The ethics of community-based research with people who use drugs: results of a scoping review.

Background: Drug user networks and community-based organizations advocate for greater, meaningful involvement of people with lived experience of drug use in research, programs and services, and policy initiatives. Community-based approaches to research provide an opportunity to engage people who use drugs in all stages of the research process. Conducting community-based participatory research (CBPR) with people who use drugs has its own ethical challenges that are not necessarily acknowledged or supported by institutional ethics review boards.

Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada.

Objectives: We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011.

Methods: We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory.

What is low threshold methadone maintenance treatment?

Background: Low threshold methadone maintenance (MMT) was developed for clients who do not have abstinence as a treatment goal. We explored how MMT programs in Canada defined low threshold and the challenges they faced.

Methods: Using semi-structured interviews, we collected data from clients (n=46), nurses/counsellors (n=15) and physicians (n=9) at three low threshold MMT programs.

Frequent food insecurity among injection drug users: correlates and concerns.

Background: Food 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.

Methods: A cross-sectional survey was conducted using interviewer-administered questionnaires.

Acute and chronic respiratory symptoms among primary care patients who smoke crack cocaine.

Among inner-city populations in Canada, the use of crack cocaine by inhalation is prevalent. Crack smoking is associated with acute respiratory symptoms and complications, but less is known about chronic respiratory problems related to crack smoking. There is also a gap in the literature addressing the management of respiratory disease in primary health care among people who smoke crack.

Prevalence and correlates of GB virus C infection in HIV-infected and HIV-uninfected pregnant women in Bangkok, Thailand.

GB virus C (GBV-C) is an apathogenic virus that has been shown to inhibit HIV replication. This study examined the prevalence and correlates of GBV-C infection and clearance in three cohorts of pregnant women in Thailand. The study population consisted of 1,719 (1,387 HIV-infected and 332 HIV-uninfected) women from three Bangkok perinatal HIV transmission studies.

Giving away used injection equipment: missed prevention message?

Background: Our objective was to examine factors associated with distributive injection equipment sharing and how needle exchange programs (NEPs) can help reduce distributive sharing among injection drug users (IDUs).

Methods: 145 English speaking Canadian IDUs ages 16 years and over who had injected in the past 30 days were recruited for a cross-sectional survey. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, social support, drug treatment readiness, program satisfaction, health and social service use and NEP drug use.

Reduced mother-to-child transmission of HIV associated with infant but not maternal GB virus C infection.

Background: Prolonged coinfection with GB virus C (GBV-C) has been associated with improved survival in human immunodeficiency virus (HIV)-infected adults. We investigated whether maternal or infant GBV-C infection was associated with mother-to-child transmission (MTCT) of HIV-1 infection.

Methods: The study population included 1364 HIV-infected pregnant women enrolled in 3 studies of MTCT of HIV in Bangkok, Thailand (the studies were conducted from 1992-1994, 1996-1997, and 1999-2004, respectively).

Physician peer assessments for compliance with methadone maintenance treatment guidelines.

Introduction: Medical associations and licensing bodies face pressure to implement quality assurance programs, but evidence-based models are lacking. To improve the quality of methadone maintenance treatment (MMT), the College of Physicians and Surgeons of Ontario, Canada, conducts an innovative quality assurance program on the basis of peer assessments. Using data from this program, we assessed physician compliance with MMT guidelines and determined whether physician factors (e.

Longitudinal trends in antiretroviral use in a cohort of men and women in Ontario, Canada.

Initial studies have shown impaired access to antiretrovirals and slower adoption of new therapies by women. It is unclear if similar treatment delays still occur, especially in those with a publicly funded health care system in Ontario, Canada. The objectives of this study were (1) to evaluate longitudinal patterns of antiretroviral use in patients with HIV in Ontario and (2) to determine if gender differences exist in access to and uptake of antiretroviral drugs over time.

Factors predicting 2-year retention in methadone maintenance treatment for opioid dependence.

Factors predicting 2-year retention in methadone maintenance and the impact of repeat treatment episodes on retention are examined. Data (n=9555 episodes) were drawn from a population-based treatment registry and analyses were performed using episode-weighted data. We estimated a binary logistic regression model with a duration of 730 days or greater as the dependent variable.

Policy changes and the methadone maintenance treatment system for opioid dependence in Ontario, 1996 to 2001.

Background: Until recently, the availability of methadone treatment in Ontario, Canada was limited. In 1996, policy changes were introduced to increase the availability of treatment. The 5-year impact of these policy changes is assessed.

Polypharmacy in HIV: impact of data source and gender on reported drug utilization.

Drug use in HIV is complex and may involve multiple therapeutic and nontherapeutic agents including prescription, over-the-counter, complementary and alternative medicine, and social/recreational drugs. This study was designed to assess the extent of such drug use in HIV-infected men and women. One hundred four adults were recruited through the HIV Ontario Observational Database from HIV outpatient clinics throughout Ontario, Canada.

Medicinal and recreational marijuana use by patients infected with HIV.

The goal of this study was to describe and compare the prevalence, predictors and patterns of marijuana use, specifically medicinal marijuana use among patients with HIV in Ontario, Canada. Any marijuana use in the year prior to interview and self-defined medicinal use were evaluated. A cross-sectional multicenter survey and retrospective chart review were conducted between 1999 and 2001 to evaluate overall drug utilization in HIV, including marijuana use.

Pushing the boundaries of outreach work: the case of needle exchange outreach programs in Canada.

In this paper, we examine the challenges of defining the boundaries of outreach work using the example of needle exchange programs. In particular, we examine the multiple and inter-related factors that extend needle exchange outreach work beyond its official mandate. Using semi-structured interviews, 59 workers at 15 programs in Ontario, Canada were asked questions about operational policies and routines.

Prior opiate injection and incarceration history predict injection drug use among inmates.

Aims: To describe injection drug use among inmates, and to identify correlates of drug injection while incarcerated.

Design: Cross-sectional survey.

Setting: Six provincial correctional centres in Ontario, Canada.

Use of complementary and alternative medicine by HIV-infected outpatients in Ontario, Canada.

Little is known about complementary and alternative medicine (CAM) use in Canadian patients with HIV. We sought to determine the prevalence of CAM use by patients attending HIV outpatient clinics in Ontario, Canada, and to compare the characteristics of users and nonusers. Impact of CAM definition on reported utilization rates was also assessed, specifically in relation to the inclusion and exclusion of vitamins, minerals, and multivitamins in CAM definition.

Voluntary HIV testing among inmates: sociodemographic, behavioral risk, and attitudinal correlates.

We sought to determine the prevalence and correlates of self-reported HIV testing among inmates in correctional centers in Ontario, Canada. A cross-sectional survey was conducted with a stratified random sample of 597 male and female adult inmates. The participation rate was 89%.

Delayed application of condoms is a risk factor for human immunodeficiency virus infection among homosexual and bisexual men.

The objective of this analysis was to identify risk factors for recent human immunodeficiency virus (HIV) infection among homosexual and bisexual men in Ontario, Canada, during 1998-2001. Participants were recruited through the provincial HIV diagnostic laboratory and through physicians and community organizations. HIV test results were used to identify recent seroconverters (cases).

Needle exchange programs. Delivery and access issues.

Objective: Examine the challenges of four service delivery models (i.e., fixed, mobile, satellite and home visits) and how service delivery may impact on NEP HIV prevention efforts.

Needle exchange: how the meanings ascribed to needles impact exchange practices and policies.

The consistency among needle exchange practices, HIV prevention, harm reduction goals, and potential program effectiveness are analyzed. Using a modified ethnographic approach, qualitative interviews were conducted with staff (n = 59) of needle exchange programs (NEPs; n = 15). Interviews addressed operational policies; funding and challenges.