scholarly journals Exploring the Perceived Risks and Benefits of Heroin Use among Young People (18–24 Years) in Mauritius: Economic Insights from an Exploratory Qualitative Study

2020 ◽  
Vol 17 (17) ◽  
pp. 6126
Author(s):  
Gareth White ◽  
Susan E. Luczak ◽  
Bernard Mundia ◽  
Smita Goorah
Keyword(s):  
Young People ◽  
Peer Influence ◽  
Illicit Drugs ◽  
Hiv Transmission ◽  
Service Providers ◽  
Heroin Use ◽  
Heroin Users ◽  
Risks And Benefits ◽  
Economic Framework ◽  
Persons Living With Hiv

The decreasing age of young people injecting illicit drugs is an under-reported challenge for the prevention of HIV transmission worldwide. Young people aged 15–24 years represent 1 in 5 persons living with HIV in Mauritius where the epidemic is driven by injecting drug use and risky sexual behaviours. We recruited 22 heroin users aged 18–24 and 5 service providers working in harm reduction (HR) for the present study. Qualitative data were collected through unstructured interviews. We adopted an economic framework and an inductive approach to the analysis, which implied revising codes and themes. The risks heroin users described as consumers of illicit drugs and as clients of HR services could not be analyzed in isolation. Polydrug use emerged as a recurrent coping mechanism resulting from the changing dynamics within the heroin market. The risks faced by women went beyond addiction and infection with HIV. How participants viewed the risks and benefits linked to using heroin was greatly influenced by gaps in knowledge that left room for uncertainty and reinforcing mechanisms such as peer influence. The study shows that qualitative research can produce in-depth socio-behavioural insights required to produce more effective services for young people.

The Experiences and Perspectives of African-Australian Community Service Providers Who Work with At-Risk and Justice-Involved Youth

2021 ◽  
pp. 0306624X2110226
Author(s):  
Stephane Shepherd ◽  
Aisling Bailey ◽  
Godwin Masuka
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Young People ◽  
Service Delivery ◽  
Community Service ◽  
Service Providers ◽  
Professional Staff ◽  
Youth Justice ◽  
Complex Needs ◽  
Australian Community

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) “What works” in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.

scholarly journals Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melvin Simuyaba ◽  
Bernadette Hensen ◽  
Mwelwa Phiri ◽  
Chisanga Mwansa ◽  
Lawrence Mwenge ◽  
...  
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Iterative Process ◽  
Service Use ◽  
Service Providers ◽  
Peer Pressure ◽  
Post Exposure Prophylaxis ◽  
Community Based ◽  
Research Activities ◽  
Lessons Learnt

Abstract Background Meeting the sexual and reproductive health (SRH) needs of adolescents and young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process of engaging AYP to finalise the design of a community-based, peer-led and incentivised SRH intervention for AYP aged 15–24 in Lusaka and the lessons learnt. Methods Between November 2018 and March 2019, 18 focus group discussions, eight in-depth interviews and six observations were conducted to assess AYP’s knowledge of HIV/SRH services, factors influencing AYP’s sexual behaviour and elicit views on core elements of a proposed intervention, including: community-based spaces (hubs) for service delivery, type of service providers and incentivising service use through prevention points cards (PPC; “loyalty” cards to gain points for accessing services and redeem these for rewards). A total of 230 AYP (15 participated twice in different research activities) and 21 adults (only participated in the community mapping discussions) participated in the research. Participants were purposively selected based on age, sex, where they lived and their roles in the study communities. Data were analysed thematically. Results Alcohol and drug abuse, peer pressure, poverty, unemployment and limited recreation facilities influenced AYP’s sexual behaviours. Adolescent boys and young men lacked knowledge of contraceptive services and all AYP of pre and post exposure prophylaxis for HIV prevention. AYP stated a preference for accessing services at “hubs” located in the community rather than the health facility. AYP considered the age, sex and training of the providers when choosing whom they were comfortable accessing services from. PPCs were acceptable among AYP despite the loyalty card concept being new to them. AYP suggested financial and school support, electronic devices, clothing and food supplies as rewards. Conclusions Engaging AYP in the design of an SRH intervention was feasible, informative and considered responsive to their needs. Although AYP’s suggestions were diverse, the iterative process of AYP engagement facilitated the design of an intervention that is informed by AYP and implementable. Trial registration This formative study informed the design of this trial: ClinicalTrials.gov, NCT04060420. Registered 19 August, 2019.

Addiction Time and Intellectual Impairment in Heroin Users

1987 ◽  
Vol 60 (3_part_2) ◽  
pp. 1099-1105
Author(s):  
Carlo Cipolli ◽  
Ivan Galliani
Keyword(s):  
Test Scores ◽  
Intellectual Functioning ◽  
Rorschach Test ◽  
Intellectual Impairment ◽  
Short Term ◽  
Heroin Use ◽  
Heroin Users

Rorschach test scores for male heroin users and nonusers ( ns = 15 each) were compared, to ascertain whether use of heroin influences intellectual impairment (as measured by such indicators of intellectual functioning as F+% and W+% responses). While the results show intellectual impairment to be greater in heroin users than in nonusers, the parametric and nonparametric indicators do not consistently show more marked impairment in long-term (4 to 5 yr. of addiction) than in short-term users (1 to 2 yr.). While intellectual functioning clearly seems influenced by heroin use, further research is required to ascertain the effect of the length of use either by comparing test and retest scores over a substantial interval or by matching samples including subjects with even longer careers of addiction.

Marijuana use among older adults in the U.S.A.: user characteristics, patterns of use, and implications for intervention

2010 ◽  
Vol 23 (5) ◽  
pp. 732-741 ◽  
Author(s):  
Diana M. DiNitto ◽  
Namkee G. Choi
Keyword(s):  
Older Adults ◽  
Psychological Distress ◽  
Social Service ◽  
Illicit Drugs ◽  
Service Providers ◽  
Adult Population ◽  
Marijuana Use ◽  
Well Being ◽  
Epidemiological Studies ◽  
Social Service Providers

ABSTRACTBackground: Epidemiological studies show that the number of older adults using marijuana is increasing. This study aimed to determine the correlates and patterns of marijuana use among older adults that might help health and social service providers better assist this group.Methods: Data are from the 2008 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration in the U.S.A. The sample consisted of 5,325 adults aged 50 years and older.Results: Of the sample, 2.8% were past-year marijuana users. Of them, 23% had used marijuana on at least half the days of the year. Past-year users were more likely to be younger (50–64 years old), black, and not married, and they had significantly higher psychological distress scores, but they did not rate their health as poorer than others in the sample, nor did they attribute many problems, including psychological problems, as being related to their marijuana use. Nevertheless, past-year users present a high-risk profile because, in addition to frequent marijuana use, they also are more likely to smoke cigarettes, engage in binge drinking, and use other illicit drugs.Conclusions: Health and social service providers should be alert to the small number of routine marijuana users among the younger members of the older adult population, especially those suffering significant psychological distress, so that these individuals can be encouraged to utilize services that will help alleviate this distress and promote a healthier lifestyle and increase general well being.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P < .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P < .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

The transion of consumption patterns of heroin users in Belgrade

2011 ◽  
Vol 26 (S2) ◽  
pp. 123-123
Author(s):  
S. Vucetic-Arsic ◽  
M. Stankovic ◽  
S. Alcaz ◽  
M. Nikic
Keyword(s):  
Drug Users ◽  
Illicit Drug ◽  
Consumption Patterns ◽  
Lifetime Prevalence ◽  
Young Population ◽  
Heroin Use ◽  
Heroin Users ◽  
Survey Technique ◽  
Special Hospital ◽  
Main Pattern

ObjectiveDuring the last two decades illicit drug use in Belgrade has been changed.Previously, one of the most common methods of illicit heroin use was via intravenous injection. In 1987, injecting drug, as main consumption patterns was accepted by 90,6% of patients, although intravenous administration fell to 75,5% in 1995.The aim of the study was to observe if the main pattern of heroin consumption had changed lately.MethodsThe study included 382 illicit drug users (mean age 28,8 ± 4,7; both gender) treated in Special Hospital for Addiction, Belgrade in period of a year (Sept. 2009–2010).We used data from Pompidou questionnaire and calculated prevalence through standard survey technique.ResultsA total of 94,5% respondents reported a lifetime prevalence of heroin as a main drug, 1,1% of other opiates, 0,3% of cocaine and amphetamine. More than 92,7% of respondents used heroin in the last month regularly. The lifetime prevalence consumption mode for intranasal use was 44,3%, injecting 39,8% and smoking/ inhaling 13,9%.First injectable route experience is reported for age 17–19 = 11.9%; for 20–22 = 25.6%; for 23–26 = 30-3%. The total number of 79,8% reported negative HIV testing result, 0,5% positive result.ConclusionThe consumption model changed in last 10 years and our study confirmed significant diversity. Intranasal administration linked with young population of heroin addicts, who never or rarely use injectable route with low level of HIV infection. Older addicts prefer intravenous use and often change to intranasal route later, for safety or damaged process of peripheral blood vessel.

scholarly journals Drug-Related Deaths Among Young People Involved in The Criminal Justice System: A Whole-Population Multi-Sectoral Data Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Jesse T Young ◽  
Holly Tibble ◽  
Rohan Borschmann ◽  
Stuart A Kinner
Keyword(s):  
Young People ◽  
Justice System ◽  
Illicit Drugs ◽  
Young Person ◽  
Linkage Study ◽  
Community Treatment ◽  
Health Concern ◽  
Youth Justice ◽  
Formerly Incarcerated ◽  
System A

IntroductionDrug-related death is substantially higher in formerly incarcerated adults compared to the general population. Despite this, remarkably little is known about the epidemiology of drug-related death among justice-involved adolescents. A richer understanding of drug-related mortality in justice-involved young people is essential for the development of effective, evidence-based interventions for this vulnerable group. Objectives and ApproachIn a whole-population cohort of justice-involved young people in Queensland, Australia, we aimed to: 1) calculate the rate of drug-related death overall, and separately by intent and drug category; and 2) estimate the probability, and identify the predictors of, drug-related death. We probabilistically linked Youth Justice Queensland and National Death Index (NDI) records for every young person who came into contact with the youth justice system in Queensland between 1 January 1993 and 31 December 2014 (N=48,963). The NDI provided death data until 31 December 2017. Crude mortality rates (CMR) were calculatedoverall, separately by intent, and by prescribed versus illicit drug cause. Competing risk survival analysis will be conducted. ResultsOf the 48,963 individuals, 1452 (3%) died by 31 December 2017. Of these, 204 (14%) deaths were due to drugs, yielding a CMR of 31 (95%CI:27-36) per 100,000 person-years. Most drug-related deaths were recorded as intentional (CMR=28; 95%CI:24-33 per 100,000 person-years) and deaths from prescribed medications were more common than illicit drugs (CMR=17; 95%CI:14-20 and CMR=11; 95%CI:9-14 per 100,000 person-years, respectively). Conclusion / ImplicationsRates of drug-related deaths following contact with the youth justice system are disproportionately high and represent a major public health concern. Our findings highlight the importance of initiation of alcohol and other drug (AOD) treatment upon contact with the youth justice system and continuous engagement with community treatment after discharge from the youth justice system. Evidenced-base prevention strategies and efforts to improve the continuity of care are urgently needed.

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