Risk factors for human immunodeficiency virus infection in intravenous drug users

Schoenbaum, Ellie E.; Hartel, Diana; Selwyn, Peter A.; Klein, R S; Davenny, Katherine; Rogers, Martha F.; Feiner, Cheryl; Friedland, Gerald

doi:10.1097/00004714-199002000-00019

Cited by 42 publications

(56 citation statements)

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“…Although not confirmed by the multivariate analyses, our results coincide with prior reports that demonstrate that among IDUs, HIV infection is linked to frequency of injection (Marmor et al 1987, Schoenbaum et al 1989. Furthermore, injection drug use in the prior two months was among several risk behaviors significantly associated with HIV infection in a drug injectors community of Santos, Brazil (de Carvalho et al 1996).…”

Section: Discussionsupporting

confidence: 86%

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida

McCoy¹,

Metsch²,

Collado-Mesa³

et al. 2004

Mem. Inst. Oswaldo Cruz

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Section: Discussionsupporting

confidence: 86%

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida

McCoy¹,

Metsch²,

Collado-Mesa³

et al. 2004

Mem. Inst. Oswaldo Cruz

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“…The simultaneous intravenous administration of heroin and cocaine known as the 'speedball' is common among polydrug abusers (Schütz et al, 1994) and concurrent cocaine and opioid abuse often continues during opioid agonist treatment (Beswick et al, 2001;Williamson et al, 2006). Speedball abuse may be associated with compromised immune function, and vulnerability to viral infections (AIDS, hepatitis) and bacterial infections (endocarditis, pulmonary infections, abscesses) (Schoenbaum et al, 1989;Kreek, 1991;Pillai et al, 1991;O'Brien, 1996). Treatment of dual dependence on cocaine and opioids presents a special challenge, because pharmacotherapies for opioid abuse usually are less effective in reducing cocaine abuse, and identification of a consistently effective pharmacotherapy for cocaine abuse remains elusive (Mendelson and Mello, 1996;Vocci et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Effects of d-Amphetamine and Buprenorphine Combinations on Speedball (Cocaine+Heroin) Self-Administration by Rhesus Monkeys

Mello

Negus

2007

Neuropsychopharmacol

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The simultaneous i.v. administration of heroin and cocaine, called a 'speedball,' is often reported clinically, and identification of effective pharmacotherapies is a continuing challenge. We hypothesized that treatment with combinations of a monoamine releaser d-amphetamine, and a mu partial agonist, buprenorphine, might reduce speedball self-administration by rhesus monkeys. Speedballs (0.01 mg/kg/inj cocaine + 0.0032 mg/kg/inj heroin) and food (1 g banana-flavored pellets) were available during four daily sessions on a second-order schedule of reinforcement (fixed ratio (FR)2 (variable ratio (VR)16:S)). Monkeys were treated for 10 days with saline or ascending doses of d-amphetamine (0.0032-0.032 mg/kg/h) + buprenorphine (0.075 or 0.237 mg/kg/day) in combination. d-Amphetamine + both doses of buprenorphine produced an amphetamine dose-dependent decrease in speedball self-administration in comparison to the saline treatment baseline (Po0.01-0.001), but food-maintained responding did not change significantly. d-Amphetamine alone (0.032 mg/kg/h) significantly decreased both food (Po0.01) and speedball-maintained responding (Po0.05). During saline control treatment, speedball unit doses of 0.0032 mg/kg/inj cocaine + 0.001 mg/kg/inj heroin were at the peak of the speedball dose-effect curve. Daily treatment with 0.01 mg/kg/h d-amphetamine + 0.237 mg/kg/day buprenorphine produced a significant downward and rightward shift in the speedball dose-effect curve (Po0.01) and no significant effect on food-maintained responding. A significant decrease in speedball self-administration was sustained over 10 days of treatment. These findings are consistent with our previous reports and suggest that medication mixtures designed to target both the stimulant and the opioid component of the speedball may be an effective approach to polydrug abuse treatment.

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“…Substance abuse can lead to high-risk sexual behaviors by affecting decision making, compromising judgment, decreasing the likelihood of condom use, and increasing the likelihood of sex-for-drug exchanges and injection drug use. [58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] Yet, research on non-injection drug use and HIV/STIs has lagged considering its importance in the current HIV/STI epidemic.Taken together, these findings mirror changing patterns of transmission of HIV/STIs in the general population. In the early stages of the HIV/STI epidemic, the most common patterns of transmission were injection drug use (approximately one quarter of AIDS cases) and male-tomale sex (two thirds of AIDS cases).…”

mentioning

confidence: 99%

A Longitudinal Study of the Prevalence, Development, and Persistence of HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth: Implications for Health Care in the Community

Romero

Teplin²,

McClelland³

et al. 2007

Pediatrics

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Objective-. To examine the prevalence, development, and persistence of sex and drug behaviors that place delinquent youth at risk for human immunodeficiency virus and other sexually transmitted infections (HIV/STI).Methods-At the baseline interview, HIV/STI drug and sex risk behaviors were assessed in a stratified random sample of 800 juvenile detainees, aged 10 to 18 years. Participants were reinterviewed approximately 3 years later (mean [SD] follow-up, 3.2 [0.3] years; median follow-up, 3.1 years). The final sample in these analyses (n = 724) includes 316 females and 408 males, 393 African Americans, 198 Hispanics, 131 non-Hispanic whites, and 2 participants who self-identified as "other."Results-Nearly three quarters of youth engaged in one or more unprotected sexual risk behaviors at follow-up. Over 60% had engaged in 10 or more risk behaviors at their baseline interview, and nearly two thirds of them persisted in 10 or more risk behaviors at follow-up. Among youth living in the community, many behaviors were more prevalent at follow-up than at baseline. Among incarcerated youth, the opposite pattern prevailed. Development and persistence of HIV/STI risk behaviors differed by gender, race/ethnicity, and age, even after adjusting for incarceration status. Compared with females, males had higher prevalence rates of many HIV/STI risk behaviors and were more likely to persist in some behaviors and develop new ones. Yet, injection risk behaviors were more prevalent among females than males and were also more likely to develop and persist. Compared with persons younger than 18, persons 18 and older had higher prevalence rates of many HIV/STI risk behaviors at follow-up. Overall, there were few racial and ethnic differences in patterns of HIV/STI risk behaviors; most involved the initiation and persistence of substance use among nonHispanic whites and Hispanics.Conclusions-Because detained youth have a median stay of only 2 weeks, HIV/STI risk behaviors in delinquent youth are a community public health problem, not just a problem for the juvenile justice system. Improving the coordination among systems that provide HIV/STI interventions to youth -primary care, education, mental health, and juvenile justice -can reduce the prevalence of risk behaviors and substantially reduce the spread of HIV/STI in young people.Corresponding Author: Linda A. Teplin, PhD, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lakeshore Drive, Suite 900, Chicago, IL 60611. . psycholegal@northwestern.edu. NIH Public Access Author ManuscriptPediatrics. Author manuscript; available in PMC 2010 January 29. Published in final edited form as:Pediatrics. 10-14Minorities are also overrepresented in the juvenile justice system, where HIV/STI risk behaviors are prevalent. 15-20 Detained youth report more risk behaviors and initiate them at younger ages than do youth in the community.21 Detained youth are likely to be at continued risk for HIV infection as they age. Adults in p...

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Risk factors for human immunodeficiency virus infection in intravenous drug users

Cited by 42 publications

References 0 publications

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida

Effects of d-Amphetamine and Buprenorphine Combinations on Speedball (Cocaine+Heroin) Self-Administration by Rhesus Monkeys

A Longitudinal Study of the Prevalence, Development, and Persistence of HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth: Implications for Health Care in the Community

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