Injection Equipment Research Articles

Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial.

Few evidence-based interventions have been widely adopted in common clinical settings, particularly for opioid-dependent people with HIV (PWH) seeking drug treatment. We developed a brief evidence-based intervention, Holistic Health for HIV (3H+), specifically for ease of implementation and integration within drug treatment settings. In this study, we compared 3H+ to the gold standard, Holistic Health Recovery Program (HHRP+) using a non-inferiority trial. Between 2012 and 2017, 106 participants were randomly assigned to either the brief 3H+ intervention or the gold standard HHRP+. HIV treatment (ART adherence, viral suppression) and risk behaviors (sharing injection equipment, condom use) were compared between the two arms at baseline, end-of-intervention (EOI-12 weeks) and at follow-up (24 weeks). Average treatment effect was calculated based on the difference-in-difference (DID) estimator and a non-parametric bootstrap was used to assess non-inferiority. At the 12-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to multiple outcomes: percent sharing syringes and needles (DID:1.4, 95%CI [-18.6,21.5], p<0.01) and attainment of high ART adherence (DID: 9.7, 95%CI: [-13.1, 32.2], p = 0.04). At the 24-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to percent sharing syringes and needles (DID: 8.9, [-10.1, 28.30], p = 0.04) and attainment of viral suppression (DID: 18.9, 95% CI:[-7.1, 42.0], p = 0.01). For other indicators, such as consistent condom use, the hypothesis test for non-inferiority was inconclusive at the 12-week EOI (DID: -20.2, 95%CI [-48.9-10.7], p = 0.51). For HIV treatment as prevention to be effective, PWH need to achieve viral suppression. In the absence of this success, they must reduce HIV risk behaviors. The finding that 3H+ was non-inferior to HHRP+ suggests that brief behavioral interventions can be deployed in real world settings to help more efficiently achieve Ending the HIV Epidemic goals.

Injection Behaviors and Use of Syringe Service Programs over Time among People Who Inject Drugs in Baltimore, Maryland

Introduction: People who inject drugs (PWID) are at increased risk for infectious disease transmission, including hepatitis C and HIV. Understanding trends in injection risk behaviors and syringe service program (SSP) use over time can help improve infectious disease prevention and other harm reduction services. Methods: Using National HIV Behavioral Surveillance System data from Baltimore, Maryland, we examined changes in receptive sharing of (1) syringes, (2) injection equipment, (3) syringes to divide drugs; and (4) receipt of syringes from SSPs among PWID from 2009 to 2018 (n = 518 in 2009, n = 638 in 2012, n = 586 in 2015, and n = 575 in 2018) using unadjusted and adjusted logistic models calculated across time for the total sample. Results: The conditional probability of receptive sharing of syringes and receipt of syringes from SSPs remained relatively stable, while receptive sharing of injection equipment and receptive sharing of syringes to divide drugs dropped substantially after 2009. White race and daily injection frequency were positively associated with sharing syringes and injection equipment and negatively associated with SSP use over time. In 2015, there was a notable shift such that women were twice as likely as men to receive syringes from SSPs and less likely than men to report the use of shared syringes or equipment. Conclusion: Findings indicate overall steady or decreasing trends in injection risk and steady trends in SSP usage over time, with some notable improvements among women and indications of shifting drug market patterns. Injection-related risk behaviors remain high among White PWID and may require targeted outreach and interventions.

Updates on syringe coverage and service uptake among needle and syringe programs in the United States, 2019–2020

BackgroundAs injection drug use has increased in the US, so too has the prevalence of receptive syringe sharing. Since the 1980s, Needle and Syringe Programs (NSPs) have been an important source of clean injection equipment and disposal of used syringes. This study reports national syringe coverage and examines the impact of program attributes on organizational-level service uptake, defined as number of syringes distributed per participant contact per year. MethodsIn 2019 and 2020, we administered an annual cross-sectional survey to NSPs operating in the US (n = 260). A national estimate of coverage was calculated by dividing the total number of syringes distributed by the 2019 and 2020 population estimate of people who inject drugs (PWID). Frequency distributions and percentages were calculated for categorical variables (e.g., funding, census region, distribution policy/modality), and median and interquartile ranges (IQR) were calculated for continuous variables (e.g., participant contacts, syringes distributed). Bivariate and multivariable mixed effects logistic regression models were used to estimate the odds ratio associated with organizational characteristics on increasing service uptake at the NSP level. ResultsFrom 2019 to 2020, the total number of participant contacts by NSPs increased from 871,976 to 898,891, and the number of syringes distributed increased from 92,648,529 to 113,071,748. The national coverage estimate increased from 29.5 (95 % CI = 15.0, 58.2) to 35.8 (95 % CI = 18.2, 70.6) syringes per PWID. Fifty-eight percent of NSPs increased service uptake in 2020 as compared to the previous year. NSPs that received government funding and NSPs that changed to a less restrictive syringe distribution policy were more likely to increase service uptake (aOR 1.80, 95 % CI = 1.01, 3.22 and aOR 3.33, 95 % CI = 1.11, 9.94, respectively). Syringe distribution modalities also diversified, with more NSPs reaching participants via backpacking/outreach, fixed site pop-ups, mobile delivery, mail-based delivery, leaving supplies out, and secondary distribution. ConclusionBoth governmental investment in harm reduction programming and needs-based distribution of syringes increased service uptake and thus should be expanded and sustained to reduce harms associated with injection drug use.

Reductions in Energy Consumption and Emission of Harmful Exhaust Gases by Fishing Vessels

This article presents an analysis of the influence of engine types, fuel types and selected methods of fuel treatment before injection on reductions in fuel consumption and exhaust emission components. This is the first of such studies, the continuation of which will allow a comprehensive assessment of the impact of cutter operations on environmental pollution. For the selected type of cutter, EEOIs (Energy Efficiency Operational Indicators) were determined to be a measure that takes into account both fuel consumption and harmful gas compound emissions depending on the type of engine used and the type of fuel. The data necessary to prepare this analysis were obtained during operational tests carried out on selected cutters with various types of engines fuelled with liquid fuel and a new catalytic fuel treatment method developed by the authors, while for the case of using gas fuel and a common rail engine, possible effects were forecasted. The effects of engine type, years of manufacture and fuel type (liquid and gas) on fuel consumption and emissions of selected exhaust components are demonstrated. The positive effects on fuel consumption and emissions of harmful exhaust constituents obtained, under laboratory test conditions, for an engine fuelled with catalytically treated fuel have allowed further research directions to be set for cutter engines equipped with injection equipment with applied catalytic coatings.

Theory and Engineering Practice of Intermittent Heat Injection-Enhanced Coalbed Methane Extraction.

Because of the strong adsorption characteristics of methane and the low permeability of coal seams, the extraction efficiency of coalbed methane (CBM) is very low. Here, based on the energy conservation equation, we propose the theory of heat injection-enhanced CBM extraction. We developed a device for heat injection-enhanced CBM extraction and performed an on-site heat injection test in the Chengzhuang coal mine. The results showed that when the water injection rate was 0.5 m3/h, the heat injection temperature was 145 °C, with two heat injections, yielding the best CBM extraction effect. This could fully utilize the heat injection equipment and achieve a fast, safe, and efficient extraction. The gas production law of the intermittent heat injection-enhanced CBM extraction method had obvious stages; the CBM concentration and daily gas production were very low during the heat injection stage but were greatly improved during the extraction stage after heat injection. The highest CBM concentration reached 100%, and the maximum daily gas production of CBM increased by 1269 times. The variation law of the cumulative gas production with time was fitted using Wang's empirical formula. Comparative analysis showed that, compared to traditional extraction, intermittent heat injection shortened the extraction time by 6.6 years. Compared with other enhanced CBM extraction methods, the intermittent heat injection method had obvious technical advantages and greater improvements in concentration and CBM extraction speed. Therefore, the results are of great significance for improving the recovery rate of CBM and for reducing greenhouse gas emissions.

Study on Selection of Diesel Engine Exhaust After-Treatment System Materials and Emission Performance for Genset Applications

The use of diesel engines for the transportation sector is ubiquitous and covers a broad continuum, like buses, trucks, agriculture, construction equipment, generators, and industrial applications. However, because of their increased use of off-road engines, they contribute more emissions in various sectors than on-road. As a result, worldwide, regardless of ongoing emission control efforts, these off-road, stationary engines also continue to be a substantial source of air pollutant emissions in the United States, European Union and Asian markets. Accordingly, while improving emissions performance, the selection of after-treatment system materials and the use of compatible after-treatment specification selections are also critical. This is only possible by effectively combining clean diesel technologies such as Fuel Injection Equipment (FIE), Turbocharger with Intercooler (TCIC), Cooled Exhaust Gas Recirculation (C-EGR), and after-treatment systems like Diesel Oxidation Catalyst (DOC), Selective Catalytic Reduction (SCR), and Diesel Particulate Filter (DPF). Overall, in this study, the influence of after-treatment system configurations and their effect on emission reduction performance are studied for three different DOC specifications based on emission testing for catalyst and size optimization. With the selected DOC catalyst specification, suitable combinations of DPF and SCR specifications are optimized further using GT-SUIT software simulation. This study was carried out during the conversion of a 15 kW NA engine to a 27 kW TCIC engine to meet diesel engine emission norms.

Drug consumption rooms are effective to reduce at-risk practices associated with HIV/HCV infections among people who inject drugs: Results from the COSINUS cohort study.

The primary aim of this study was to evaluate the impact of drug consumption rooms (DCRs) in France on injection equipment-sharing, while the secondary aims focused upon their impact on access to hepatitis C virus (HCV) testing and opioid agonist treatment (OAT). The COhort to identify Structural and INdividual factors associated with drug USe (COSINUS cohort) was a 12-month longitudinal study of 665 people who inject drugs (PWID), conducted in Bordeaux, Marseille, Paris and Strasbourg. We used data from face-to-face interviews at enrolment and at 6-month and 12-month visits. The participants were recruited in harm reduction programmes in Bordeaux and Marseille and in DCRs in Strasbourg and Paris. Participants were aged more than 18 years, French-speaking and had injected substances the month before enrolment. We measured the impact of DCR exposure on injection equipment sharing, HCV testing and the use of medications for opioid use disorder, after adjustment for significant correlates. We used a two-step Heckman mixed-effects probit model, which allowed us to take into account the correlation of repeated measures and to control for potential bias due to non-randomization between the two groups (DCR-exposed versus DCR-unexposed participants). The difference of declared injection equipment sharing between PWID exposed to DCRs versus non-exposed was 10% (1% for those exposed versus 11% for those non-exposed, marginal effect = -0.10; 95% confidence interval = -0.18, -0.03); there was no impact of DCRs on HCV testing and OAT. In the French context, drug consumption rooms appear to have a positive impact on at-risk practices for infectious diseases such as human immunodeficiency virus (HIV) and hepatitis C virus.

Administration of intravenous fluids and medicines in children and young people.

Managing intravenous (IV) access is a standard proficiency for UK nurses, enabling them to administer IV injections and IV infusions and to manage injection equipment and infusion pumps and devices. In this article the author describes various types of venous access devices that are commonly seen in practice and details the preparation, checking and administration of IV fluids and medicines, including some complications that may arise. The author also discusses the calculation of fluid requirements, types of IV fluids, displacement values and ongoing care of venous access devices.

Ultra-low soot/ particulate emissions from a dimethyl ether-fueled agricultural tractor engine

This study eveluates using dimethyl ether (DME) fuelled engine for marching towards zero soot and particulate matter (PM) emissions in the agricultural sector. Comparative emissions and particulate characteristics were analysed for a customised DME-fuelled engine and an unmodified baseline diesel engine. The experimental investigations were performed on a multi-cylinder tractor engine using a dedicated DME fuel injection equipment (FIE) and an unmodified diesel FIE. Regulated emissions, namely carbon monoxide (CO), hydrocarbons (HC), and oxides of nitrogen (NOx), smoke opacity, and particulates were measured at three engine speeds (1200, 1600 and 2000 rpm) and five loads (1.29, 2.59, 3.88, 5.18, and 6.47 bar BMEP). The static fuel injection timing for both test fuels was maintained constant; however, the actual injection timing could be slightly different for both test fuels because of their different physicochemical properties. DME-fuelled engine exhibited relatively higher HC and CO emissions than diesel at low loads; however, both test fuels exhibited nearly identical emissions at higher loads. NOx emissions were lower for DME-fuelled engine than baseline diesel, and its smoke opacity was also negligible at all engine loads and speeds. The particulate number concentration for DME-fuelled engines was much lower than baseline diesel at all test conditions, except 1.29 bar BMEP. Particulate emissions from DME-fuelled engine were mainly in the form of nanoparticles and nucleation mode particles, with negligible numbers of accumulation mode particles. This experimental study demonstrated that DME-fuelling of the tractor engine reduced emissions and it can be used as a sustainable and greener fuel to develop cleaner engines for agriculture/ transport sectors.

Sexually Transmitted Infections in Pre-Exposure Prophylaxis Patients

Background and Objective: Pre-exposure prophylaxis (PrEP) effectively prevents the spread of the human immunodeficiency virus (HIV). HIV is a disease primarily contracted by men who have sex with men or the sharing of needles, syringes, and other drug injection equipment. However, there is some disparity over the thought that PrEP patients have a disproportionate incidence of sexually transmitted infections (STIs) compared with non-PrEP patients. This study aims to clarify the disparity and identify if PrEP patients have a higher incidence of STIs. Methods: A survey of 143 respondents was conducted on STI incidence, risk factors, and abstinence from May 13, 2022, to June 20, 2022. The results were analyzed in Statistical Package for the Social Sciences (SPSS V28.0.0.0). SPSS was used to analyze the descriptive statistics associated with STI data obtained from the Naval Medical Readiness and Training Command, Camp Lejeune, Community Health Clinic Patient and Laboratory Tracker. Results: This study found a higher incidence of STIs among PrEP patients than non-PrEP patients and a statistical significance (p = 0.010) between the number of partners a person had sex with over the past year and the lifetime incidence of STIs. Portions of the data in the linear regression were used to calculate the significance and can be used as a predictor of STIs based on the number of partners a person has. This can help patients within this community understand their actual risk of contracting an STI based on a potential risk factor. Conclusion and Implications for Translation: This study found a higher incidence of STIs among PrEP patients than non-PrEP patients. Additionally, the study can help public health professionals understand the risks associated with military patients who take PrEP and target specific risk factors that influence the disparity in the incidence of STIs. Future studies may use survey data from this study to understand the implications of other risk factors and their association with STIs. Public health professionals can also use these data to develop a predictive index for many risk factors. A predictive index on STI risk is an extremely valuable tool as it allows users to view their risk of obtaining an STI. Copyright © 2023 Sleeman and Hoban. Published by Global Health and Education Projects, Inc.This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Corrosion Study of the Injection Equipments in Water in Al-Ahdeb Wells ‐Iraq

Water injection equipments such as pipelines, which are used in the second recovery of oil in the Al-Ahdeb wells, suffer from the corrosion in water during maintaining vacuum deoxygenated tower that used to decrease concentration of the dissolved oxygen gas in the water from 6.2-9.1 ppm to o.5 ppm. This study involved calculation the corrosion rates of the internal surfaces of the pipelines either during operation of the vacuum unit or when the tower out of operation. Finally, find the solution by one of the following suggestions. In the first suggestion removal of the dissolved O2 from water is achieved by increasing the dosage of the oxygen scavenger (sodium sulphite). The second suggestion involves removing the dissolved O2 from water by bubbling the oxygenated water with nitrogen gas. The study showed that the corrosion rates of various inside diameter pipelines are between 0.13 mm/yr and 1.5 mm/yr during operation of the vacuum tower and between 3.2 mm/yr and 18.5 mm/yr when the tower out of the operation. While the results showed that the corrosion rate of the pipelines when the tower out of operation reached to the acceptable value of 0.1 mm/y when the dissolved oxygen in the injected water removed by increasing the dosage of the sodium sulphite (Na2SO3) to 48-72 ppm. The results also explained that corrosion rates of the pipelines reached to 0.5 mm/y when the dissolved oxygen removed by bubbling the water with nitrogen gas.

Injection partnership characteristics and HCV status associations with syringe and equipment sharing among people who inject drugs

BackgroundSharing of syringes is the leading transmission pathway for hepatitis C (HCV) infections. The extent to which HCV can spread among people who inject drugs (PWID) is largely dependent on syringe-sharing network factors. Our study aims to better understand partnership characteristics and syringe and equipment sharing with those partners, including measures of relationship closeness, sexual activity, and social support, as well as self and partner HCV status to better inform interventions for young urban and suburban PWID.MethodsData are from baseline interviews of a longitudinal network-based study of young (aged 18–30) PWID (egos) and their injection network members (alters) in metropolitan Chicago (n = 276). All participants completed a computer-assisted interviewer-administered questionnaire and an egocentric network survey on injection, sexual, and support networks.ResultsCorrelates of syringe and ancillary equipment sharing were found to be similar. Sharing was more likely to occur in mixed-gender dyads. Participants were more likely to share syringes and equipment with injection partners who lived in the same household, who they saw every day, who they trusted, who they had an intimate relationship with that included condomless sex, and who provided personal support. PWID who had tested HCV negative within the past year were less likely to share syringes with an HCV positive partner compared to those who did not know their status.ConclusionPWID regulate their syringe and other injection equipment sharing to some extent by sharing preferentially with injection partners with whom they have a close personal or intimate relationship, and whose HCV status they are more likely to know. Our findings underscore the need for risk interventions and HCV treatment strategies to consider the social context of syringe and equipment sharing within partnerships.

Alcohol use among people who inject drugs living with HIV in Kenya is associated with needle sharing, more new sex partners, and lower engagement in HIV care.

We assessed the prevalence and correlates of alcohol use among 870 people who inject drugs living with HIV in Kenya, with attention toward (1) sexual and injecting risk behaviors for HIV transmission and (2) HIV care engagement. We defined heavy alcohol use as > 14 drinks/week for men and > 7 drinks/week for women, moderate alcohol use as any lesser but non-zero amount, and any alcohol use as either moderate or heavy use. Approximately 39% of participants reported any alcohol use and 15% heavy use. In multivariate analysis, any alcohol use compared to no use was associated with needle sharing, > 3 new sex partners in the past 3 months, being unaware of HIV status, never enrolling in HIV care, and not being on ART (all p < 0.05). Heavy alcohol use as compared to no use was associated with needle sharing (aOR = 2.72; 95% CI 1.43,5.13), injection equipment sharing (aOR = 1.80; 95% CI 1.00,3.16), > 3 new sex partners in the past 3 months (aOR = 1.99; 95% CI 1.12,3.49), and being unaware of HIV status (aOR = 2.77; 95% CI 1.46,5.19). There was no association between any measure of alcohol use and unsuppressed viral load. Alcohol use among people who inject drugs living with HIV may carry elevated risk of HIV transmission mediated by sexual and injecting practices and is associated with lower engagement in multiple stages of the HIV care cascade.

Risky sexual practices and hepatitis C viremia among HIV-positive men who have sex with men in Taiwan.

Understanding the risk behaviors associated with sexually-transmitted hepatitis C virus (HCV) infection among men who have sex with men (MSM) may inform the public health policies and interventions aiming to achieve HCV microelimination. HIV-positive MSM who had one of the following conditions were enrolled to undergo face-to-face questionnaire interviews to collect information on their sexual practices in the past 12 months: (1) elevation of aminotransferases in the past 6 months; (2) acquisition of sexually transmitted infections in the past 6 months; and (3) previous HCV infections. Plasma HCV RNA were tested at enrolment and every 3 months during follow-up. Baseline characteristics and risky behaviors were compared to identify factors associated with HCV viremia between HCV-viremic MSM and HCV-aviremic MSM in multivariate analysis. Among 781 MSM with a median age of 36 years, 57 (7.3%) had HCV viremia and 724 (92.7%) no HCV viremia during follow-up. A high proportion (38.9%) of the participants reported having used recreational drugs in the past 12 months, with 34.4% of them having slamming, but only 4.8% reported having shared their injection equipment. In multivariate analysis, use of recreational drugs (adjusted odds ratio [aOR], 2.14; 95% CI, 1.16-3.96), having participated in group sex (aOR, 2.35; 95% CI 1.24-4.40) and having had condomless receptive anal intercourse (aOR, 1.97; 95% CI 1.07-3.62) were significantly associated with HCV viremia. Among high-risk HIV-positive MSM, use of recreational drugs and risky sexual contacts were associated with HCV viremia, suggesting the mucosal contacts as the major route of HCV transmission.

Dimethyl ether fuel injection system development for a compression ignition engine for increasing the thermal efficiency and reducing emissions

In this study, a dedicated fuel injection equipment (FIE) for a 100% dimethyl ether (DME)-fueled three-cylinder engine was developed. DME has a cetane number (>55) higher than baseline diesel (40–50), making it a promising compression ignition (CI) engine fuel. However, some physicochemical properties of DME, namely lubricity, viscosity, density, calorific value, vapour pressure, incompatibility with elastomers, etc., necessitate modifications in the existing FIE to deliver a power output equivalent to baseline diesel fuelled engine. Modifications included customized DME storage tanks, supply lines, return lines, and a pneumatic pre-supply feed pump. In addition, a customized high-pressure pump (HPP) (inline mechanical pump) and a set of modified injectors with larger nozzle hole diameters were used for the DME engine. The engine speed was varied from 1000 to 2000 rpm, and off-road operating conditions were simulated using a non-road steady cycle (NRSC). A detailed evaluation of the FIE for its comparative combustion, performance, and emissions characteristics of DME was conducted vis-à-vis baseline diesel. The DME-fuelled engine showed an increase of ∼4.7% in brake thermal efficiency (BTE) under full load conditions and an increase of ∼8.32% BTE under simulated non-road-testing conditions. In addition, the DME-fuelled engine exhibited no visible smoke and negligible soot in the engine exhaust. DME combustion reduced HC emissions by ∼50% at low and medium engine speeds, and a ∼100% reduction was seen at higher engine speeds compared to baseline diesel engine. The CO emission decreased by ∼90%, and the CO2 emissions were ∼15% lower for DME. Lower exhaust gas temperature (EGT) and lower heat release rate (HRR) during premixed combustion indicated that DME-fuelled engine acted as a low heat rejection (LHR) engine. This study demonstrated a 100% DME-fueled engine with a customized FIE, delivering higher thermal efficiency and lower emissions than conventional diesel engines for on- and off-road applications.

Use of fuel injection equipment with increased injection pressure for reducing environmental footprint

BACKGROUND: Environmental pollution causes a number of irreversible consequences, including those associated with climate warming, acid precipitation, deterioration of climatic conditions and others. The problem of reducing harmful emissions of diesel engines containing in exhaust gases is currently relevant, as the implementation of the EURO 4/5/6 standards is becoming increasingly difficult for both new automotive equipment and those already in operation.&#x0D; AIMS: Reduction of harmful emissions into the atmosphere and reduction of environmental footprint by increasing the fuel injection pressure in a diesel cylinder.&#x0D; MATERIALS AND METHODS: The 6Ch15/18 (7D6-150) diesel engines, having nominal power of 110 kW at 1500 min-1, specific effective fuel consumption of 224 g/(kWh) and oil burn of 0.32% of the fuel consumption intended for diesel generator units, were tested. During steady-state tests, diesel exhaust gases were collected to analyze their composition and determine the dispersion of solid particles (SP) with an increase in fuel injection pressure by tightening the nozzle springs.&#x0D; RESULTS: It was revealed that with an increase in the tightening of the nozzle springs and an increase in the injection pressure (PI), emissions of solid particles with exhaust gases decrease, and the fuel efficiency of diesel increases. As a result of the tests carried out, it was found that with an increase in the springs tightening of the injectors from (PI increased from 160 to 185 kPa), emissions of nitrogen oxides (NOx) decreased by 15%, emissions of carbon monoxide (CO) decreased by 15%, emissions of hydrocarbons (CxHy) decreased by 54% and emissions of solid particles (SP) decreased by 33%. Improved mixing and better preparation of fuel for combustion explain the change in CO emissions with the PI increase. The emissions of CxHy indicate a significant improvement in the completeness of fuel combustion in the cycle. Emissions of solid particles containing in exhaust gases are reduced due to the intensification of mixing of air and fuel vapor, contributing to a more complete burn-off of soot in a cylinder. The CxHy emissions are reduced and meet the EURO-3 and EURO-4 standards. The environmental footprint was as follows: NEF = 51.34 Сt/year at PI = 160 kPa and NEF = 43.66 Сt/year at PI = 185 kPa, which indicates a decrease in the environmental footprint by 1.17 times or by 15%.&#x0D; CONCLUSIONS: The practical value of the study lies in the possibility of using fuel injection equipment with increased fuel injection pressure into a cylinder to reduce harmful emissions from diesel exhaust gases down to the required standards.

HIV Criminal Laws Are Legal Tools of Discrimination

Laws should protect people living with HIV against discrimination on the basis of their HIV diagnosis. Yet, in the United States most states have HIV-specific criminal laws that legally sanction discrimination against people living with HIV. The purpose of this article is to educate readers regarding HIV criminal laws, which have become legal tools of discrimination that are used against people of color and economically marginalized communities. HIV-specific laws are outdated and do not reflect current scientific evidence. HIV is a treatable chronic illness in which daily medication can suppress the virus to an undetectable level preventing sexual transmission. Thousands of people with HIV across the country have been brought into the criminal justice system through arrest under HIV-specific statutes. Despite evidence that HIV laws do not align with science, they continue to be enforced every day across the United States (Blecher-Cohen, 2021; Cockerill & Wahlert, 2015). There are two types of HIV criminal laws. The first type are HIV exposure laws that criminalize people with HIV who are accused of not disclosing their HIV status before sexual contact, sharing injection equipment, or donating blood and organs. Currently, 35 states have HIV-specific laws that prosecute people with HIV for actual or perceived exposure to HIV without there being neither intention to harm nor actual transmission. The only requirement is that the person with HIV is aware of their status (Harsono et al., 2017).

HEPATITIS B, HEPATITIS C AND HIV AMONG DRUG USERS IN METHADONE MAINTENANCE TREATMENT: PREVALENCE, DOSES, TREATMENT COMPLIANCE

TheUsersofopioidsubstances,especiallyinjectingdrugs,areathighriskofinfection with blood- borne viruses,such as hepatitis B,C and human immunodeficiency virus, due to the sharing of needles and injection equipment. Methadone substitution treatment is approven device in the risk reduction strategy of hepatitis B,C and HIV infection.The aim of this studyis to determine: the socio-demographic and medical psychiatric characteristics of patients with hepatitis B,C and HIV under methadone,the prevalence of hepatitis C,B and HIV,the dose of methadone and compliance with treatment in this population. Materials and methods: This is a retrospective descriptive study of patients admitted to the center of addictology at the hospital Ar-razi of Sale in Morocco , specifically in methadone unit. Results: The prevalence of hepatitis C, B and HIV were respectively 80%, 13% and 4% in patients with positive serology, the average dose of methadone was higher than the dose of all patients enrolled in the methadone program. 80% of patients under methadone with positive serology to HCV, HBV and HIV had a polyconsumption of psychoactive substances (cannabis, cocaine, alcohol, benzodiazepine). 72% of our patients with hepatitis C received treatment for their infection while all the patients with HIV were put on antiretroviral drugs with good therapeutic compliance. Conclusion:Methadone substitution therapy has proven to be a successful strategy to reduce the risk of HIV, HCV and HBV infection in opioid-dependent patients. However, the adjustment of methadone doses and systematic screening for HIV, HCV and HBV is essential in this vulnerable population.

Network ethnic homophily and injection equipment sharing among Latinx and White non-Latinx people who inject drugs

Latinx people who inject drugs (PWID) are less likely to engage in injection equipment sharing, but are more vulnerable to injection drug use (IDU)-related morbidity and mortality than Whites. Identifying subgroups of Latinx PWID who do engage in equipment sharing and likely bear the brunt of this health burden is a priority. Ethnic disparities may reflect contextual drivers, including injection networks. Latinx PWID with low ethnic homophily (the proportion of individuals with the same ethnic background) may be more likely to share equipment due to forced distancing from health-protective ethnocultural resources and power imbalances within injection networks. The current study offers a framework and examines how associations between network ethnic homophily and injection equipment sharing differ among 74 Latinx and 170 non-Latinx White PWID in the Chicagoland area (N = 244). Latinx had less homophilous than non-Latinx Whites (p <.001). Ethnic homophily was protective for equipment sharing among Latinx (OR = 0.17, 95%CI [0.77, 0.04], p = .02), but not non-Latinx Whites (OR = 1.66, 95%CI [0.40, 6.93], p = .49). Our findings implicate the need for targeted cultured interventions that focus on Latinx PWID who are more vulnerable to morbidity and mortality, potentially due to less access to ethnic peers.

Factors associated with receptive injection equipment sharing among people who inject drugs: findings from a multistate study at the start of the COVID-19 pandemic

BackgroundReceptive injection equipment sharing (i.e., injecting with syringes, cookers, rinse water previously used by another person) plays a central role in the transmission of infectious diseases (e.g., HIV, viral hepatitis) among people who inject drugs. Better understanding these behaviors in the context of COVID-19 may afford insights about potential intervention opportunities in future health crises.ObjectiveThis study examines factors associated with receptive injection equipment sharing among people who inject drugs in the context of COVID-19.MethodsFrom August 2020 to January 2021, people who inject drugs were recruited from 22 substance use disorder treatment programs and harm reduction service providers in nine states and the District of Columbia to complete a survey that ascertained how the COVID-19 pandemic affected substance use behaviors. We used logistic regression to identify factors associated with people who inject drugs having recently engaged in receptive injection equipment sharing.ResultsOne in four people who inject drugs in our sample reported having engaged in receptive injection equipment sharing in the past month. Factors associated with greater odds of receptive injection equipment sharing included: having a high school education or equivalent (adjusted odds ratio [aOR] = 2.14, 95% confidence interval [95% CI] 1.24, 3.69), experiencing hunger at least weekly (aOR = 1.89, 95% CI 1.01, 3.56), and number of drugs injected (aOR = 1.15, 95% CI 1.02, 1.30). Older age (aOR = 0.97, 95% CI 0.94, 1.00) and living in a non-metropolitan area (aOR = 0.43, 95% CI 0.18, 1.02) were marginally associated with decreased odds of receptive injection equipment sharing.ConclusionsReceptive injection equipment sharing was relatively common among our sample during the early months of the COVID-19 pandemic. Our findings contribute to existing literature that examines receptive injection equipment sharing by demonstrating that this behavior was associated with factors identified in similar research that occurred before COVID. Eliminating high-risk injection practices among people who inject drugs requires investments in low-threshold and evidence-based services that ensure persons have access to sterile injection equipment.