Heterosexual transmission of HIV often occurs in the context of intimate sexual partnerships. There is mounting evidence that couple-based HIV prevention interventions may be more effective than individual-based interventions for promoting risk reduction within such relationships. Yet, concerns have been raised about the safety of couple-based prevention approaches, especially with regard to the risk of intimate partner violence against women.
View Article and Find Full Text PDFTo help reduce the elevated risk of acquiring HIV for African-American and Latina women drug users in primary heterosexual relationships, we developed a brief couple-based HIV counseling and testing prevention intervention. The intervention was based on an integrated HIV risk behavior theory that incorporated elements of social exchange theory, the theory of gender and power, the stages-of-change model, and the information-motivation-behavior skills model. In this article, we describe the development, content, and format of the couple-based HIV testing and counseling intervention, and its delivery to 110 couples (220 individuals) in a randomized effectiveness trial, the Harlem River Couples Project, conducted in New York City from 2005 to 2007.
View Article and Find Full Text PDFA growing body of evidence indicates interprofessional collaborative practice improves patient care. With this in mind, Louisiana State University Health Sciences Center formally committed to expanding interprofessional education (IPE) initiatives. Thirty-eight self-selected students enrolled in an IPE elective course during the fall of 2012.
View Article and Find Full Text PDFA randomized trial was conducted to test the effectiveness of couple-based HIV counseling and testing (CB-HIV-CT) and women-only relationship-focused HIV counseling and testing (WRF-HIV-CT) in reducing HIV risk compared to the National Institute on Drug Abuse HIV-CT standard intervention. Substance using HIV-negative women and their primary heterosexual partner (N = 330 couples) were randomized to 1 of the 3 interventions. Follow-up assessments measuring HIV risk behaviors and other relevant variables were conducted at 3- and 9-months postintervention.
View Article and Find Full Text PDFOnly lung cancer surpasses breast cancer as a cause of death from cancer. However, the burden of cancer is not borne equally across racial and ethnic groups. In the United States, African American women have significantly higher mortality rates from breast cancer than white women.
View Article and Find Full Text PDFIntranasal transmission of hepatitis C virus (HCV) via contaminated drug-sniffing implements is a potential but unconfirmed source of viral infection. We demonstrate the virological plausibility of intranasal transmission by confirming that blood and HCV RNA are present in the nasal secretions and drug-sniffing implements of HCV-infected intranasal drug users recruited from a community health clinic in New York City.
View Article and Find Full Text PDFIn recent years, epidemiological monitoring data has indicated sharp increases in prescription drug misuse. Despite these increases, little is known about the context or patterns associated with prescription drug misuse, particularly among youth or young injection drug users (IDUs). A three-city study of 213 young IDUs found prescription drug misuse to be pervasive, specifically the use of opioids and benzodiazepines.
View Article and Find Full Text PDFBackground: Hepatitis C virus (HCV) is the most common bloodborne pathogen in the United States and is a leading cause of liver-related morbidity and mortality. Although it is known that HCV is most commonly transmitted among injection drug users, the role of sexual transmission in the spread of HCV remains controversial because of inconsistent findings across studies involving heterosexual couples.
Methods: A novel multilevel modeling technique designed to overcome the limitations of previous research was performed to assess multiple risk factors for HCV while partitioning the source of risk at the individual and couple level.
Ketamine, a dissociative anesthetic, has emerged as an increasingly common drug among subgroups of young injection drug users (IDUs) in cities across the United States. In-depth qualitative interviews were conducted with 213 young IDUs aged 16-28 years recruited in New York, New Orleans, and Los Angeles between 2004 and 2006. While some initiated injection drug use with ketamine, the drug was more frequently injected by IDUs with extensive polydrug using histories.
View Article and Find Full Text PDFSeveral recent studies have utilized respondent-driven sampling (RDS) methods to survey hidden populations such as commercial sex-workers, men who have sex with men (MSM) and injection drug users (IDU). Few studies, however, have provided a direct comparison between RDS and other more traditional sampling methods such as venue-based, targeted or time/space sampling. The current study sampled injection drug users in three U.
View Article and Find Full Text PDFComput Stat Data Anal
August 2006
In the social and health sciences, data are often structured hierarchically, with individuals nested within groups. Dyads constitute a special case of hierarchically structured data with variation at both the individual and dyadic level. Analyses of data from dyads pose several challenges due to the interdependence between members within dyads and issues related to small group sizes.
View Article and Find Full Text PDFEffective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding the last injection episode were combined from three projects (N = 1,030) recruiting injection drug users.
View Article and Find Full Text PDFRecent studies have revealed a variety of contexts involving HIV risk behaviors among women who exchange sex for money or drugs. Event analysis was used to identify the individual, relationship, and contextual factors that contribute to these high-risk sex exchange practices. Analyses were conducted on data obtained from 155 drug-using women who reported details of their most recent sex exchange event with male clients.
View Article and Find Full Text PDFBackground: Effective on January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), which allows syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to persons 18 years of age or older and permits the possession of those syringes for the purposes of injecting drugs.
Objective: To assess changes in receptive syringe sharing since the inception of the ESAP.
Methods: Sociodemographic characteristics and syringe use data regarding the last injection episode were combined from 3 projects (n = 1181) recruiting injection drug users in ongoing studies in Harlem and the Bronx in New York City from January 2001 through June 2003.
This study examined sharing noninjection drug implements as a risk factor for hepatitis C (HCV) infection among women drug users (n = 123) with no history of drug injection. Participants were street-recruited from East Harlem, New York City, between October 1997 and June 1999. Participants were administered a survey measuring risk factors for HCV.
View Article and Find Full Text PDFJ Psychoactive Drugs
May 2004
Hepatitis C virus (HCV) is a major cause of chronic liver disease in the United States and worldwide. It is primarily transmitted through blood-to-blood contact with an infected individual. HCV is hyperendemic among injection drug users (IDUs), who contract the virus through contaminated syringes and drug preparation equipment shared with other IDUs.
View Article and Find Full Text PDFBMC Med Res Methodol
October 2003
Background: Public health research involving social or kin groups (such as sexual partners or family members), rather than samples of unrelated individuals, has become more widespread in response to social ecological approaches to disease treatment and prevention. This approach requires the development of innovative sampling, recruitment and screening methodologies tailored to the study of related individuals.
Methods: In this paper, we describe a set of sampling, recruitment and screening protocols developed to enlist urban, drug-using, heterosexual couples into a public health research study.
This study described the most recent injection events of injection-drug-using women, determined the prevalence of HIV, hepatitis B (HBV), and hepatitis C (HCV), and identified significant predictors of injection-related risk behaviors. After validation of drug use, 185 street-recruited women participated in structured interviews and were offered HIV, HBV, and HCV testing and counseling. Interview topics included (1) demographic characteristics, (2) characteristics of injection partners (IPs), and (3) relevant situation-specific factors.
View Article and Find Full Text PDFObjectives: This report documents the prevalence of hepatitis C virus (HCV) infection among self-reported noninjecting drug users recruited from two New York City neighborhoods.
Methods: Participants were recruited in separate studies from East Harlem and the Lower East Side of Manhattan and were administered structured questionnaires and tested for HCV.
Results: HCV prevalence rates among those reporting no history of injecting drugs ranged from 5% to 29%, according to age, gender, and study location.
Many studies have found that the longer a drug user remains in treatment, the more positive the outcome. The majority of studies on the effects of time in treatment have followed subjects from the time they enter treatment. The subjects of the present study are injection drug users and crack users who were out of treatment at the time of their recruitment to the study.
View Article and Find Full Text PDFAs AIDS cases among US women continue to increase, a better understanding of women's behavioural risk patterns is needed to inform intervention efforts. Data were from 2,945 women drug injectors and crack users. Statistical analyses compared sociodemographic variables, lifetime behavioural risk patterns, HIV sero-prevalence and history of sexually transmitted diseases, and determined predictors of HIV infection separately in 16 low and four high sero-prevalence sites.
View Article and Find Full Text PDFOne hundred fifty-eight drug users received an interview that included self-reported drug use. Opiate/cocaine use in the prior 48 hours was assessed by urinalysis. Fifty-five subjects received a urine test after the interview and 103 were tested before.
View Article and Find Full Text PDFCrack cocaine users are at high risk for HIV, with higher frequency crack users engaging in higher rates of HIV-related sexual risk behaviors. This study will assess the variables impacting changes in crack use frequency. Out-of-treatment crack users were street recruited in East Harlem, NY.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr Hum Retrovirol
March 1999
Objectives: This study assessed the relation between year of recruitment into an AIDS prevention project and likelihood of engaging (yes/no) in injection risk behaviors.
Methods: In total, 834 injection drug users were recruited over a 44-month period (January 1992-August 1995) in New York City. Logistic regression was used to examine trends in three behaviors, across four successive annual cohorts: using needles/syringes that were previously used by another person, using injection supplies (e.
Objectives: This study assessed recent trends in HIV seroprevalence among injecting drug users in New York City.
Methods: We analyzed temporal trends in HIV seroprevalence from 1991 through 1996 in 5 studies of injecting drug users recruited from a detoxification program, a methadone maintenance program, research storefronts in the Lower East Side and Harlem areas, and a citywide network of sexually transmitted disease clinics. A total of 11,334 serum samples were tested.