People Who Research Articles

Assessing Spillover Effects of Medications for Opioid Use Disorder on HIV Risk Behaviors among a Network of People Who Inject Drugs

Assessing Spillover Effects of Medications for Opioid Use Disorder on HIV Risk Behaviors among a Network of People Who Inject Drugs

PCR239 Perspectives on Pre-Exposure Prophylaxis (PrEP) Among People Who Could Benefit From PrEP: Qualitative Research Findings

PCR239 Perspectives on Pre-Exposure Prophylaxis (PrEP) Among People Who Could Benefit From PrEP: Qualitative Research Findings

Hepatitis C (HCV) Reinfection and Risk Factors among Clients of a Low-Threshold Primary Healthcare Service for People Who Inject Drugs in Sydney, Australia.

Hepatitis C (HCV) reinfection studies have not focused on primary healthcare services in Australia, where priority populations including people who inject drugs (PWID) typically engage in healthcare. We aimed to describe the incidence of HCV reinfection and associated risk factors in a cohort of people most at risk of reinfection in a real-world community setting. We conducted a secondary analysis of routinely collected HCV testing and treatment data from treatment episodes initiated with direct-acting antiviral (DAA) therapy between October 2015 and June 2021. The overall proportion of clients (N = 413) reinfected was 9% (N = 37), and the overall incidence rate of HCV reinfection was 9.5/100PY (95% CI: 6.3-14.3). Reinfection incidence rates varied by sub-group and were highest for Aboriginal and/or Torres Strait Islander people (20.4/100PY; 95% CI: 12.1-34.4). Among PWID (N= 321), only Aboriginality was significantly associated with reinfection (AOR: 2.73, 95% CI: 1.33-5.60, p = 0.006). High rates of HCV reinfection in populations with multiple vulnerabilities and continued drug use, especially among Aboriginal and Torres Strait Islander people, highlight the need for ongoing regular HCV testing and retreatment in order to achieve HCV elimination. A priority is resourcing testing and treatment for Aboriginal and/or Torres Strait Islander people. Our findings support the need for novel and holistic healthcare strategies for PWID and the upscaling of Indigenous cultural approaches and interventions.

Youth Justice Staff Perspectives on Psychological Resilience Interventions and Outcomes in Young People Who Offend

ABSTRACT Interventions aimed at increasing psychological resilience are an important factor in reducing recidivism in young people. However, little is known about how practitioners understand, apply, and assess the efficacy of the interventions they deliver. This knowledge gap is concerning as case workers are at the forefront of intervention delivery, where intervention success has wide implications for the young person and society. To provide some of the first evidence in this area, we conducted in-depth semi-structured interviews with 12 Youth Justice case workers based in Wales (UK). We used reflexive thematic analysis to examine four pre-conceived key themes. The first theme involved understanding what resilience is in young people along with the psychological factors that promoted resilience and psychological factors that undermined it. The second theme revolved around intervention strategies used to develop resilience in young people. The third theme focused upon intervention delivery, and the final theme related to intervention outcomes that included behavioral and psychological changes. Our findings offer some of the first evidence into effective psychological based resilience interventions, methods of delivery, psychological and behavioral changes related to desistance from a case workers perspective. Potential future considerations for interventions relating to youth who continue offending are discussed.

De-escalation of Disease-Modifying Therapy for People with Multiple Sclerosis Due to Safety Considerations: Characterizing 1-Year Outcomes in 25 People Who Switched from Ocrelizumab to Diroximel Fumarate.

Switching disease-modifying therapy (DMT) may be considered for relapsing-remitting multiple sclerosis (RRMS) if a patient's current therapy is no longer optimal. This was particularly important during the recent COVID-19 pandemic because of considerations around immune deficiency and impaired vaccine response associated with Bcell-depleting DMTs. This real-world, single-center study aimed to evaluate change or decline in functional ability and overall disease stability in people with RRMS who were switched from Bcell-depleting ocrelizumab (OCRE) to diroximel fumarate (DRF) because of safety concern related to the COVID-19 pandemic. Adults with RRMS were included if they had been clinically stable for ≥ 1year on OCRE. Data collected at baseline and 1year post switch included relapse rate, magnetic resonance imaging (MRI), blood work for assessment of peripheral immune parameters, the Cognitive Assessment Battery (CAB), optical coherence tomography (OCT), and patient-reported outcomes (PROs). Participants (N = 25) had a mean (SD) age of 52 (9) years, and a mean (SD) duration of 26 (8) months' treatment with OCRE before the switch to DRF. Median washout duration since the last OCRE infusion was 7months (range 4-18months). No participants relapsed on DRF during follow-up, and all remained persistent on DRF after 1year. There were no significant changes in peripheral immune parameters, other than an increase in the percentage of CD19+ cells 1year after switching (p < 0.05). Similarly, there were no significant changes in CAB, OCT, and PROs. These preliminary findings suggest that transition to DRF from OCRE may be an effective treatment option for people with RRMS who are clinically stable but may need to switch for reasons unrelated to effectiveness. Longer follow-up times on larger samples are needed to confirm these observations.

Talking about Homelessness and School: Recommendations from Canadian Young People Who Have Experienced Homelessness

The primary research question driving this paper is the following: “What are the schooling experiences of young people who are at risk of or experiencing homelessness?” Through interviews with 28 young people in two cities in Ontario, Canada, the authors identified several common experiences, including the following: lack of available information that could help them cope with their housing difficulties; prejudice and bullying from other students, sometimes stemming from their housing problems but also due to factors such as racialization, gender identity, poverty, and substance use; and individual support from some teachers and support staff, although this was dependent on being in school. They proposed changes to help young people still in school, including the inclusion of non-judgmental information and guidance on dealing with poverty and homelessness in school curricula, educating school staff about the ‘symptoms’ of homelessness to help them identify students at risk, and creating more safe and supportive school environments overall.

Incidence and Determinants of COVID-19 Among People Who Smoke (2018–2021): Findings From the ITC EUREST-PLUS Spain Surveys

ObjectiveTo estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke. MethodsThis is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables. ResultsThe overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9–8.0%), with no significant differences between males (6.3%; 95% CI: 3.6–9.0%) and females (5.6%; 95% CI: 3.2–8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04–5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03–0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14–0.56). ConclusionThe correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.

Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021.

Late HIV diagnosis is associated with a wide range of negative outcomes. The aim of this study was to identify the characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations. The NYS HIV registry was used to identify people who received a CDX from 2016 to 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates. There were 14,866 people newly diagnosed with HIV in NYS from 2016 to 2021, of which 19.0% had a CDX. Those with female sex at birth, history of injection drug use, or history of male-to-male sexual contact/history of injection drug use risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX. Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics that may lead to delayed diagnostic testing.

The Lived Experience of Informal Caregivers of People Who Have Severe Mental Illness and Coexisting Long-Term Conditions: A Qualitative Study.

People with severe mental illness (SMI) experience higher rates and poorer outcomes of physical long-term conditions (LTCs). The management of SMI and LTCs is highly complex and many people with SMI rely on informal carers for support, which may lead to high levels of caregiver burden, and caregiver burnout. Caregiver burnout can result in poor health outcomes for informal carersand a reduction in the quality of care they are able to provide. Therefore, it is important to understand the caring experience to identify and address factors that contribute to burden and burnout. This paper reports a secondary qualitative analysis of semistructured interviews and focus groups conducted with informal carers of people who have coexisting SMI and LTCs. We recruited 12 informal carers in England between December 2018 and April 2019. The transcripts were coded and analysed thematically. We identified two overarching themes and five subthemes. The themes included 'Fighting on all fronts: Mounting strain between demands and resources', which described the challenge of providing care in the context of coexisting SMI and LTCs, and 'Safekeeping: The necessity of chronic hypervigilance', which captured how informal carers' roles were defined by managing high-risk situations, leading to hypervigilance and paternalistic approaches to care. The experience of informal carers for people with SMI and coexisting LTCs is marked by limited access to support and the management of significant risk, which could contribute to high caregiver burden. Further primary research is needed to understand how the experiences of the caregiver role for people with SMI and LTCs influencecaregiver burden. Our PPI panel DIAMONDS Voice provided guidance on this study fromconception, designand development of interview guides and recruitment materialsto final write-up. DIAMONDS Voice consists of service users and carers who have experience of SMI and LTCs. Three carer members reviewed the final manuscript, and two are credited as authors.

Past-Year HIV Testing, Current Antiretroviral Therapy Use, and Participation in Services for People Who Inject Drugs.

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between demographics and PWID service use, past-year HIV testing, and current antiretroviral therapy (ART) use. Among 10,311 HIV-negative PWID, 56% reported past-year HIV testing, and of the 553 HIV-positive PWID, 69% reported current ART use. Of the HIV-negative PWID, 64% (2874/4482) in drug treatment and 62% (3386/5440) who used syringe service programs (SSPs) reported past-year HIV testing. Among HIV-positive PWID, 75% (187/248) in drug treatment and 67% (200/298) SSP participants were on ART. In the adjusted multivariable model, past-year HIV testing was associated with drug use treatment (aPR 1.26, 95% CI 1.23-1.31) and SSP participation (aPR 1.19, 95% CI 1.13-1.26) among HIV-negative PWID. Current ART use was associated with drug use treatment (aPR 1.13, 95% CI 1.00-1.28) but the link was not significant probably due to small sample size. Findings support the expansion and improvement of PWID-targeted services, into comprehensive programs, including drug use treatment, SSP, and HIV testing and treatment.

Perceived Risk of Developing Certain Cancers in People Who Smoke Tobacco in Eastern Kentucky: An Opportunity for Patient Education

Perceived Risk of Developing Certain Cancers in People Who Smoke Tobacco in Eastern Kentucky: An Opportunity for Patient Education

Developing a Digital Therapeutic for Alcohol Reduction – a Pilot Study of Curb, an App for People Who Want to Change Their Relationship With alcohol

Developing a Digital Therapeutic for Alcohol Reduction – a Pilot Study of Curb, an App for People Who Want to Change Their Relationship With alcohol

New Psychometric Evidence of the Grief Impairment Scale (GIS) in People Who Have Experienced the Death of a Loved One From a Network Psychometric Approach in Two Latin American Countries.

This study aimed to evaluate the psychometric properties of the Grief Impairment Scale (GIS) using a network psychometric model. A total of 1048 individuals from Peru and El Salvador participated. A network psychometric model was used to determine internal structure, reliability, and cross-country invariance. The results indicate that the GIS items were grouped into a single network structure through Exploratory Graph Analysis. Reliability was estimated by structural consistency, and it was found that when replicating the network structure within an empirical dimension, a single network structure was consistently obtained, and all items remained stable. Furthermore, the network structure was invariant, thus functioning similarly across the different country groups. In conclusion, the GIS presented solid psychometric evidence of validity based on its internal structure, reliability, and cross-country invariance. Therefore, the GIS is a psychometrically sound measure of functional impairment symptoms due to grief for Peruvian and Salvadoran individuals.

Characterizing the Use of Healthcare Access Supports Among People Who Use Drugs in Vancouver, Canada, 2017 to 2020: A Cohort Study.

For structurally marginalized populations, including people who use drugs (PWUD), equitable access to healthcare can be achieved through healthcare access supports. However, few studies characterized utilization of formal (eg, outreach workers, healthcare professionals) and informal (eg, friends/family) supports. Therefore, we sought to estimate the prevalence of and factors associated with receiving each type of support among PWUD. We used data from 2 prospective cohort studies of PWUD in Vancouver, Canada, in 2017 to 2020. We constructed separate multivariable generalized linear mixed-effects models to identify factors associated with receiving each of the 3 types of supports (ie, healthcare professionals, outreach workers/peer navigators, and informal supports) compared to no supports. Of 996 participants, 350 (35.1%) reported receiving supports in the past 6 months at baseline, through informal supports (6.2%), outreach workers (14.1%), and healthcare professionals (20.9%). In multivariable analyses, HIV positivity, chronic pain, and avoiding healthcare due to the past mistreatment were positively associated with receiving supports from each of healthcare professionals and outreach workers. Men were less likely to receive any types of the supports (all P < .05). Utilization of healthcare access supports was relatively low in this sample. However, formal supports appeared to have reached PWUD exhibiting more comorbidities and experiencing discrimination in healthcare. Further efforts to make formal supports more available would benefit PWUD with unmet healthcare needs, particularly men.

The People Who Do All Things Together: Living Base Ecclesial Communities in the Democratic Republic of the Congo

This article analyzes the pastoral practice and ecclesiological vision of living base ecclesial communities (CEVBs) in the Democratic Republic of the Congo through a case study in the Diocese of Tshumbe. Contextualizing this within the broader history of Global South base communities, the author argues that CEVBs exemplify Vatican II’s people of God ecclesiology and Africa’s image of the church as the family of God. They also embody Pope Francis’s calls for a more synodal and dialogical church that empowers laity, provides opportunities for women’s leadership, and integrates faith and social concern.

Lived Experience Matters: Automatic Detection of Stigma toward People Who Use Substances on Social Media

Lived Experience Matters: Automatic Detection of Stigma toward People Who Use Substances on Social Media

Volunteering Experiences of Young People Who Experience Social Marginalization: Examining the Impact on Their Identity and Lives

Volunteering Experiences of Young People Who Experience Social Marginalization: Examining the Impact on Their Identity and Lives

Virologic Response and Reinfection Following HCV Treatment among Hospitalized People Who Inject Drugs: Follow-Up Data from the OPPORTUNI-C Trial.

Treatment of hepatitis C among people who inject drugs (PWID) may be complicated by loss to follow-up and reinfection. We aimed to evaluate sustained virologic response (SVR) and reinfection, and to validate complete pharmacy dispensation as a proxy for cure among PWID enrolled in a trial of opportunistic HCV treatment. Data were obtained by reviewing the electronic patient files and supplemented by outreach HCV RNA testing. Reinfection was defined based on clinical, behavioral, and virological data. Intention to treat SVR ≥ 4 within 2 years after enrolment was accomplished by 59 of 98 (60% [95% CI 50-70]) during intervention conditions (opportunistic treatment) and by 57 of 102 (56% [95% CI 46-66]) during control conditions (outpatient treatment). The time to end of treatment response (ETR) or SVR ≥ 4 was shorter among intervention participants (HR 1.55 [1.08-2.22]; p = 0.016). Of participants with complete dispensation, 132 of 145 (91%) achieved ETR or SVR > 4 (OR 12.7 [95% CI 4.3-37.8]; p < 0.001). Four cases of reinfection were identified (incidence 3.8/100 PY [95% CI 1.0-9.7]). Although SVR was similar, the time to virologic cure was shorter among intervention participants. Complete dispensation is a valid correlate for cure among individuals at risk of loss to follow-up. Reinfection following successful treatment remains a concern.

The Effect of Fomo (Fear of Missing Out) and Price Discount on Impulse Buying with Religiosity as a Moderating Variable in Palembang City People Who Shop at E-Commerce Shopee

this research departs from the problem that whether fomo (fear of missing out) and price discount on impluse buying with religiousity as a moderating variable on palembang city communities shopping at shopee e-commerce. The purpose of this study was to know and analyze how much influence fomo (fear of missing out) and price discount on impluse buying with religiousness as a moderating variable on palembang city communities shopping at shopee e-commerce. This research uses quantitative research. The population in this study were consumers who decided to buy or use shopee in Palembang city, without distinguishing gender, the number of which was unknown. The sampling technique used in this study was purposive sampling. There were 100 samples of Palembang City residents. Data collection was carried out online via WhatsApp social media. While the data analysis used in this research is SEM (Structural Equation Modeling) through SmartPLS 4.0 with a moderating analysis model. The results of the analysis show FoMO (Fear of Missing Out) (X1) has a positive and significant effect on Impulse Buying (Y) with a P value of 0.029 or &lt; 0.05, so it can be concluded that there is a significant effect of FoMO (Fear of Missing Out) on Impulse Buying in Palembang City People who shop at Shopee E-Commerce. FoMO (Fear of Missing Out) (X1) has a positive and significant effect on Religiosity (Z) with a P value of 0.014 or &lt; 0.05, so it can be concluded that there is a significant effect of FoMO (Fear of Missing Out) on Religiosity in Palembang City People who Shop at Shopee E-Commerce. Price Discount (X2) has a positive and significant effect on Impulse Buying (Y) with a P value of 0.045 or &lt; 0.05, so it can be concluded that there is a significant effect of Price Discount on Impulse Buying in Palembang City People Shopping at E-Commerce Shopee. Price Discount (X2) has a positive and significant effect on Religiosity (Z) with a P value of 0.000 or &lt; 0.05, so it can be concluded that there is a significant effect of Price Discount on Religiosity in Palembang City People who Shop at Shopee E-Commerce. Religiosity (Z) has a positive and significant effect on Impulse Buying (Y) with a P value of 0.034 or &lt; 0.05, so it can be concluded that there is a significant effect of Religiosity on Impulse Buying in Palembang City People Shopping at E-Commerce Shopee. The effect of FoMO (Fear of Missing Out) on Impulse Buying through Religiosity in Palembang City People Shopping at Shopee ECommerce, indicated by a T-statistic value of 1.435 &lt; 1.96 and a p-value of 0.151&gt; 0.05. this means that hypothesis 6 is not accepted. The effect of Price Discount on Impulse Buying through Religiosity in Palembang City People Shopping at Shopee ECommerce, indicated by a T-statistic value of 2.015 &gt; 1.96 and a p-value of 0.044 &lt; 0.05. this means that hypothesis 7 is accepted.that FoMO (Fear of Missing Out) and Price Discount on Impluse Buying. Then the results of the moderating variable in the form of religiosity have a role in moderating (strengthening and weakening) FoMO (Fear of Missing Out) and Price Discount on Impluse Buying at Shopee.

Assessment of Stigma, Violence and Coping Mechanisms Among HIV Infected People Who Inject Drugs in Akwa-Ibom State, Nigeria

People who inject drugs (PWIDs) living with HIV face high levels of stigma, violence, and rape due to their risky lifestyles, potentially facilitating the spread of HIV. This study assessed the level and type of stigma and violence among PWIDs attending Heartland Alliance in Akwa Ibom State and their coping mechanisms. This descriptive cross-sectional study of 442 PWIDs receiving care at four one-stop shops in the state was conducted using mixed methods. Quantitative data were collected through pretested structured questionnaires and an adopted stigma scale, administered by trained research assistants using Computer Assisted Personal Interviewer (CAPI). For qualitative data, one focus group discussion (FGD) was held at each site with 8-10 purposively selected PWIDs, and transcripts were analyzed thematically. The study findings reveals that most respondents were male (78%) with a mean age of 32.7±7 years. Pentazocine use was common (52%), and 18% shared needles, with 15% sharing blood after injections among friends. More than half (58%) missed more than one dose of ARVs in the past week. Perceived stigma (59%) was more common than internal stigma (18%), with predictors being student status, non-disclosure of HIV status, and non-adherence to treatment. PWIDs Physical violence (47.5%) and verbal abuse (37.1%) were prevalent among PWIDs. Female PWIDs had a ninefold higher risk of rape. Coping mechanisms included isolation, increased substance use, battle readiness, and positive reframing. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: PWIDs face significant levels of stigma, violence, and non-adherence, jeopardizing treatment outcomes and perpetuating STI, HIV, and blood-borne infection transmission. Establishing harm-reduction programs is essential to address these vulnerabilities and the consequences associated with drug use.