Human Immunodeficiency Virus Prevention and the Potential of Drug Abuse Treatment

Metzger, David S.; Navaline, Helen

doi:10.1086/377548

Cited by 46 publications

(38 citation statements)

References 29 publications

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“…Greater integration of drug use topics into HIV risk reduction interventions is needed along with more attention to the drug use in the context of sexual risk practices (Herbst et al 2005). Integration of STI/HIV care with substance abuse education and treatment also is warranted (Hirshfield et al 2004;Metzger and Navaline 2003;Metzger et al 1998). Drug treatment has been shown to decrease HIV risk and HIV infections, as well as significantly lower rates of drug use, drug-related behaviors, and HIV infections among drug users who remain in treatment programs (Gibson et al 1999;Metzger et al 1993;Metzger and Navaline 2003;Shoptaw et al 2005).…”

Section: Discussionmentioning

confidence: 99%

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

et al. 2008

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We examined how drugs, high-risk sexual behaviors, and socio-demographic variables are associated with recent HIV infection among men who have sex with men (MSM) in a case-control study. Interviewers collected risk factor data among 111 cases with recent HIV infection, and 333 HIV-negative controls from Chicago and Los Angeles. Compared with controls, cases had more unprotected anal intercourse (UAI) with both HIV-positive and HIV-negative partners. MSM with lower income or prior sexually transmitted infections (STI) were more likely to be recently HIV infected. Substances associated with UAI included amyl nitrate ("poppers"), methamphetamine, Viagra (or similar PDE-5 inhibitors), ketamine, and gamma hydroxybutyrate (GHB). Cases more frequently used Viagra, poppers, and methamphetamine during UAI compared with controls. In multivariate analysis, income, UAI with HIV-positive partners, Viagra, and poppers remained associated with recent HIV seroconversion. Better methods are needed to prevent HIV among MSM who engage in high-risk sex with concurrent drug use.

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Section: Discussionmentioning

confidence: 99%

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

et al. 2008

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“…There is evidence that, many IDUs have changed their injection drug practices to reduce their HIV risk (Quan et al, 2002). This evidence includes studies of drastically reduced HIV incidence among IDUs participating in interventions such as syringe exchange (Ksobiech, 2003), community outreach (Needle et al, 2005), and drug abuse treatment (Metzger and Navaline, 2003). There is also strong evidence that when HIV prevention interventions are implemented on a sufficiently large scale, it is possible to avert HIV epidemics among IDUs (Des Jarlais et al, 1995a).…”

Section: Parenteral Transmission Of Hiv In Idusmentioning

confidence: 99%

Behavior Change and Health-Related Interventions for Heterosexual Risk Reduction Among Drug Users

Semaan

Jarlais

Malow

2006

Substance Use & Misuse

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Prevention of heterosexual transmission of HIV between and from drug users is important for controlling the local and global HIV heterosexual epidemic. Sex risk reduction interventions and health-related interventions are important for reducing the sex risk behaviors of drug users. Sex risk reduction interventions address individual-level, peer-level, and structural-level determinants of risk reduction. Health-related interventions include HIV counseling and testing, prevention and treatment of sexually transmitted diseases, and delivery of highly active antiretroviral therapy. It is important to adapt effective interventions implemented in resource-rich countries to the realities of the resourceconstrained settings and to address relevant contextual factors.RESUMEN-Il est important de prévenir la transmission hétérosexuelle du VIH à partir des usagers de drogue pour contrôler l'épidémie hétérosexuelle locale et mondiale de VIH. Des interventions ciblant à la fois la réduction de risque sexuel et la santé des usagers de drogue sont nécessaires. Les interventions de réduction de risque sexuel prennent en compte le niveau individuel, le niveau des pairs et celui des déterminants structurels de la réduction des risques. Les interventions visant l'amélioration de la santé comprennent le conseil et le dépistage du VIH, la prévention et le traitement des infections sexuellement transmissibles et la prescription d'antirétroviraux. Il est important d'adapter les interventions efficaces mises en place dans les pays riches aux réalités des contextes de pays à ressources limitées et de tenir compte des facteurs contextuels pertinents. Keywords global research; HIV; injection drug use; research interventions; sexual risk HIV Infection and Injection Drug UsersInjection drug use continues to complicate the control of the global HIV epidemic (UNAIDS, 2004). In 2003, 136 countries reported injecting drug use and 93 countries reported HIV infection among injection drug users (IDUs) (World Health Organization, 2003). IDUs are at risk for infection with HIV through both multiperson use ("sharing") of drug injection equipment and through unsafe sex behaviors (Aceijas et al., 2004). Although the scope and effectiveness of interventions aimed at reducing HIV infection through drug injection equipment has been well documented in the literature (Des Jarlais et al., 2005;Quan et This review describes sex risk reduction interventions with drug users and their effectiveness in reducing sexual risk behaviors of IDUs and other drug users. We highlight the needs and opportunities for these interventions, discuss the generalizability of the results to resourceconstrained settings, and outline the implications for global research efforts and public health practice. Although our literature review is not comprehensive, it highlights many areas that affect sexual transmission of HIV to and from drug users in both resource-rich and resourceconstrained settings. Efforts to reduce substance abuse and HIV risk associated with injection behav...

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“…Drug abuse treatment, particularly opioid agonist regimens such as methadone maintenance are effective in reducing the frequency of injection drug use, and subsequently, the incidence of HIV infection (Metzger and Navaline, 2003) and tuberculosis (Snyder et al, 1999). Since only 15-20% of IDUs are enrolled in a drug treatment program at any given time in the U.S. (Metzger and Navaline, 2003), increasing the number and proportion of drug users in treatment is an important public health goal.…”

Section: Introductionmentioning

confidence: 99%

Facilitating entry into drug treatment among injection drug users referred from a needle exchange program: Results from a community-based behavioral intervention trial

Strathdee

Ricketts

Huettner

et al. 2006

Drug and Alcohol Dependence

118

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We evaluated a case management intervention to increase treatment entry among injecting drug users referred from a needle exchange program (NEP). A randomized trial of a strengths based case management (intervention) versus passive referral (control) was conducted among NEP attenders requesting and receiving referrals to subsidized, publicly funded opiate agonist treatment programs in Baltimore, MD. Logistic regression identified predictors of treatment entry within 7 days, confirmed through treatment program records. Of 247 potential subjects, 245 (99%) participated. HIV prevalence was 19%. Overall, 34% entered treatment within 7 days (intervention: 40% versus control: 26%, p = 0.03). In a multivariate "intention to treat' model (i.e., ignoring the amount of case management actually received), those randomized to case management were more likely to enter treatment within 7 days. Additional 'as treated' analyses revealed that participants who received 30 min or more of case management within 7 days were 33% more likely to enter treatment and the active ingredient of case management activities was provision of transportation. These findings demonstrate the combined value of offering dedicated treatment referrals from NEP, case management and transportation in facilitating entry into drug abuse treatment. Such initiatives could be implemented at more than 140 needle exchange programs currently operating in the United States. These data also support the need for more accessible programs such as mobile or office-based drug abuse treatment.

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Human Immunodeficiency Virus Prevention and the Potential of Drug Abuse Treatment

Cited by 46 publications

References 29 publications

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

Behavior Change and Health-Related Interventions for Heterosexual Risk Reduction Among Drug Users

Facilitating entry into drug treatment among injection drug users referred from a needle exchange program: Results from a community-based behavioral intervention trial

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