Injection Equipment Research Articles

P3.101 Prevalence of HIV and HCV and HIV Transmission Related Risk Factors Among Persons Who Inject Drug (PWID) in Barnaul, Russia

BackgroundThe annual numbers of registered HIV cases in Russia continue to grow. The epidemic is driven by use of contaminated illicit injection equipment. In 2006 HIV prevalence in Barnaul was...

Reductions in HIV/STI Incidence and Sharing of Injection Equipment among Female Sex Workers Who Inject Drugs: Results from a Randomized Controlled Trial

BackgroundWe evaluated brief combination interventions to simultaneously reduce sexual and injection risks among female sex workers who inject drugs (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico during 2008–2010, when harm reduction coverage was expanding rapidly in Tijuana, but less so in Juarez.MethodsFSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month participated in a randomized factorial trial comparing four brief, single-session conditions combining either an interactive or didactic version of a sexual risk intervention to promote safer sex in the context of drug use, and an injection risk intervention to reduce sharing of needles/injection paraphernalia. Women underwent quarterly interviews and testing for HIV, syphilis, gonorrhea, Chlamydia and Trichomonas, blinding interviewers and assessors to assignment. Poisson regression with robust variance estimation and repeated measures ordinal logistic regression examined effects on combined HIV/STI incidence and receptive needle sharing frequency.FindingsOf 584 initially HIV-negative FSW-IDUs, retention was ≥90%. After 12 months, HIV/STI incidence decreased >50% in the interactive vs. didactic sex intervention (Tijuana:AdjRR:0.38,95% CI:0.16–0.89; Juarez: AdjRR:0.44,95% CI:0.19–0.99). In Juarez, women receiving interactive vs. didactic injection risk interventions decreased receptive needle-sharing by 85% vs. 71%, respectively (p = 0.04); in Tijuana, receptive needle sharing declined by 95%, but was similar in active versus didactic groups. Tijuana women reported significant increases in access to syringes and condoms, but Juarez women did not.InterpretationAfter 12 months in both cities, the interactive sexual risk intervention significantly reduced HIV/STI incidence. Expanding free access to sterile syringes coupled with brief, didactic education on safer injection was necessary and sufficient for achieving robust, sustained injection risk reductions in Tijuana. In the absence of expanding syringe access in Juarez, the injection risk intervention achieved significant, albeit more modest reductions, suggesting that community-level interventions incorporating harm reduction are more powerful than individual-level interventions.Trial Registrationclinicaltrials.gov NCT00840658

Translation of Biomedical Prevention Strategies for HIV

Early achievements in biomedical approaches for HIV prevention included physical barriers (condoms), clean injection equipment (both for medical use and for injection drug users), blood and blood product safety, and prevention of mother-to-child transmission. In recent years, antiretroviral drugs to reduce the risk of transmission (when the infected person takes the medicines; treatment as prevention) or reduce the risk of acquisition (when the seronegative person takes them; preexposure prophylaxis) have proven to be efficacious. Circumcision of men has also been a major tool relevant for higher prevalence regions such as sub-Saharan Africa. Well-established prevention strategies in the control of sexually transmitted diseases and tuberculosis are highly relevant for HIV (ie, screening, linkage to care, early treatment, and contact tracing). Unfortunately, only slow progress is being made in some available HIV-prevention strategies such as family planning for HIV-infected women who do not want more children and prevention of mother-to-child HIV transmission. Current studies seek to integrate strategies into approaches that combine biomedical, behavioral, and structural methods to achieve prevention synergies. This review identifies the major biomedical approaches demonstrated to be efficacious that are now available. We also highlight the need for behavioral risk reduction and adherence as essential components of any biomedical approach.

Lessons learned from a community based intervention to improve injection safety in Pakistan

BackgroundA national study in 2007 revealed that in Pakistan the prevalence of hepatitis B is 2.5% and for hepatitis C it is 5%. Unsafe injections have been identified as one of the reasons for the spread of these infections. Trained and untrained providers routinely perform unsafe practices primarily for economic reasons i.e. they reuse injection equipment on several patients. The patients, do not question the provider about the need for an injection because of social barriers or whether the syringe is coming from a new sterile packet due to lack of knowledge. The present paper represents an intervention that was developed to empower the community to improve unsafe injection practices in rural Pakistan.MethodsIn a rural district of Pakistan (Tando Allahyar, Sindh) with a population of approximately 630,000 a multipronged approach was used in 2010 (June to December) to improve injection safety. The focus of the intervention was the community, however providers were not precluded. The organization of interventions was also carefully planned. A baseline assessment (n=300) was conducted prior to the intervention. The interventions comprised large scale gatherings of the community (males and females) across the district. Smaller gatherings included teachers, imams of mosques and the training of trained and untrained healthcare providers. The Pakistan Television Network was used to broadcast messages recorded by prominent figures in the local language. The local FM channel and Sunday newspaper were also used to disseminate messages on injection safety. An end of project assessment was carried out in January 2012. The study was ethically reviewed and approved.ResultsThe interventions resulted in improving misconceptions about transmission of hepatitis B and C. In the baseline assessment (only 9%) of the respondents associated hepatitis B and C with unsafe injections which increased to 78% at the end of project study. In the baseline study 15% of the study participants reported that a new syringe was used for their most recent injection. The post-intervention findings showed an increase to 29% (n=87).ConclusionIt is difficult to assess the long-term impact of the intervention but there were several positive indicators. The duration of intervention is the key to achieving a meaningful impact. It has to be at least 18–24 months long.

Maintenance Therapy with Opium Tincture for Injecting Drug Users; Implications for Prevention from Viral Infections

Maintenance Therapy with Opium Tincture for Injecting Drug Users; Implications for Prevention from Viral Infections

Prevalence of HIV infection in individuals with history of intravenous drug use via community announcement in Isfahan- Iran

Objective: Injection drug using is a major risk factor for Human Immunodeficiency Virus (HIV) infection in developing countries. Ten percent of the HIV/AIDS cases worldwide are attributed to Injection drug use. Among injection drug users (IDUs), HIV and other blood-borne infections are spread primarily through risk behaviors related to sharing of contaminated syringes and drug injection equipments. The aim of present study was to determine HIV prevalence among cases with background of intravenous drug use via community announcement in Isfahan, Iran. Methodology: The cross-sectional study was conducted in 1599 volunteers from 16 different cities of Isfahan province, Iran who had a history of intravenous drug use in 2009. Participants were invited to reference laboratories and Serum samples were separated. Diagnosis of HIV infection was determined by enzyme linked immunosorbent assay (ELISA).Western blotting was done to confirm HIV ELISA positive specimen. The collected data was coded and entered in a data base file. Descriptive statistical method was used for data analysis. Results: Out of 1599 volunteers with a history of Intravenous drug use 24 of them (1. 5%) were HIV-antibody-seropositive. Conclusion: Prevalence of HIV infection among IDUs in Isfahan province is relatively high. Therefore it is essential to perform more effective prevention strategies and continuous education programs to control risk behaviors among IDUs. Moreover, available prevention services such as needle and syringe programs are useful to reduce the frequency of HIV among the population of drug users. doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3541 How to cite this:Hashemipour M, Nokhodian Z, Yaran M, Ataei B, Tayeri K, Nobari RF, et al. Prevalence of HIV infection in individuals with history of intravenous drug use via community announcement in Isfahan- Iran. Pak J Med Sci 2013;29(1)Suppl:395-398. doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3541 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Experimental investigation into the effects of two-stage injection on fuel injection quantity, combustion and emissions in a high-speed optical common rail diesel engine

Diesel combustion and the formation of pollutants are directly influenced by the spatial and temporal distributions of the fuel within the combustion chamber of an internal combustion engine. The requirements for more efficient and responsive diesel engines have led to the introduction and implementation of multiple injection strategies. However, the effects of such injection modes on the hydraulic systems, such as the high pressure pipes and fuel injectors, must be thoroughly examined and compensated for. The objective of this study was to investigate the effects of fuel injection equipment characterisation and optimisation on diesel combustion and emissions with two-stage fuel injection. The fuel injection system was characterised and optimised through the measurement of the fuel injection rate and quantity, in particular, the interaction between the two injection events was quantified and compensated for. The effects of twin and variable split two-stage injection and dwell angle on diesel combustion and emissions were investigated in a high-speed direct injection single-cylinder optical diesel engine using heat release analysis and high-speed fuel spray and combustion visualisation technique. The results indicated that two-stage injection has the potential for simultaneous reduction of NOx and soot emissions. Nevertheless, the studied two-stage strategies resulted in higher soot emission, mainly due to the interaction between two consecutive fuel injection events, whereby the fuel sprays during the second injection were injected into burning regions, generating fuel-rich combustion. In addition, the variable two-stage strategies produced high levels of uHC emission in comparison to single and twin split injection cases. This was mainly attributed to firstly greater fuel quantity injected during the second injection and secondly poor mixing and air utilisation during the second fuel injection event.

ON THE ROLE OF SCREENING AND EDUCATIONAL CAMPAIGNS ON CONTROLLING HCV IN CORRECTIONAL INSTITUTIONS

The prevalence of infection with hepatitis C virus (HCV) is higher among prison inmates compared with the general population because of the high proportion of intravenous drug misusers. In this paper, a mathematical model for the spread of HCV in correctional institutions is developed and analyzed. The impact of educational campaigns and screening of HCV infected individuals is examined. In the presence of screening, the study suggests that targeted education campaigns of more than 50% will be highly effective in controlling the sharing of injection equipment among intravenous drug users, thereby reducing HCV prevalence within the correctional institutions. Further, we applied optimal control theory to the proposed model. The controls represent educational campaigns and screening. The objective is based on minimizing cumulative latent and infectious cases within the correctional institution, while maximizing the number of susceptible nonintravenous drug misusers. The optimal control is characterized and numerically solved. Overall, the application of optimal control theory in this study suggests that, more effort should be devoted to educational campaigns compared to screening.

Psichoaktyvių medžiagų vartojimo žalos mažinimas:koncepcijos pokyčiai ir veiksmingumas

Infectious diseases such as HIV and virus hepatitis B and C are closely connected with drug use. These diseases are one of the hardest drug use results affecting health. The relation between drug injections and infection transmission is undeniable. Therefore, in many countries prevention of drug use harm and its reduction is the aim of societies‘ health policy and strategies of fighting against drugs. The aim of this work: to review the concept of harm reduction, to analyse and present literature material related to particularity of implementation, importance and effectiveness of one element of harm reduction programme - needle and syringe / exchange. The methodology of the study is analysis and synthesis of scientific literature and sources, meta-analysis, structuring and summarizing information.Harm reduction is a policy or programme oriented towards reducing negative drug use effects on health of an individual person and the whole society in general as well as social and economical areas without a strict requirement for a person to give up using drugs. Using clean injection equipment, its sterilization, reducing of risky habits while preparing drug mixtures/solutions and promotion of condom use are especially important kinds of intervention in programmes of reducing HIV, spread of hepatitis, overdosing and other drug connected death cases. However drug harm reduction programmes are not alternatives to other means of treatment for drug use. Harm reduction, widespread worldwide, is being consolidated and integrated with different health care and social services. Usually “packages“ of various services of harm reduction are provided in low threshold centres.

Detection of nerve structures during peripheral nerve blockade in pigs model

Objective: In recent years regional anesthesia has gained great popularity. However, like any other medical procedure, the regional anesthesia carries certain risk of unintended intraneural injection and consequential neurological complications. Studies in animals have suggested that intraneural application of local anesthetics may cause mechanical injury. Previous studies, however, have used small animal models and clinically irrelevant injection speed or equipment. In this study we used equipment and injection methods in common clinical use to study the consequences and pressure dynamics of intraneural injection. Our hypothesis is that an intraneural injection is heralded by higher injection pressure and leads to neurologic impairment in pigs. Materials and Methods: Ten pigs of mixed breed (21-26 kg, 4-6 months old) were studied. After general anesthesia, the sciatic nerves (n = 20) were exposed bilaterally. Under direct vision, a 25-gauge insulated nerve block needle was placed either intraneurally (n = 10) or perineurally (n = 10), and 4 ml of preservative-free lidocaine 2% was injected using an automated infusion pump (15 ml/min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations during next 7 days. Results: All perineural injections resulted in injection pressures below 40 kPa. In contrast, intraneural injections resulted in significantly higher peak pressures (P 140 k Pa. Conclusion: High injection pressure (>140 kPa) predicts intraneural injection and consequential neurologic deficit. As long as the injection pressure is low, injection into poorly compliant tissue can be avoided and neurological complication can be prevented.

Ship-based Offshore CCS Featuring CO2 Shuttle Ships Equipped with Injection Facilities

Transport of CO2 is a key component in the CCS chain for commercial projects, and CO2 shipping is being reconsidered as an alternative to pipeline transport even when the distance across the sea is not so quite long. The ship-based transport will make it possible to couple CO2 recovery plant and storage site without being limited to a single sink-source match, and decoupling and moving to another sink can be done with relative ease when necessary. It also removes the pipeline construction and removal activities in coastal zone where the social activities like fishery are often high.In this paper, the technical and economic feasibility of shuttle-type shipping and offshore operation for CO2 injection from the ship to the well(s) are studied. The main components needed for the proposed system are liquefaction of CO2, temporary storage at port, offloading, shuttle ship with Dynamic Positioning System and injection equipments onboard, flexible riser pipe whose end is connected with the wellhead on the sea floor, and pickup system at site.

Influence By Injection Drug Use In Patients With Hiv-Tb

Every year reported a patient with HIV is increasing. HIV can infect humans, through sexual whether heterosexual or homosexual, infection through contaminated blood flow, such as sharing drug injection equipment and infection from mother to child. HIV / AIDS, TB and injection drug use (IDU) contribute to the spread of the epidemic and increased mortality rates in communities around the world. TB is the leading cause of death among HIV-infected IDUs. In this present paper, we present the results that gained from binary logistic regression method and used to model the relationship between the ordinal outcome variable. The significant variables are chosen based on the p-value criteria which associated with the significant level of model that lies at the level of  = 0.25. Logit determination and the correlation between the variables are also discussed for further analysis. The use of mathematical software PASWand AMOS version 18 is applied in this research as an alternative calculation procedure derived from the methodology. Among the factors involved in this study were age, gender, race, level of CD4 content of less than 200/mm3, heterosexual, receiving blood infected with HIV, smoking, hepatitis, pneumonia and toxoplasmosis. This study found that there were six significant factors were age, gender, levels of CD4 less than 200/mm3, heterosexual, smoking and pneumonia. For structural equation modeling showed that the critical ratio for the diagnosis of HIV and TB patient through HIV_TB: IDU and CD4 was significant level at 0.05 and have a strong relationship. Overall, the results showed that age, gender, level of CD4 content of less than 200/mm 3 , heterosexual, smoking and pneumonia were contributing factors to TB infection in people with HIV-positive through injection drug use (IDU) in Kelantan. The government and relevant parties should provide ongoing effort to increase awareness about the dangers of social relations and illness with TB and HIV-positive IDUs by conducting campaigns, talks and tighten laws involving social problems.

Burden of pediatric hepatitis C

Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread HCV infection throughout Egypt. Parenteral acquisition of HCV remains a major route for infection among Egyptian children. Insufficient screening of transfusions, unsterilized injection equipment and re-used needles and syringes continue to be major routes of HCV transmission in developing countries, whereas vertical transmission and adolescent high-risk behaviors (e.g., injection drug abuse) are the major routes in developed countries. The risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%. Early stages of HCV infection in children do not lead to marked impairment in the quality of life nor to cognitive, behavioral or emotional dysfunction; however, caregiver stress and family system strain may occur. HCV slowly progresses to serious complications as cirrhosis (1%-2%) and hepatocellular carcinoma (HCC) especially in the presence of risk factors as hemolytic anemias, obesity, treated malignancy, and concomitant human immune deficiency and/or hepatitis B virus co-infection. HCV vaccine remains elusive to date. Understanding the immune mechanisms in patients who successfully cleared the infection is essential for vaccine development. The pediatric standard of care treatment consists of pegylated interferon-α 2a or b plus ribavirin for 24-48 wk. The new oral direct acting antivirals, approved for adults, need further evaluation in children. Sustained virologic response varies depending on the viral load, genotype, duration of infection, degree of aminotransferase elevation, adiposity and single nucleotide polymorphisms of interleukin (IL)-28B locus. The goals of treatment in individual patients are virus eradication, prevention of cirrhosis and HCC, and removing stigmatization; meanwhile the overall goal is decreasing the global burden of HCV. IL-28B polymorphisms have been also associated with spontaneous clearance of vertically acquired HCV infection. The worldwide economic burden of HCV for children, families and countries is estimated to be hundreds of millions of US dollars per year. The United States, alone, is estimated to spend 199-336 million dollars in screening, monitoring and treatment during one decade. The emotional burden of having an HCV infected child in a family is more difficult to estimate.

20813 BWR複雑流路内における溶融燃料落下挙動(086-4【熱流体工学のフロンティア(4)】)

It is important to estimate the behavior of molten core jet in RPV (Reactor Pressure Vessel) of BWR when severe accident occurred as can be seen from Fukushima Danchi nuclear power plant accident. Thus we are developing a simulation code to estimate the behavior of molten core falling in a lower plenum of BWR. Since there are many complicated structures in the plenum, it is expected that molten core would be injected in the complicated flow channel. The objective of the present study is to investigate the influence of complicated structures m a lower plenum on jet by experiment. To investigate it, we observe jet injection which simulated the molten core falling accident experimentally. We constructed a model of a lower plenum and a steady jet injection equipment. Results of preliminary experiment showed that jet behavior is affected by complicated flow structure

Applying Lean Manufacturing Tool (SMED/QCO) to Overcome Additional Investment for Meeting Customer Needs – A Study at Robert Bosch (I) Limited

Nowadays the market is increasingly demanding more customized products, thus making the manufacturers under the pressure of cost reduction, to survive in the highly competitive market. Working on this, Robert Bosch INdia (RBIN) Limited, Bangalore Plant (BanP) designs and produces Diesel systems which make vehicles more cleaner and economical. To be the world’s leading manufacturer of diesel injection systems, Bosch has to manufacture its very own design to fulfill the requirements for every customers, economically. Fuel Injection Equipment in diesel engine is the “Heart of the Engine” and plays a major role in its performance, emissions and reliability. Hot Forged Rail (HFR) finds its application in common rail fuel injection system, which stores the fuel at high pressure (1600bar). And at the same time, the pressure oscillation, which is generated due to the high pressure pump delivery and the injection of fuel are damped by the rail volume. Its design varies according to customer requirement and engine design. Therefore, BanP has to produce different types of rails to complete diesel market in India. In order to be customer centric and productive, BOSCH follows Bosch Production Systems (BPS), the elements of BPS in Lean manufacturing are Value Stream Mapping (VSM), Value Stream Design (VSD) and Value Stream Planning (VSP). The Single Minute Exchange of Die (SMED) is one important lean manufacturing tool to reduce waste and improve production flexibility, allowing lot size reduction and manufacturing flow improvements. Quick Change Over (QCO) is a set of activities (preparation, changing and adjustment) which are being carried out in between the production of two varieties to reduce changeover time and to reach the optimum production running. The proposed SMED approach was tested for injection machines changeovers in the automotive industry and the implementation had enabled reduction in setup time, through company’s internal resources reorganizations without the need for significant investment. The objective of the present study is to implement the SMED/QCO tool approach in RBIN, BanP, HFR production line to reduce the changeover time by >65% and improve availability by 15%, thereby eliminating the possibility of investing on new production line to meet customer demand.

Frequent food insecurity among injection drug users: correlates and concerns

BackgroundFood insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs). Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk.MethodsA cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use.ResultsIn the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else’s injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals.ConclusionsFindings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed.

Network Structure and the Risk for HIV Transmission Among Rural Drug Users

Research suggests that structural properties of drug users' social networks can have substantial effects on HIV risk. The purpose of this study was to investigate if the structural properties of Appalachian drug users' risk networks could lend insight into the potential for HIV transmission in this population. Data from 503 drug users recruited through respondent-driven sampling were used to construct a sociometric risk network. Network ties represented relationships in which partners had engaged in unprotected sex and/or shared injection equipment. Compared to 1,000 randomly generated networks, the observed network was found to have a larger main component and exhibit more cohesiveness and centralization than would be expected at random. Thus, the risk network structure in this sample has many structural characteristics shown to be facilitative of HIV transmission. This underscores the importance of primary prevention in this population and prompts further investigation into the epidemiology of HIV in the region.

The effect of maximum open height on operating characteristics of polymer injected pump poppet valve

Reciprocating polymer injected pump is the key injection equipment of tertiary oil recovery, the poppet valve in it exists the problem of large vibration noise, low efficiency and short life when transportation high viscosity medium. So the CFD technique is adopted to simulate and analyze the inner flow fields of fluid end poppet valve. According to the practical structure of the poppet valve, a simplified 2D axis-symmetry geometry model of the flow field is established. Combined with pump speed, plunger stroke and plunger diameter, given the boundary condition of the inlet valve, then the numerical simulation of flow field under six different maximum open heights is done depending on software Fluent. The relationship between open height to valve gap flow velocity, hydraulic loss and lag angle is obtained. The results indicate that, with the increase of open height, the valve gap flow velocity decreases, inlet outlet pressure differential decreases and hydraulic loss decreases. But the lag angle is continuously increasing with the increase of maximum open height, the valve has a good work performance when the open height is 1, 1.5, 2, 2.5, 3mm, but when it reaches 3.5mm, the valve performance becomes poor. The study can offer certain reference to understand operating characteristics of poppet valve, help to reduce the hydraulic losses and raise volume efficiency of the pump.

Transmission of Hepatitis C Virus Among People Who Inject Drugs: Viral Stability and Association With Drug Preparation Equipment

Hepatitis C virus (HCV) transmission among people who inject drugs remains a challenging public health problem. We investigated the risk of HCV transmission by analyzing the direct association of HCV with filters, water to dilute drugs, and water containers. Experiments were designed to replicate practices by people who inject drugs and include routinely used injection equipment. HCV stability in water was assessed by inoculation of bottled water with HCV. Viral association with containers was investigated by filling the containers with water, inoculating the water with HCV, emptying the water, and refilling the container with fresh water. Transmission risk associated with drug preparation filters was determined after drawing virus through a filter and incubating the filter to release infectious particles. HCV can survive for up to 3 weeks in bottled water. Water containers present a risk for HCV transmission, as infectious virions remained associated with water containers after washing. Physical properties of the water containers determined the degree of HCV contamination after containers were refilled with water. HCV was also associated with filter material, in which around 10% of the viral inoculum was detectable. This study demonstrates the potential risk of HCV transmission among injection drug users who share water, filters, and water containers and will help to define public health interventions to reduce HCV transmission.

U.S. drug use and migration experiences of Mexican female sex workers who are injection drug users.

To describe U.S.-based drug/sex behaviors and correlates of lifetime U.S. drug use by Mexican female sex workers who inject drugs (FSW-IDUs). Between 2008-2010, 315 migrant FSW-IDUs residing in Tijuana and Ciudad Juarez, Mexico responded to questionnaires. Twenty-seven percent (n=85) of FSW-IDUs were U.S. migrants; of these, 46% (n=39) were deportees. One-half of U.S.-migrant FSW-IDUs consumed illicit drugs in the U.S., and two-thirds of these injected drugs in the U.S. Among U.S. injectors, over 75% ever received or shared used injection equipment. The majority (92%) of U.S.-migrant FSW-IDUs never obtained U.S. drug treatment services. HIV prevalence was 4% among U.S.-migrant and 5% among non-U.S. migrant FSW-IDUs; 100% of U.S.-migrant and 75% of non-U.S. migrant FSW-IDUs were unaware of their HIV status. Binational coordination to improve access to substance use treatment and HIV testing services in Mexico and the U.S. among marginalized binational migrants may be critical to containing HIV transmission.