Heterosexual transmission of HIV-1 associated with the use of smokable freebase cocaine (crack)

Chiasson, Mary Ann; Stoneburner, Rand; Hildebrandt, Deborah S.; Ewing, William E.; Telzak, Edward E.; Jaffe, Harold W.

doi:10.1097/00002030-199109000-00011

Cited by 245 publications

(84 citation statements)

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“…Further, both crack smoking (Chaisson et al, 1991;Edlin et al, 1994) and nitrite inhalant use (Seage et al, 1992;Chesney et al, 1998) have been associated with an increased risk of HIV-infection. These associations have been related to the exchange of high-risk sex for drugs (Chaisson et al, 1991;Edlin et al, 1994), to their occurrence within high risk social networks (Neaigus et al, 1994), and potentially to contact between contaminated drug use paraphernalia and oral and buccal mucosal abrasions and lesions .…”

Section: Discussionmentioning

confidence: 99%

“…These associations have been related to the exchange of high-risk sex for drugs (Chaisson et al, 1991;Edlin et al, 1994), to their occurrence within high risk social networks (Neaigus et al, 1994), and potentially to contact between contaminated drug use paraphernalia and oral and buccal mucosal abrasions and lesions .…”

Section: Discussionmentioning

confidence: 99%

“…Practices that involve sharing smoke between two or more individuals carry a risk of drug-related disease transmission, both through the act of drug use itself (Ungerleider et al, 1982;Taylor et al, 1982;Hamadeh et al, 1988;Livengood et al, 1985;Centers for Disease Control, 1991;Leonhardt et al, 1994) and through related high risk sexual activity and sexual activity in high risk social networks (Chaisson et al, 1991;Edlin et al, 1994;Neaigus et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

“…However, many inhalation drug users are new illicit drug users van Ameijden et al, 1994) and this augments the pool of individuals at risk for transition to injection drug use van Ameijden et al, 1994;Irwin et al, 1996). Further, crack smoking has been associated with an increased risk of HIV infection, particularly through the exchange of high-risk sex for drugs (Chaisson et al, 1991;Edlin et al, 1994) as has nitrite inhalant use (Seage et al, 1992;Chesney et al, 1998). Thus the increased population of inhalational drug users poses a challenge to HIV prevention e orts van Ameijden et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

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Doing a shotgun: a drug use practice and its relationship to sexual behaviors and infection risk

Perlman

Henman

Kochems

et al. 1999

Social Science & Medicine

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There has been a rise in the frequency with which inhalational routes such as smoking are used for illicit drug use. A growing population of new inhalational drug users augments the pool of individuals at risk for transition to injection drug use. Further, illicit drug smoking has been implicated in the transmission of a variety of pathogens by the respiratory route, and crack smoking has been associated with an increased risk of HIV infection, particularly through the exchange of high-risk sex for drugs. Shotguns are an illicit drug smoking practice in which smoked drugs are exhaled or blown by one user into the mouth of another user. We conducted a series of ethnographic observations to attempt to characterize more fully the practice of shotgunning, the range of associated behaviors, and the settings and contexts in which this practice occurs. Shotguns may be seen as a form of drug use which has close ties to sexual behaviors, and which has both pragmatic and interpersonal motivations, combining in a single phenomenon the potential direct and indirect risk of disease transmission by sexual, blood borne and respiratory routes. These data support the need to develop and evaluate comprehensive risk reduction interventions, which take into consideration the relationships between interpersonal and sexual behaviors and speci®c forms of drug use. #

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Doing a shotgun: a drug use practice and its relationship to sexual behaviors and infection risk

Perlman

Henman

Kochems

et al. 1999

Social Science & Medicine

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“…Studies have shown the association of heterosexually acquired HIV infection with both alcohol 1 and non-injected forms of cocaine. 11 The role of local patterns of alcohol and illicit drug use in the spread of HIV infection in small Brazil- More than half of the patients (36 out of 65) first presented in advanced stages of HIV-disease (CDC stages C, A3 or B3). These cases show the frequent occurrence of HIV infection in subjects who were not aware of their HIV status or not willing to get medical treatment.…”

Section: Discussionmentioning

confidence: 99%

HIV infection and AIDS in a small municipality in Southeast Brazil

2005

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ObjectiveStudies on the aspects of HIV infection in small Brazilian municipalities are invaluable to appropriately design control strategies, better allocate resources, and improve health care services. The objective of the study was to assess the clinical and epidemiological aspects of HIV infection in a small municipality. Methods A descriptive study was carried out in Miracema, a small municipality in the northwestern area of the state of Rio de Janeiro, Brazil, between July 1999 and December 2003. All HIV-infected adult patients followed up at the local HIV/AIDS Program were included. Clinical and epidemiologic characteristics were prospectively assessed through standardized questionnaires. Results A total of 65 adult patients who attended the local HIV/AIDS Program were analyzed. Most (34) were women (male to female ratio: 0.9). An absolute predominance of patients who were born in Miracema or neighboring municipalities (94%), lived in Miracema (90.7%), were single (70.8%), attributed the acquisition of HIV infection to unprotected heterosexual intercourse (72.3%) and had a past history of snorting cocaine (27.7) was found Central nervous system disorders (including five cases of cryptococcal meningitis) and acute pulmonary pneumocystosis-like respiratory failure were major causes of morbidity. Most patients (56.9%) were at presented in advanced stages of HIV infection. ConclusionsThe predominance of patients on advanced stages of HIV infection suggest the existence of a large pool of undiagnosed cases in the community. A major feature of the cohort was an inverted male to female ratio. Further investigations over a broader geographic area are urgently needed for better understanding the clinical and epidemiological characteristics of HIV infection in small Brazilian municipalities and rural areas. Resumo Objetivo

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