Transmission Of Blood-borne Viruses Research Articles

Detected substance abuse among injecting drug users through analysis of used syringes in Tunisia

Background and aimsInjecting drug use poses significant public health risks due to unsafe practices such as syringe sharing, reuse, and risky sexual behaviors, which increase the transmission of bloodborne viruses. In Tunisia, limited data on injecting drug use hinders the development of informed health and harm reduction policies. MethodsA syringe collection campaign was conducted in Tunis in November 2022. The used syringes were provided by the Tunisian Association for Information and Orientation on AIDS and Addiction (ATIOST), a harm-reduction service. These syringes had been distributed to people who inject drugs (PWID) as part of a mobile syringe exchange program. The objective of the study was to analyze the contents of the used syringes to gain further insights into drug use patterns among PWID. The residual substances in the syringes were examined using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), in accordance with the standardized protocol of the European Syringe Collection and Analysis Project Enterprise (ESCAPE). ResultsA total of 261 syringes from five collection sites were analyzed. Among these, 87 % contained at least one psychoactive substance, while 32 % contained more than two psychoactive substances. The most frequently identified psychoactive substances were buprenorphine (50.28 %), amphetamine (11.65 %) and tramadol (9.66 %). No substances were detected in 34 syringes. ConclusionThis method provides rapid data on drug use trends in specific regions and timeframes, revealing differences that can inform tailored prevention and harm reduction strategies. Such analyses are valuable for comparative studies across countries in the European Neighbourhood Policy (ENP-South) region.

Trends in the prevalence of HIV, HCV, and co-infection and associated factors among young people who inject drugs (PWID) in Catalonia (2008–2019)

ABSTRACT People who inject drugs (PWID) face a significantly increased risk of blood-borne virus (BBV) infections, including HIV and hepatitis C virus (HCV), as well as co-infections. To better understand this issue, bio-behavioral surveillance studies were conducted among PWID attending harm reduction facilities in Catalonia, forming part of the comprehensive Integrated HIV/STI Surveillance System since 2008. The goal of this study was to describe the prevalence of HIV, HCV, and HIV-HCV coinfection and associated socio-demographic and behavioural factors among young PWID in Catalonia by gender and to examine trends over time, from 2008 to 2019. We first estimated the prevalence of HIV, HCV, and their co-infection and sample characteristics, and then, we calculated prevalence ratios (PR) and adjusted prevalence ratios (aPR) to identify the variables associated with HIV infection, HCV infection, and HIV-HCV co-infection. We found that the overall prevalence of HIV, HCV and HIV-HCV co-infection in 2019 was 20.1%, 66.2%, and 16.8%, respectively. In multivariable analysis, we found that being female (aPR: 1.55, 95% CI: 1.05–2.30), age (aPR: 1.09, 95% CI: 1.04–1.14), having born outside of Spain (aPR: 1.67, 95% CI: 1.19–2.34), homelessness (aPR: 1.90, 95% CI: 1.34–2.68), daily injection (aPR: 1.46, 95% CI: 1.04–2.04), sharing needles (aPR: 1.93, 95% CI: 1.32–2.82), involvement in sex work (aPR: 1.82, 95% CI: 1.09–3.03), and imprisonment (aPR: 2.54, 95% CI: 1.75–3.67) was associated with increased prevalence of HIV and HCV co-infection, while being a new injector (aPR: 0.64, 95% CI: 0.43–0.93) was associated with decreased prevalence. Overall, this research provides valuable insights into the risks and determinants of HIV and HCV co-infection among young PWID. The study’s findings contribute to the existing body of knowledge on blood-borne virus transmission in this population, informing evidence-based strategies for prevention and harm reduction.

Management of occupational exposure to blood and body fluids in primary care.

Primary care workplaces where occupational exposure to blood and body fluids may occur should have policies and procedures in place to manage such incidents. All healthcare workers should be immunised against hepatitis B and ideally should have documentation of their antibody response to vaccination. Knowledge of hepatitis B immune status helps streamline the response to any exposure. Most occupational exposures carry a low risk of transmission of bloodborne viruses, and management can often be undertaken in general practice. Urgent risk assessment and management is crucial. If postexposure prophylaxis for hepatitis B or HIV is required, the earlier it is given, the more likely it is to be effective. Two-drug HIV postexposure prophylaxis is now more accessible because generic formulations of the drug combination are available, and general practitioners can prescribe this on a private prescription.

A cross-sectional assessment of injection of "salts" and HIV transmission-related behaviours among a cohort of people who inject drugs in Kyrgyzstan.

Despite the increasing availability of new psychoactive substances (hereafter referred to as "salts") in Eastern Europe and Central Asia, there is a dearth of epidemiological data on the relationship between injecting "salts" and HIV risk behaviours. This is particularly relevant in settings where injection drug use accounts for a substantial proportion of the HIV burden, such as in Kyrgyzstan, a former Soviet Republic. This study assessed whether injecting "salts" is associated with sexual and injection-related HIV risk behaviours among people who inject drugs in Kyrgyzstan. The Kyrgyzstan InterSectional Stigma Study is a cohort of people who inject drugs in Kyrgyzstan's capital of Bishkek and the surrounding rural administrative division of Chuy Oblast. We conducted a cross-sectional analysis using survey data collected from cohort participants between July and November 2021, which included information on injection drug use (including "salts") and HIV risk behaviours. To minimize confounding by measured covariates, we used inverse-probability-weighted logistic and Poisson regression models to estimate associations between recent "salt" injection and HIV risk behaviours. Of 181 participants included in the analysis (80.7% men, 19.3% women), the mean age was 40.1 years (standard deviation [SD] = 8.8), and 22% (n = 39) reported that they had injected "salts" in the past 6 months. Among people who injected "salts," 72% (n = 28) were men, and most were ethnically Russian 59% (n = 23), with a mean age of 34.6 (SD = 9.6). Injecting "salts" was significantly associated with a greater number of injections per day (adjusted relative risk [aRR] = 1.59, 95% confidence interval [CI] = 1.30-1.95) but lower odds of using syringe service programmes in the past 6 months (adjusted odds ratio [aOR] = 0.20, 95% CI = 0.12-0.32). Injecting "salts" was also significantly associated with lower odds of condomless sex in the past 6 months (aOR = 0.42, 95% CI = 0.24-0.76) and greater odds of having ever heard of pre-exposure prophylaxis (aOR = 4.80, 95% CI = 2.61-8.83). (PWID) people who inject drugs who inject "salts" are a potentially emergent group with increased HIV acquisition risk in Kyrgyzstan. Targeted outreach bundled with comprehensive harm reduction and pre-exposure prophylaxis services are needed to prevent transmission of HIV and other blood-borne viruses.

The Impact of Drugs and Substance Abuse on Viral Pathogenesis-A South African Perspective.

Illicit drug and alcohol abuse have significant negative consequences for individuals who inject drugs/use drugs (PWID/UDs), including decreased immune system function and increased viral pathogenesis. PWID/UDs are at high risk of contracting or transmitting viral illnesses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). In South Africa, a dangerous drug-taking method known as "Bluetoothing" has emerged among nyaope users, whereby the users of this drug, after injecting, withdraw blood from their veins and then reinject it into another user. Hence, the transmission of blood-borne viruses (BBVs) is exacerbated by this "Bluetooth" practice among nyaope users. Moreover, several substances of abuse promote HIV, HBV, and HCV replication. With a specific focus on the nyaope drug, viral replication, and transmission, we address the important influence of abused addictive substances and polysubstance use in this review.

Unprotected Risky Sex Among Men with Opioid Dependence: Is More Needed to Be Done?

Background and Objectives: Risky behaviors are common among patients with substance use disorders. Knowing the determinants of risky sexual behaviors can identify individuals who may benefit from targeted interventions. The primary aim of the study was to assess unprotected risky sexual behavior and its sociodemographic and clinical correlates in treatment-seeking opioid-dependent patients. Methods: A cross-sectional exploratory study was done on 112 married treatment-seeking opioid-dependent male patients. A semi-structured proforma consisting of sociodemographic and clinical details was used to assess sexual behavior, other risky behaviors like injecting drug use (IDU), and knowledge of and attitude toward risky sexual behavior. Results: The mean age of the sample was 34.1 years, and that at first sexual intercourse was 18.6 years. History of unprotected risky sex (unprotected sex with a casual partner or female sex worker or person having a sexually transmitted disease or with males or having sex for rewards) was present in 30 patients (26.8% of the sample). Unprotected risky sex was found to be significantly associated with younger age at first sexual encounter ( p = .010), more sexual partners ( p < .001), greater frequency of masturbation ( p = .031), and watching pornography ( p = .028). However, it was not found to be related to other risky behaviors such as IDU ( p = .210) and sex under intoxication ( p = .149) and also did not vary between treatment-naïve and under-treatment populations ( p = .434). No significant relationship was found between knowledge and attitude about risky sexual behavior and unprotected risky sex in the present sample. Conclusion: Risky sexual behavior in opioid-dependent patients is a concern, as this may be an additional mode of transmission of blood-borne viruses apart from IDU. Safe sex practices need to be emphasized in this population, and efforts at behavioral changes are desirable.

Using ambulance surveillance data to characterise blood-borne viral infection histories among patients presenting with acute alcohol and other drug-related harms.

Preventable transmission of blood-borne viruses (BBV), including human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV), continue in at-risk populations, including people who use alcohol and drugs (AODs). To our knowledge, no studies have explored the use of ambulance data for surveillance of AOD harms in patients with BBV infections. We used electronic patient care records from the National Ambulance Surveillance System for people who were attended by an ambulance in Victoria, Australia between July 2015 and July 2016 for AOD-related harms, and with identified history of a BBV infection. Descriptive and geospatial analyses explored the epidemiological and psychosocial characteristics of patients for these attendances. The present study included 1832 patients with a history of a BBV infection who required an ambulance for AOD-related harms. Amphetamines were reported in 24.7% of attendances where the patient identified HIV history, and heroin was reported more often for patients with viral hepatitis history (HCV: 19.2%; HBV: 12.7%). Higher proportions of attendances with a viral hepatitis history were observed in patients from the most socially disadvantaged areas. Geospatial analyses revealed higher concentrations of AOD attendances with a BBV history occurring in metropolitan Melbourne. Our study describes the utility of ambulance data to identify a sub-population of patients with a BBV history and complex medical and social characteristics. Repeat attendances of BBV history patients to paramedics could present an opportunity for ongoing surveillance using ambulance data and possible paramedic intervention, with potential linkage to appropriate BBV services.

“No-one just does drugs during business hours!”: evaluation of a 24/7 primary needle and syringe program in St Kilda, Australia

BackgroundPrimary needle and syringe programs (NSPs) have been integral for the prevention of blood-borne virus (BBV) transmission among people who inject drugs. Despite this, many people who inject drugs face barriers accessing these services, particularly after-hours when most services are closed. To our knowledge, the St Kilda NSP, in Melbourne, Victoria, is the only primary NSP providing 24/7 dedicated stand-alone face-to-face services for people who inject drugs in Australia. We conducted an evaluation of the St Kilda NSP to assess its role and effectiveness in meeting client needs.MethodsMixed research methods were used to conduct the evaluation. We analysed four quantitative data sets including the Victorian Needle and Syringe Program Information System data; NSP ‘snapshot’ survey data; and St Kilda NSP records of after-hours contacts and naloxone training events. Qualitative interviews were conducted with 20 purposively selected NSP clients, which were focused on individual needs, expectations and experiences accessing the service. Interviews were audio recorded and transcribed, and data were analysed thematically. A convergent research design was used to merge the five data sets.ResultsSt Kilda NSP had 39,898 service contacts in 2018; 72% of contacts occurred outside business hours. Similarly, of 1,185,000 sterile needles and syringes dispatched, 71% were distributed outside business hours. Participants described valuing the after-hours service because drug use patterns did not always align with standard NSP opening hours and after-hours access afforded anonymity when collecting injecting equipment. Narratives highlighted several additional benefits of the 24/7 service, including: access to safer sex equipment; material support; naloxone training; referrals to specialist services; face-to-face emotional and social support from a non-judging worker; and for women involved in sex work in particular, being able to seek refuge when feeling unsafe on the streets.ConclusionsOur study provides evidence of the social and health benefits (beyond that of preventing BBV transmission) that can be gained through the provision of 24/7 primary NSP services. Findings support the need for the establishment of after-hours primary NSPs in other areas of Australia where active street-based drug markets operate outside business hours and concentrated numbers of people who inject drugs live and spend time.

Effectiveness of interventions to reduce sexually transmitted infections and blood-borne viruses in incarcerated adult populations: a systematic review protocol.

This review will identify, synthesize, and make recommendations regarding the effectiveness of interventions to reduce sexually transmitted infections (STIs) and blood-borne viruses (BBVs) in incarcerated adult settings. High-risk sexual behaviors, intravenous drug use, piercing, and tattooing are well documented within incarceration environments. Despite the World Health Organization's Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021 and the Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis, and Sexually Transmitted Infections for the Period 2022-2030, STI rates within adult incarceration environments continue to rise. Identifying and implementing best-practice interventions to prevent and manage STIs and BBVs will aid infection reduction in correctional settings. The review results will inform the development of educational programs, health promotion, and policies and procedures to improve health outcomes for incarcerated populations. This review will consider studies in any language from any adult incarceration facility. Studies set in juvenile facilities or detention centers will be excluded. Any intervention for preventing or reducing STI and/or BBV transmission will be included. This review will follow the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include PubMed, CINAHL (EBSCO), Ovid Library, PsycINFO (EBSCO), Cochrane CENTRAL, and Scopus. Two independent reviewers will screen titles and abstracts and assess full-text citations against inclusion criteria. Methodological quality will be appraised using JBI's standardized critical appraisal instruments. Where possible, studies will be pooled using meta-analysis. Where statistical pooling is not possible, findings will be presented in narrative format. Certainty of evidence will be ascertained using the GRADE approach. PROSPERO CRD42022325077.

Compliance with good practice guidelines for the prevention of vascular access infections: the multi-centre PHYDEL survey in French haemodialysis units

French guidelines for the prevention of vascular access infections in a haemodialysis setting were released in 2005. Compliance with these guidelines is currently unknown. The aim of this study was to assess compliance with the guidelines for vascular access infection prevention in French haemodialysis units, and to describe the difficulties reported. A cross-sectional survey was conducted between March and December 2019 in 200 haemodialysis units in France, selected at random. Data were collected via questionnaire, completed by telephone interview with an infection control practitioner. A practice was deemed compliant when >85% of units declared that they always complied with the guidelines. In total, 103 units (51.5%) agreed to participate. Most practices complied with the guidelines; however, some practices did not reach the 85% compliance threshold for working in pairs when connecting central venous catheter (CVC) lines, performing hand hygiene before disconnecting lines, rinsing antiseptic soap before painting CVC exit site or arteriovenous fistula (AVF) puncture site, allowing antiseptic paint to dry, handling CVC branches with antiseptic impregnated gauze, performing hand hygiene after AVF compression with gloves, wearing protective eyewear when connecting/disconnecting CVC or when puncturing AVF, and wearing a gown when puncturing AVF. The most frequently reported difficulties were understaffing, difficulties with skin preparation because of exit site skin damage, and lack of buttonhole technical expertise. Despite good overall compliance, this survey highlights some shortcomings in compliance with infection prevention guidelines, which could be associated with either higher risk of vascular access infection or increased blood-borne virus transmission.

Cost-effectiveness of Kidney Transplantation From Donors at Increased Risk of Blood-borne Virus Infection Transmission.

Demand for donor kidneys outstrips supply. Using kidneys from selected donors with an increased risk of blood-borne virus (BBV) transmission (hepatitis B virus and hepatitis C virus [HCV], human immunodeficiency virus) may expand the donor pool, but cost-effectiveness of this strategy is uncertain. A Markov model was developed using real-world evidence to compare healthcare costs and quality-adjusted life years (QALYs) of accepting kidneys from deceased donors with potential increased risk of BBV transmission, because of increased risk behaviors and/or history of HCV, versus declining these kidneys. Model simulations were run over a 20-y time horizon. Parameter uncertainty was assessed through deterministic and probabilistic sensitivity analyses. Accepting kidneys from donors at increased risk of BBVs (2% from donors with increased-risk behaviors and 5% from donors with active or past HCV infection) incurred total costs of 311 303 Australian dollars with a gain of 8.53 QALYs. Foregoing kidneys from these donors incurred total costs of $330 517 and a gain of 8.44 QALYs. A cost-saving of $19 214 and additional 0.09 QALYs (~33 d in full health) per person would be generated compared with declining these donors. Increasing the availability of kidneys with increased risk by 15% led to further cost-savings of $57 425 and additional 0.23 QALY gains (~84 d in full health). Probabilistic sensitivity analysis using 10 000 iterations showed accepting kidneys from donors at increased risk led to lower costs and higher QALY gains. Shifting clinical practice to accept increased BBV risk donors would likely produce lower costs and higher QALYs for health systems.

Progression of blood-borne viruses through bloodstream: A comparative mathematical study

Background and ObjectivesBlood-borne pathogens are contagious microorganisms that can cause life-threatening illnesses, and are found in human blood. It is crucial to examine how these viruses spread through blood flow in the blood vessel. Keeping that in view, this study aims to determine how blood viscosity, and diameter of the viruses can affect the virus transmission through the blood flow in the blood vessel. A comparative study of bloodborne viruses (BBVs) such as HIV, Hepatitis B, and C, has been addressed in the present model. A couple stress fluid model is used to represent blood as a carrying medium for virus transmission. The Basset-Boussinesq-Oseen equation is taken into account for the simulation of virus transmission. MethodsAn analytical approach to derive the exact solutions under the assumption of long wavelength and low Reynolds number approximations is employed. For the computation of the results, a segment (wavelength) of blood vessels about 120 mm with wave velocities in the range of 49 − 190 mm/sec are considered, where the diameter of BBVs ranges from 40-120 nm. The viscosity of the blood varies from 3.5-5.5 × 10−3 Ns/m2 which affect the virion motion having a density range 1.03 − 1. 25 g/m3. ResultsIt shows that the Hepatitis B virus is more harmful than other blood-borne viruses considered in the analysis. Patients with high blood pressure are highly susceptible for transmission of BBVs. ConclusionsThe present fluid dynamics approach for virus spread through blood flow can be helpful in understanding the dynamics of virus propagation inside the human circulatory system.

A Comparative Study to Assess the Mental Health Problems, Quality of Life, Work Ability and Social Adjustments Among OST and Non-OST Drug Users in Chandigarh

Introduction: Injectable drug use is a cause of disease burden and a contributor to blood-borne virus transmission and health-related problems. It is one of the serious problems of our country. The best suitable strategy of treatment for opioid dependence is ‘opioid substitution therapy’ (OST). It is beneficial for the injectable drug users (IDUs) in reduction in the behaviour of injecting and opioid use, which helps in reducing criminal activities, domestic violence, enhancing ties within the family and improving productivity. Objective: To assess the mental health problems, quality of life, work ability and social adjustability among OST and non-OST IDUs. Materials and Methods: The descriptive study was conducted among 100 male IDUs (50 in the OST group and 50 in the non-OST group), registered with the two selected non-governmental organizations (NGOs) of Chandigarh selected by using the consecutive sampling technique. The OST group was contacted during their visit to the centre for receiving the daily dose of OST, while the non-OST group was contacted during their visit to the NGO centres for getting fresh syringes in exchange with used syringes under the syringe exchange programme. The data were collected by interviewing the study subjects by using the interview schedule comprising of the (a) socio-demographic profile, (b) health problems, (c) substance-use-related problems scale, (d) work ability and social adjustability scale, (e) the depression, anxiety and stress scale-21 and (f) World Health Organization Quality-of-Life BREF (WHOQOL BREF) Scale. All the tools were standardized and available in the open domain. Results: The study subjects were in the age group of 18–58 years with the mean age of 27.52 ± 6.67 years. Significantly lesser problems in the OST group study participants related to health, occupation, finance, legal, family, marital and social status were reported than those in the non-OST group participants ( t-test, p < 0.01). A significantly higher percentage of the study participants in the non-OST group had depression, anxiety and stress than that in the OST group. Quality of life of IDUs in the OST group was significantly better than that of IDUs in the non-OST group, as per the WHOQOL BREF Scale (Mann–Whitney U test, p < 0.05). Conclusion: IDUs on OST therapy (OST group) were having lesser problems in the area of health (physical and mental), occupational, financial, legal, family, marital, social and better quality of life than those in the non-OST group.

Failure of sterilization in a dental outpatient facility: Investigation, risk assessment, and management.

In 2017, an incident of failed sterilization of dental instruments occurred at a large dental outpatient facility in Singapore. We aim to describe findings of the investigation of the sterilization breach incident, factors related to risk of viral transmission to the potentially affected patients, and the contact tracing process, patient management, and blood test results at a 6-month follow-up.A full assessment of the incident was immediately carried out. The factors related to risk of viral transmission due to affected instruments were analyzed using 3 keys points: breached step(s) and scale of the incident, prevalence of underlying bloodborne diseases and immunity in the Singapore population, health status of potential source patients, and type of dental procedure performed, and health status of affected patients and type of dental procedure received.Up to 72 affected instrument sets were used in 714 potentially affected patients who underwent noninvasive dental procedures. The investigation revealed that there was a lapse in the final step of steam sterilization, resulting in the use of incompletely sterilized items. The assessment determined that there was an extremely low risk of bloodborne virus transmission of diseases to the patients. At the 6-month follow-up, there were no infected/colonized cases found related to the incident.Lapses in the sterilization process for medical and dental instruments can happen, but a risk assessment approach is useful to manage similar incidents. Quick response and proper documentation of the sterilization process can prevent similar incidents.

The impact of opioid agonist treatment on hospitalisations for injecting-related diseases among an opioid dependent population: A retrospective data linkage study

BackgroundInjecting-related bacterial and fungal infections cause substantial illness and disability among people who use illicit drugs. Opioid agonist treatment (OAT) reduces injecting frequency and the transmission of blood borne viruses. We estimated the impact of OAT on hospitalisations for non-viral infections and examine trends in incidence over time. MethodsWe conducted a retrospective cohort study using linked administrative data. The cohort included 47 163 individuals starting OAT between August 2001 and December 2017 in New South Wales, Australia, with 454 951 person-years of follow-up. The primary outcome was hospitalisation for an injecting-related disease. The primary exposure was OAT status (out of OAT, first four weeks of OAT, and OAT retention [i.e., more than four weeks in treatment]). Covariates included demographic characteristics, year of hospitalisation, and recent clinical treatment. Results9122 participants (19.3%) had at least one hospitalisation for any injecting-related disease. Compared to time out of treatment, retention on OAT was associated with a reduced rate of injecting-related diseases (adjusted rate ratio[ARR]=0.92; 95%CI 0.87–0.97). The first four weeks of treatment was associated with an increased rate (ARR 1.53, 95%CI 1.38–1.70), which we believe is explained by referral pathways between hospital and community OAT services. The age-adjusted incidence rates of hospitalisations for any injecting-related disease increased from 34.8 (95% CI =30.2–40.0) per 1000 person-years in 2001 to 54.9 (95%CI=51.3–58.8) in 2017. InterpretationStable OAT is associated with reduced hospitalisations for injecting-related bacterial infections; however, OAT appears insufficient to prevent these harms as the rate of these infections is increasing in Australia.

Knowledge and experience of using performance and image enhancing drugs among attendees of a Needle and Syringe Program in Australia: A qualitative study

BackgroundThe availability and utilisation of performance and image enhancing drugs (PIEDs) have been increasing in the last decade. This study aimed to understand the knowledge and experience of PIED use amongst attendees of a Needle and Syringe Program (NSP) in Australia. It also investigated their experience of seeking medical advice and accessing the NSP service. MethodsSemi-structured interviews were conducted with 19 participants between September 2016 and April 2017. Audio recordings of the interviews were transcribed verbatim and content analysis was conducted. ResultsAll 19 participants were male, with 10 participants aged 18–25 and 15 working. Participants showed sound knowledge of injecting practices and side effects; however, their understanding about blood-borne virus transmission risks was limited. Most of them reported experiencing injection-related injuries and considered this as common. They would seek general medical advice; however, they would not disclose their PIED use if not required as their past experience indicated that general practitioners lacked knowledge and support. Participants expressed concerns before their first visit to the NSP service, but thought staff were open minded, non-judgemental and helpful after the visit. They also highlighted the difficulty in accessing the service for injection equipment during business hours and provided suggestions on service improvement including extending the opening hours, using vending machines and providing a peer support program. ConclusionsThe findings suggest there is a need to educate PIED users about blood-borne virus transmission risks, improve general practitioners’ understanding about PIED use, and investigate the feasibility of extending the NSP service hours and for the service to provide a peer support program to clients who use PIEDs.

Overdose prevention centres in the UK

Overdose prevention centres in the UK

The Effectiveness of Low Dead Space Syringes for Reducing the Risk of Hepatitis C Virus Acquisition Among People Who Inject Drugs: Findings From a National Survey in England, Wales, and Northern Ireland.

Syringes with attached needles (termed fixed low dead space syringes [LDSS]) retain less blood following injection than syringes with detachable needles, but evidence on them reducing blood-borne virus transmission among people who inject drugs (PWID) is lacking. Utilizing the UK Unlinked Anonymous Monitoring cross-sectional bio-behavioral surveys among PWID for 2016/18/19 (n = 1429), we showed that always using fixed LDSS was associated with 76% lower likelihood (adjusted odds ratio = 0.24, 95% confidence interval [CI]: .08–.67) of recent hepatitis C virus infection (RNA-positive and antibody-negative) among antibody-negative PWID compared to using any syringes with detachable needles.

Characteristics and Donation Outcomes of Potential Organ Donors Perceived to Be at Increased Risk for Blood-borne Virus Transmission: An Australian Cohort Study 2010-2018.

Safely increasing organ donation to meet need is a priority. Potential donors may be declined because of perceived blood-borne virus (BBV) transmission risk. With hepatitis C (HCV) curative therapy, more potential donors may now be suitable. We sought to describe potential deceased donors with increased BBV transmission risk. We conducted a cohort study of all potential organ donors referred in NSW, Australia, 2010-2018. We compared baseline risk potential donors to potential donors with increased BBV transmission risk, due to history of HIV, HCV or hepatitis B, and/or behavioral risk factors. There were 624 of 5749 potential donors (10.9%) perceived to have increased BBV transmission risk. This included 298 of 5749 (5.2%) with HCV (including HBV coinfections) and 239 of 5749 (4.2%) with increased risk behaviors (no known BBV). Potential donors with HCV and those with increased risk behaviors were younger and had fewer comorbidities than baseline risk potential donors (P < 0.001). Many potential donors (82 with HCV, 38 with risk behaviors) were declined for donation purely because of perceived BBV transmission risk. Most were excluded before BBV testing. When potential donors with HCV did donate, they donated fewer organs than baseline risk donors (median 1 versus 3, P < 0.01), especially kidneys (odds ratio 0.08, P < 0.001) and lungs (odds ratio 0.11, P = 0.006). Many potential donors were not accepted because of perceived increased BBV transmission risk, without viral testing, and despite otherwise favorable characteristics. Transplantation could be increased from potential donors with HCV and/or increased risk behaviors.

Needlestick and sharps' injury in healthcare students: Prevalence, knowledge, attitude and practice.

Needlestick and sharps injury is an occupational hazard, and it presents with a constant risk of exposure to blood-borne pathogens. Students are particularly at risk due to a lack of experience and handling skills. The present study was designed to assess the prevalence of needle stick injury and evaluate the knowledge, attitude, and practice regarding its prevention and management among students of a medical campus. A cross-sectional, questionnaire-based study was conducted among healthcare students of the medical campus in Sangli, Maharashtra. Overall, the study included 942 participants belonging to medical, dental, and nursing faculties. Overall, the prevalence rate of needlestick and sharps injury was found to be 25.2%. The prevalence was highest amongst nursing students. The students had adequate knowledge about blood-borne virus (BBV) transmission and prevention of needlestick injury. However, there was a substantial shortfall in post-exposure prophylaxis knowledge amongst the students. A deficit in translation between knowledge to practice was noted, particularly in the case of needlestick injury prevention and management. The present study found that one in four students experience needlestick injury; overall knowledge regarding prevention and management of needlestick injury was lesser than desired, and gaps in knowledge and practice were identified in the present study. This can be rectified by curricular reforms, periodic educational programs and stern reinforcement of guidelines. Instilling reporting centers and devising a standing operating procedure in the event of needlestick injury are the needs of the hour.