Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward

Wolfe, Daniel; Carrieri, Patrizia; Shepard, Donald S.

doi:10.1016/s0140-6736(10)60832-x

Cited by 385 publications

(432 citation statements)

References 89 publications

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“…Alcohol users may also be less likely to seek support from their family, friends, and caregivers, which may lead to non-adherence to ART [36]. Moreover, they may also simultaneously engage in any substance use in order to cope with the treatment side-effects which may also lead to poor treatment compliance [37].…”

Section: Discussionmentioning

confidence: 99%

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Pokhrel

Pokhrel²,

Neupane³

et al. 2018

Global Health Action

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Background: People living with Human Immunodeficiency Virus (HIV) often suffer from alcohol-use disorders resulting in their poor health and treatment outcomes. Little is known about the association of harmful alcohol drinking with their adherence to anti-retroviral therapy (ART) and health-related quality of life (QOL) in low-resource settings. Objective: This study aimed to investigate associations between harmful alcohol drinking, adherence to ART and health-related QOL in HIV-positive people, stratified by gender, in Nepal. Methods: We conducted a cross-sectional study of 682 HIV-positive people on ART to measure their self-reported harmful alcohol drinking and non-adherence to ART in the previous month of data collection. We also measured health-related QOL using a WHOQOL-HIV BREF scale. The association between harmful alcohol drinking and non-adherence to ART was examined using multiple logistic regressions. Additionally, multiple linear regressions examined association between harmful alcohol drinking and QOL. Results: Harmful alcohol drinking was associated with non-adherence to ART among men (AOR: 2.48, 95% CI: 1.50, 4.11, p < 0.001) and women (AOR: 2.52, 95% CI: 1.32, 4.80, p = 0.005). Men were more likely to have lower score for the psychological (β = −0.55, p = 0.021) and level of independence (β = −0.68, p = 0.018) domains when they had harmful alcohol drinking. Moreover, women were more likely to have lower scores for the physical (β = −1.01, p = 0.015), social relations (β = −0.82, p = 0.033), environmental (β = −0.88, p = 0.011), and spiritual (β = −1.30, p = 0.005) domains of QOL when they had harmful alcohol drinking. Conclusions: Harmful alcohol drinking had a negative association with ART adherence and QOL in both HIV-positive men and women in Nepal. Screening for alcohol-use disorders and community-based counseling services should be provided while delivering ART services to improve treatment adherence and QOL.

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Section: Discussionmentioning

confidence: 99%

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Pokhrel

Pokhrel²,

Neupane³

et al. 2018

Global Health Action

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“…For example, in their review of substance use stigma, Livingston et al [6] reported that health professionals often think that substance users will fail to adhere to the care recommended, that they are not vested in their own health, that they abuse the system through drug-seeking behaviours, and that they overuse system resources. Similarly, Wolfe and colleagues [39], in their discussion of barriers to care for injecting drug users with HIV, stated that some health care providers see substance users as troublesome and noncompliant. Unfortunately, these perceptions reflect incorrect stereotypes.…”

Section: Discussionmentioning

confidence: 99%

“…This corresponds with a significant body of literature demonstrating a discourse of agency and 'deservingness' as it pertains to substance use itself, and the consequences of substance use including the acquisition of HIV. Often, substance users are perceived by not only broader society, but also by health care professionals, to have control over their substance use [6,41,42] and to have brought their HIV infection upon themselves [39,43]. Consequently, they are often considered less worthy of support.…”

Section: Discussionmentioning

confidence: 99%

Stigma in the Dutch Health Care Sector: HIV-Positive Substance Users’ Experiences and Health Care Providers’ Perspectives

Stutterheim¹,

Roberts²,

Baas³

et al. 2017

ARC Journal of Nursing and Healthcare

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“…This makes them more likely to have higher amounts of HIV in the blood compared to people receiving ART who do not inject drugs. [34][35][36] In addition, undetectable viral load does not mean that there is no virus but rather that the amount of HIV is below a level that tests can detect 33 and it is unknown how much treatment can reduce the risk of intravenous HIV transmission and what the intravenous transmission risk is when the HIV blood level is undetectable. Thus, the HIV blood titers in this study might be a reasonable representation of the real life intravenous exposure risk of underserved populations of drug injectors.…”

Section: Infectious Hiv In Low Dead Space Syringesmentioning

confidence: 99%

Recovering Infectious HIV from Novel Syringe–Needle Combinations with Low Dead Space Volumes

Abdala

Patel

Heimer

2016

AIDS Research and Human Retroviruses

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This study determines if detachable syringe-needle combinations redesigned to reduce their dead space volume may substantially reduce the burden of exposure to infectious HIV among people who inject drugs. Two novel, low dead space (LDS) syringe-needle designs-one added a piston to the plunger (LDS syringe) and the other added a filler to the needle (LDS needle) to reduce their dead space-were compared to standard detachable needle-syringe combinations and to syringes with fixed needles. LDS and standard syringes attached to LDS and standard needles of 23-, 25-, and 27-gauge size were contaminated with HIV-infected blood in the laboratory. The proportion of syringeneedle combinations containing infectious HIV was analyzed after syringes were (1) stored up to 7 days at 22°C or (2) rinsed with water. Detachable syringes attached to 25-gauge needles yielded comparable proportions of syringes with infectious HIV, whether the needle was standard or LDS. Among needles of greater diameter (23 gauge), LDS needles tended to reduce recoverable HIV to a greater extent than standard needles. Syringes with fixed needles showed superior results to LDS syringes attached to needles of equivalent diameter and were less likely to get clogged by blood. Detachable LDS syringe-needle designs must be recommended with caution since they still pose potential risk for HIV transmission. Distribution of LDS syringes and needles must be accompanied by recommendations and instructions for their proper rinsing and disinfection in order to reduce viral burden and chances of needle clogging.

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Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward

Cited by 385 publications

References 89 publications

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Stigma in the Dutch Health Care Sector: HIV-Positive Substance Users’ Experiences and Health Care Providers’ Perspectives

Recovering Infectious HIV from Novel Syringe–Needle Combinations with Low Dead Space Volumes

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