Epidemics Of Drug Use Research Articles

Dual Epidemics of Drug Use and Syphilis Among Chinese Female Sex Workers: Results of Eight Consecutive Cross-Sectional Surveys from 2006 to 2013 in Qingdao, China.

Eight consecutive annual cross-sectional surveys were conducted to examine the trend of the prevalence of HIV, syphilis, drug use and their correlates among female sex workers (FSWs) in Qingdao, China. Among sampled FSWs over the 8 years, a higher proportion of older, married or cohabited, higher education levels and more on-call FSWs were observed in recent years. The syphilis prevalence increased significantly from 1.0 % in 2006 to 13.5 % in 2013, with illicit drug use rate ranging from 21.8 % in 2007 to 55.5 % in 2010. Multivariate logistic regression analyses showed that drug use, syphilis and unprotected vaginal sex predicted each other. The dual epidemics of illicit drug use and syphilis among FSWs underscore the urgency to implement a tailored intervention to curb the dual epidemics while also preventing an HIV epidemic in the context of diversified commercial sex dynamic.

Pilot trial of a recovery management intervention for heroin addicts released from compulsory rehabilitation in China

China faces the challenge of dual epidemics of drug use and HIV/AIDS. Despite the high relapse rate among heroin addicts released from compulsory rehabilitation facilities, there are few programs available in China to assist these addicts in the community. We pilot-tested in China a Recovery Management Intervention (RMI) program designed to facilitate early detection of relapse and prompt linkage from compulsory rehabilitation to the community and, if participants relapse, to community-based methadone maintenance treatment (MMT) programs. One hundred heroin addicts were randomly assigned to either the Standard Care group (n=50) or the RMI group (n=50). At the end of the 3-month trial, participants in the RMI group, relative to the standard care group, demonstrated positive outcomes in recidivism due to relapse (0 vs. 6%, p=.08; d=0.354), MMT participation (8% vs. 0, p=0.06; d=0.417), and employment (33% vs. 2%, p<.001; d=0.876), although no difference was found in urine testing results (8.5% vs. 8.7%; d=0.013) among interviewed participants. These pilot study results were based on a small sample size and short-term observation, suggesting the need for more research to further improve and test RMI effectiveness with larger samples over a longer period of time in order to provide evidence in support of RMI as an effective strategy for community reintegration among addicts released from rehabilitation facilities in China.

Prevalence of drug use among students of vocational schools in Klaipėda city, Lithuania, in 2004–2006

The aim was to evaluate the prevalence and trends of drug use among students of vocational schools in Klaipeda city and to establish the relationships between psychosocial factors and drug abuse. Two cross-sectional questionnaire surveys were carried out among first-year students of vocational schools in Klaipeda. Random samples of 912 and 342 students aged 16-19 years (representatives of Western part of Lithuania) were questioned in 2004 and 2006, respectively. Questionnaires were filled out anonymously in the classroom. Questions have covered information on drugs such as marihuana, club drugs, injectable drugs, and other drugs. Logistic regression was used for evaluation of relationship between drug use and different psychosocial and behavioral determinants of drug use. In 2004, 56.0% of male respondents and 42.0% of female respondents have reported any drug use during their life. The analysis of standardized data (by the place of residence) showed an increase in the prevalence of drug use during 2004-2006: up to 65.5% in boys (P<0.05) and up to 44.0% in girls (P>0.05). Percentage of club drug users increased significantly in girls (from 21.5% to 29.8%; P=0.040) and exceeded the level of boys. The average number of drugs of different types used by boys changed slightly from 1.57 to 1.63 (P>0.05), but increased significantly in girls (from 1.49 to 1.88, P<0.001). The use of drugs was related to school location (graduates of Klaipeda schools used drugs more frequently), communication with friends who use drugs, participation in the parties where drugs are used, alcohol use, and smoking. In 2006 survey, more significant relationship between drug use and social and behavioral factors was observed. Several indicators of drug use showed a significant increase in drug abuse among students of vocational schools in Klaipeda during the period of 2004-2006. Multisectorial efforts and integrated preventive measures should be applied for the prevention of epidemics of drug use in Klaipeda city.

Epidemics of HIV and sexually transmitted infections in Central Asia: Trends, drivers and priorities for control

Objective To present a synthetic review and analysis of data describing the epidemics of HIV, syphilis and drug use in Central Asia (except Turkmenistan), and structural factors driving these. Design Achieving a comprehensive understanding of the co-epidemiology of HIV and STI and the structural factors driving these is key to the development of an effective response. We used a multi-methods situational analysis design to achieve this. Methods We used three primary methods of data collection during the first 6 months of 2004: interviews with key informants; recording and analysis of government statistics and review of scientific and grey literature. Results The Central Asian countries are experiencing major epidemics of drug use driven by poor economic circumstances and the transit of at least 35% of global opiate production from Afghanistan through their territories. They are in the early stages of drug injection-associated epidemics of HIV infection, set against a background of high rates of sexually transmitted diseases. The region is one of the poorest in the world and experiences extremely high levels of economic migration, with attendant vulnerability to HIV transmission. Conclusions Central Asia is highly vulnerable to a crisis of HIV/AIDS, driven by structural factors which require a regional response. Without concerted action, we may expect to see the rapid development over 4–5 years of an HIV epidemic concentrated among IDUs, and achieving very high prevalence levels in this group; followed by a generalising epidemic, developing over 15–30 years with sexual transmission as the predominant mode. The region should be considered a global priority for intervention.

The relationship between heterosexual and injecting drug use related HIV epidemics

To present a synthetic review and analysis of data describing the epidemics of HIV, syphilis and drug use in Central Asia (except Turkmenistan), and structural factors driving these.Achieving a comprehensive understanding of the co-epidemiology of HIV and STI and the structural factors driving these is key to the development of an effective response. We used a multi-methods situational analysis design to achieve this.We used three primary methods of data collection during the first 6 months of 2004: interviews with key informants; recording and analysis of government statistics and review of scientific and grey literature.The Central Asian countries are experiencing major epidemics of drug use driven by poor economic circumstances and the transit of at least 35% of global opiate production from Afghanistan through their territories. They are in the early stages of drug injection-associated epidemics of HIV infection, set against a background of high rates of sexually transmitted diseases. The region is one of the poorest in the world and experiences extremely high levels of economic migration, with attendant vulnerability to HIV transmission.Central Asia is highly vulnerable to a crisis of HIV/AIDS, driven by structural factors which require a regional response. Without concerted action, we may expect to see the rapid development over 4–5 years of an HIV epidemic concentrated among IDUs, and achieving very high prevalence levels in this group; followed by a generalising epidemic, developing over 15–30 years with sexual transmission as the predominant mode. The region should be considered a global priority for intervention.

HIV in the inner cities: Epidemiologic trends and their influence on policy-making decisions

AIDS in the inner cities represents a multilevel problem with extensive social and medical aspects. Concurrent epidemics of drug use and sexually transmitted diseases fuel the HIV epidemic in the inner city. The response to the epidemic has met with limited success to date, due in part to poor communications and mistrust between existing institutions in the inner cities. Policies and programs that address the cofactors as well as the existing rivalries are likely to have a better impact and solution to the questions raised.

Epidemiology of HIV Infection and AIDS in the United States

HIV-1 disease has been recognized as a distinct clinical entity for fewer than 10 years. Yet during that time, the virus has spread around the world and affects people of virtually all ages, genders, sexual behaviors, and geographic regions. In the United States, there have been more than 140,000 individuals diagnosed with AIDS, the clinical end stage of HIV-1 disease, and it is projected that AIDS incidence will accelerate through at least 1993. In the early years of the infection epidemic in the United States, the virus spread rapidly and insidiously, predominantly among homosexual men, intravenous drug users, people with hemophilia, and recipients of infected blood products. Since then, the epidemic has been propagated concurrently with epidemics of drug use (intravenous and noninjectable) and sexually transmitted diseases such as syphilis. Since its beginning, HIV-1 has disproportionately affected members of racial and ethnic minorities, particularly in large cities, where transmission takes place sexually, parenterally, and perinatally. The epidemic of HIV-1 has spread outside of traditional urban epicenters and is more significantly affecting adolescents, women, and heterosexuals. There is a great need for renewed and refocused infection-prevention efforts. Projections of resource and medical service needs should be based on up-to-date and accurate assessments of infection epidemic parameters, including infection prevalence, incidence, and acceleration (changes in epidemic velocity over time) rates.