injection risk
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2021 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Joshua Falk ◽  
Carl Latkin ◽  
Maggie Kaufmann ◽  
Leslie Williams ◽  
...  

Abstract Background Hepatitis C (HCV) infection has been rising in the suburban and rural United States, mainly via injection-based transmission. Injection and sexual networks are recognized as an important element in fostering and preventing risky behavior, however the role of social support networks has received somewhat less attention. Methods Using baseline data from an ongoing longitudinal study, we examined the composition and structure of injection drug use (IDU), sex, and social support networks of young people who inject drugs (aged 18-30) and their injection network members. Lasso logistic regression was used to select a subset of network characteristics that were potentially important predictors of injection risk behaviors and HCV exposure. Results Several measures of IDU, sexual and support network structure and composition were found to be associated with HCV exposure, receptive syringe sharing (RSS), and ancillary equipment sharing. Gender and sexual relationships were important factors for all risk behaviors. Support network characteristics were also important, notably including a protective effect of majority Hispanic support networks for RSS and HCV exposure. Both IDU network residence heterogeneity and support network geography were associated with injection equipment sharing. Conclusions The associations of IDU and support network geography with equipment sharing highlight the need to extend harm reduction efforts beyond urban areas. Greater understanding of support network influences on risk behavior may provide important insights to strengthen the benefits of harm reduction. In considering the probability of HCV transmission, it is important to consider setting and network structures that promote propagation of risk.



2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yesenia Aponte-Melendez ◽  
Pedro Mateu-Gelabert ◽  
Chunki Fong ◽  
Benjamin Eckhardt ◽  
Shashi Kapadia ◽  
...  

Abstract Background While people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding the impact of the current pandemic on PWID. We examine how COVID-19 has affected PWID in New York City across four domains: substance use, risk behaviors, mental health, and service utilization. Methods As part of a randomized trial to improve access to HCV treatment for PWID, we recruited 165 participants. Eligibility criteria included detectable HCV RNA and recent drug injection. The present cross-sectional analysis is based on a subsample of 106 participants. We compared responses between two separate samples: 60 participants interviewed prior to the pandemic (pre-COVID-19 sample) and 46 participants interviewed during the pandemic (COVID-19 sample). We also assessed differences by study group [accessible care (AC) and usual care (UC)]. Results Compared to the pre-COVID-19 sample, those interviewed during COVID-19 reported higher levels of mental health issues, syringe reuse, and alcohol consumption and greater reductions in syringe-service programs and buprenorphine utilization. In the analysis conducted by study group, the UC group reported significantly higher injection risk behaviors and lower access to buprenorphine treatment during COVID-19, while during the same period, the AC group reported lower levels of substance use and injection risk behaviors. Conclusion The current study provides insight on how COVID-19 has negatively affected PWID. Placing dispensing machines of harm-reduction supplies in communities where PWID live and increasing secondary exchange, mobile services, and mail delivery of supplies may help maintain access to lifesaving supplies during big events, such as COVID-19. Trial registration ClinicalTrials.gov NCT03214679. Registered July 11 2017. https://clinicaltrials.gov/ct2/show/NCT03214679.



Author(s):  
Juan-Miguel Guerras ◽  
Juan Hoyos ◽  
Luis de la Fuente ◽  
Francisca Román ◽  
Oskar Ayerdi ◽  
...  

This study describes the prevalence of anabolic-androgenic steroid (AAS) injection, their main correlates, and the prevalence of specific AAS injection risk behaviours among men who have sex with men (MSM), an area insufficiently addressed in scientific research. Participants were HIV-negative MSM attending four HIV/STI diagnosis services: two clinics and two community programmes in Madrid and Barcelona. Participants answered an online self-administered questionnaire. Crude and adjusted lifetime prevalence and prevalence ratios (PRs) were calculated by different factors and using Poisson regression models with robust variance. Of the 3510 participants, 6.1% (95% CI: 5.3–6.9) had injected AAS before and 3.5% (95% CI: 2.9–4.2) had done so in the last 12 months. In the multivariate analysis, AAS injection was independently associated with being over 40 years old (aPR = 3.6; 95% CI: 2.0–6.5) and being born in Latin America (aPR = 2.5; 95% CI:1.9–3.4), and was less strongly associated (aPRs of around two) with having been recruited into STI clinics, having ever been paid for sex before, injected drugs, used drugs for sex, having been diagnosed with an STI before, and having been diagnosed with HIV at the recruitment consultation. Only three participants, 1.4%, of those who had injected AAS before had shared AAS or equipment for preparation or injecting before. Conclusions: In contrast to drugs, AAS injecting behaviours do not play a relevant, direct role in the transmission of blood-borne infections among MSM. However, AAS injectors have a higher prevalence of sexual risk behaviours. These findings should be confirmed using new studies that employ other sampling procedures.



2021 ◽  
Vol 127 ◽  
pp. 108344
Author(s):  
Tyler S. Bartholomew ◽  
Daniel J. Feaster ◽  
Hardik Patel ◽  
David W. Forrest ◽  
Hansel E. Tookes




2021 ◽  
Author(s):  
Anna L. Hotton ◽  
Mary Ellen Mackesy-Amiti ◽  
Basmattee Boodram

AbstractBackgroundAmong young people who inject drugs (PWID) homelessness is associated with numerous adverse psychosocial and health consequences, including risk of relapse and overdose, psychological distress and suicidality, limited treatment access, and injection practices that increase the risk of HIV and hepatitis C (HCV) transmission. Homeless PWID may also be less likely to access sterile syringes through pharmacies or syringe service programs.MethodsThis study applied random-effects meta-regression to examine trends over time in injection risk behaviors and homelessness among young PWID in Chicago and surrounding suburban and rural areas using data from 11 studies collected between 1997 and 2017. In addition, subject-level data were pooled to evaluate the effect of homelessness on risk behaviors across all studies using mixed effects logistic and negative binomial regression with random study effects.ResultsThere was a significant increase in homelessness among young PWID over time, consistent with the general population trend of increasing youth homelessness. In mixed-effects regression, homelessness was associated with injection risk behaviors (receptive syringe sharing, syringe mediated sharing, equipment sharing) and exchange sex, though we detected no overall changes in risk behavior over time.ConclusionsIncreases over time in homelessness among young PWID highlight a need for research to understand factors contributing to youth homelessness to inform HIV/STI, HCV, and overdose prevention and intervention services for this population.



2020 ◽  
Vol 39 (7) ◽  
pp. 898-907
Author(s):  
Jennifer P. Jain ◽  
Steffanie A. Strathdee ◽  
Brooke S. West ◽  
Patricia Gonzalez‐Zuniga ◽  
Gudelia Rangel ◽  
...  


2020 ◽  
Vol 52 (5) ◽  
pp. 336-346 ◽  
Author(s):  
Martin Kåberg ◽  
Niklas Karlsson ◽  
Andrea Discacciati ◽  
Katarina Widgren ◽  
Ola Weiland ◽  
...  


Web Applications are commonly using all the services made available online. The rapid development of the Internet of Things (IOT), all the organizations provides their services and controlled through an online, like online transaction of money, business transaction of buying and selling the products, healthcare services, military and GPS Systems. Web application development and maintenance is very difficult based on the security. Attacks are many forms to stealing the secure, personal information and privacy data. There is one major open source community Open Web Application Security Project (OWASP) providing information, development and validation of web application projects to make application to be secure. This research work, discussing few of the solutions, detection and prevention methods of Injection risk out of the top 10 OWASP risks. Due to the injection risk, impact on business that may lead to loss of information, unauthorized access of personal and secure information.



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