Syringe-mediated drug-sharing (backloading): a new risk factor for HIV among injecting drug users

Jose, Benny; Friedman, Samuel R.; Neaigus, Alan; Curtis, Richard; Grund, Jean Paul; Goldstein, Mark A.; Ward, Thomas P.; Jarlais, Don C. Des

doi:10.1097/00002030-199312000-00017

Cited by 118 publications

(49 citation statements)

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“…Fortunately, despite having a multiplicity of motivations and symbolic meanings imbedded in social contexts, needle sharing behaviors have been amenable to behavior change (Des Jarlais et al, 1994b suggesting the potential for behavior change regarding drug smoking behaviors such as`doing a shotgun'. However, as with the direct sharing of syringes, the sharing of ®lters and spoons, and indirect syringe sharing through front and backloading practices (Jose et al, 1993;Hunter et al, 1995), it may be necessary to develop interventions which take into account the social contexts and social etiquette' related to these behaviors in order to e ect long term behavior change and risk reduction (Hunter et al, 1995;Grund et al, 1996;Rhodes and Quirk, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there is a need for a fuller understanding of inhalational drug use practices, their correlates and consequences. Ethnographic observations have been valuable in characterizing the range of drug injection practices and in delineating the practices which are associated with infectious complications and the transmission of HIV (Grund, 1993;Jose et al, 1993;Koester, 1994;Trotter, 1995;Grund et al, 1996). Less attention has been devoted to characterizing the practices of inhalation drug use which might confer the risk of infection.…”

Section: Social Science and Medicine 48 (1999) 1441±1448mentioning

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: Social Science and Medicine 48 (1999) 1441±1448mentioning

confidence: 99%

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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“…24,25 HIV risk occurs when a blood-tainted syringe is used by someone else to inject drugs or if the drug solution and equipment become contaminated when the blood-tainted syringe is (a) reused to add water when preparing additional drugs or (b) used to divide drugs solution when more than one person is sharing. 26 Injectors share drug solutions by drawing from a common container; backloading is the term for when the drug solution is transferred through the back, or plunger end of the receiving syringe, 27 and frontloading is when the needle is removed from a second syringe and drug is transferred through the front of that syringe. 28,29 Frontloading is less common in the United States than in other countries because diabetic syringes commonly used in the United States do not have detachable needles.…”

Section: What Have We Learned About Individual Hiv Risk Behaviors Of mentioning

confidence: 99%

“…33 Epidemiologic links between HIV and sharing drug solution and equipment have been documented but are not as strong as the links between HIV and syringe sharing. 27,29,[33][34][35][36][37] The potential for HIV transmission through drug solution and equipment is inferred from studies that show association between these behaviors and other blood-borne viruses; findings of HIV antibodies and HIV polymerase chain reaction gene products in used syringes, cotton, cookers, and water 38 ; and laboratory studies demonstrating potential for HIV transmission.…”

Section: What Have We Learned About Individual Hiv Risk Behaviors Of mentioning

confidence: 99%

Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

Garfein²,

et al. 2006

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In a changing public health landscape in which local, state, and federal agencies must confront threats of bioterrorism, emerging infections, and numerous chronic diseases, transmission of HIV among injection drug users (IDUs) continues to be an important public health issue and one of the driving forces behind the HIV epidemic. Using a computerized MEDLINE search of published articles from January 1981 through October 2005, we conducted a literature review of practical epidemiologic aspects of HIV/AIDS among IDUs in the United States. Although recent trends indicate a decline in the proportion of newly diagnosed HIV infections associated with injection drug use, drug-use behaviors overall still account for 32% of new HIV diagnoses. Factors in addition to syringe sharing contribute to HIV transmission among IDUs: risky sexual behaviors, sharing of drug preparation equipment and drug solutions, and contextual and social factors. Promising approaches for HIV prevention include rapid HIV testing, office-based substance abuse treatment, behavioral interventions, improved communication about syringe exchange programs, and case management. HIV among IDUs continues to be an important public health problem in the 21st century. It is imperative that public health agencies continue to monitor and combat the HIV epidemic among IDUs to ensure that hard-won gains will not be eroded.

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“…These may include sketches or maps of activity areas.Although participant observation is generally considered a qualitative research method, observations of IDUs frequenting a shooting gallery, for example, can be quite systematic by randomizing time of day and day of the week when observations are made (Carlson et al 1994a). The significance of participant observation for revealing unrecognized pathways for HIV transmission among IDUs and documenting needle circulation and bleach-cleaning patterns stands as a recent example of the value of this method (Jose et al 1993;Koester and Hoffer 1994;Price 1993).…”

Section: Participant Observation and Fieldworkmentioning

confidence: 99%

Qualitative Research Methods in Drug Abuse and AIDS Prevention Research: An Overview

Carlson¹,

Siegal²,

Falck³

1995

PsycEXTRA Dataset

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INTRODUCTIONAlmost two decades ago, at the first workshop/technical review on qualitative research methods and ethnography sponsored by the National Institute on Drug Abuse (NIDA), Siegal (1977, p. 79) remarked that despite the existence of numerous excellent qualitative studies on drug DEFINING QUALITATIVE RESEARCH METHODS Feldman and Aldrich (1990) date the beginnings of modem qualitative research on drugs to DeQuincey's "Confessions of an English Opium Eater," published in 1822, in which the author took on the role of participant observer among eminent addicts and recorded his observations.Since that time, qualitative research methods have become more systematically defined in the fields of anthropology and sociology (Agar 1980(Agar , 1986Bernard 1988;Denzin 1970Denzin , 1989Glaser and Strauss 1967;Naroll and Cohen 1973; Pelto 1973, 1978;Strauss and Corbin 1990;Vidich and Stanford 1994; Schoepfle 1987a, 1987b).Appropriately applied, qualitative research methods are neither soft science nor the mere journalistic reporting of values, beliefs, and behaviors. Moreover, through their capacity to expose the hidden worlds of drug users and those close to them in their holistic contexts, qualitative and quantitative methods can complement one another.As Denzin and Lincoln (1994b) note, the word "qualitative" implies an emphasis on process and an indepth understanding of perceived meanings, interpretations, and behaviors, in contrast with the measurement of the quantity, frequency, or even intensity of some externally defined variables. Since qualitative methods have different meaning for different people-depending on a person's intellectual background, research problem, and theoretical interests-it is worthwhile to examine several definitions.According to Denzin and Lincoln (1994b, p. 2 Strauss and Corbin (1990, pp. 17-18) offer an even broader definition of qualitative methods in the course of developing the methodology of grounded theory: "By qualitative research we mean any kind of research that produces findings not arrived at by means of statistical procedures or other means of quantification." Strauss and Corbin (1990) note, however, that some researchers employ qualitative interviewing techniques to gather textual data that are subsequently coded and analyzed statistically; in effect, they quantify qualitative data. Other qualitative metbodologists (Bernard 1988;Trotter and Potter 1993;Weller and Romney 1988) employ systematic interviewing techniques, such as triad sorting, to produce data that are analyzed quantitatively.The results of such analyses generate an understanding of cognitive categories, or how people perceive the relationship among categories in some domain, such as HIV risk behaviors.Traditionally, the process of describing and analyzing how people perceive the world and their behaviors has been the goal of professional ethnographers trained in anthropology and sociology.While ethnography is often equated with the practice of qualitative methodologies (Brooks 1994;Werner and Schoepfle 1987a...

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Syringe-mediated drug-sharing (backloading): a new risk factor for HIV among injecting drug users

Cited by 118 publications

References 0 publications

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

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

Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

Qualitative Research Methods in Drug Abuse and AIDS Prevention Research: An Overview

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