Women

Transgender women have been understudied and underserved in Paraguay; data are urgently needed to understand their HIV prevention and care needs. To estimate HIV prevalence and related risk and preventive behaviors among trans women in Paraguay, we conducted a cross-sectional survey in 2017. We employed starfish sampling – a hybrid venue-based and peer-referral method combining recruitment at randomly sampled venues and randomly selected clients from program lists, followed by short-chain referrals of eligible peers. Among 304 trans women enrolled, HIV prevalence was 24.8% (95% confidence interval [CI] 18.5–31.2%), with risk increasing with age (adjusted odds ratio [AOR] 1.06 per year, 95% CI 1.03–1.10), residence in Asunción department (AOR 4.75, 95% CI 1.57–14.36), and cocaine use (AOR 2.09, 95% CI 1.11–3.95). Trans women in Paraguay need to be prioritized for interventions with high HIV prevention efficacy. Substance use interventions to address cocaine use may also yield prevention benefits for trans women in our context.

scholarly journals Associations of tobacco smoking with body mass distribution; a population-based study of 65,875 men and women in midlife

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sidsel Graff-Iversen ◽  
Stephen Hewitt ◽  
Lisa Forsén ◽  
Liv Grøtvedt ◽  
Inger Ariansen
Keyword(s):  
Cardiovascular Risk ◽  
Smoking Status ◽  
Health Indicators ◽  
Population Based ◽  
Lower Percentage ◽  
Body Region ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Men And Women ◽  
Never Smokers

Abstract Background Studies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently. The present study aimed to assess the associations of smoking status and volume smoked with HC and WC and their ratio in a population with low prevalence of obesity together with high prevalence of smoking. Methods We used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997–99 including 65,875 men and women aged 39–44 years. Analysis of associations were adjusted for confounding by socioeconomic position, health indicators, and additionally for BMI. Results Compared with never-smokers, when adjusting for confounders and in addition for BMI, mean HC remained lower while mean WC and waist-hip-ratio (WHR) were higher in current smokers. The finding of a lower HC and higher WHR level among smokers was consistent by sex and in strata by levels of education and physical activity, while the finding of higher WC by smoking was less consistent. Among current smokers, BMI-adjusted mean HC decreased whereas WC and WHR increased by volume smoked. Compared with current smokers, former smokers had higher BMI-adjusted HC, lower WHR and among women WC was lower. Conclusions The main finding in this study was the consistent negative associations of smoking with HC. In line with the hypothesis that lower percentage gluteofemoral fat is linked with higher cardiovascular risk, our results suggest that smoking impacts cardiovascular risk through mechanisms that reduce the capacity of fat storage in the lower body region.

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