The document summarizes a study examining HIV stigma among opioid-dependent individuals under community supervision. It describes high HIV rates in Washington D.C. and the criminal justice system. The study used a stigma scale to assess stigma in 16 participants. Females and homosexuals reported higher levels of stigma than males and heterosexuals, particularly around disclosure concerns. The study aims to reduce stigma and HIV risk through counseling in Project STRIDE, which provides medication-assisted treatment for opioid dependence and HIV.
Richard Garfein, Ph.D., M.P.H., of UC San Diego Department of Medicine, presents "HIV, HCV, and TB Infection among Injection Drug Users in San Diego" at AIDS Clinical Rounds
Drug use patterns among participants in a woman-focused RCT in GeorgiaIrma Kirtadze M.D.
The purpose of this poster presentation is to depict preliminary results from small-scale RCT IMEDI study and show the drug use patterns among women who use illicit substance and the rate of HIV infection.
Richard Garfein, Ph.D., M.P.H., of UC San Diego Department of Medicine, presents "HIV, HCV, and TB Infection among Injection Drug Users in San Diego" at AIDS Clinical Rounds
Drug use patterns among participants in a woman-focused RCT in GeorgiaIrma Kirtadze M.D.
The purpose of this poster presentation is to depict preliminary results from small-scale RCT IMEDI study and show the drug use patterns among women who use illicit substance and the rate of HIV infection.
Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the ...Δρ. Γιώργος K. Κασάπης
There was a more than twofold increase in the rate of suspected self-poisoning suicide cases between 2011 and 2018, according to a new study that looked at more than 1.6 million such cases.
Here’s what else you need to know:
•Overall trends: Cases of suicide attempts by self-poisoning doubled in those aged 10-18 between 2011 and 2018, rising from around 39,000 to more than 78,000.
•Gender: More girls than boys attempted suicide by self-poisoning. The rate of intentional attempts among girls 10-18 also steadily increased from 2011-2018.
•Outcomes: The number of serious outcomes — including death and hospitalizations — as a result of the poisoning increased 235% between 2000 and 2018, and more than 1,400 children died.
Physical activity acculturation and sexual risk behaviors among LatinasRick Goldman
http://publichealthconsulting.org/ Karina Villalba gives a presentation in Atlanta at the Annual conference of the American Public Health Association. The title of the presentation is: Physical Activity, Acculturation, and Sexual Risk Behaviors Among Latinas: A Longitudinal Community Based Study
There is a need for health and human service professionals to understand the connection with substance abuse and infectious disease in women. It is important for them to:
understand and an appreciate the issues facing substance abuse treatment and prevention specialists, public health specialists and child welfare workers working with addicted women and their children.
Social integration and the mental health needs of lgbtq asylum seekers in nor...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
This infographic shows highlights of the evidence that health communication can make an impact on other HIV prevention strategies, such as partner reduction and cross-generational sex.
Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the ...Δρ. Γιώργος K. Κασάπης
There was a more than twofold increase in the rate of suspected self-poisoning suicide cases between 2011 and 2018, according to a new study that looked at more than 1.6 million such cases.
Here’s what else you need to know:
•Overall trends: Cases of suicide attempts by self-poisoning doubled in those aged 10-18 between 2011 and 2018, rising from around 39,000 to more than 78,000.
•Gender: More girls than boys attempted suicide by self-poisoning. The rate of intentional attempts among girls 10-18 also steadily increased from 2011-2018.
•Outcomes: The number of serious outcomes — including death and hospitalizations — as a result of the poisoning increased 235% between 2000 and 2018, and more than 1,400 children died.
Physical activity acculturation and sexual risk behaviors among LatinasRick Goldman
http://publichealthconsulting.org/ Karina Villalba gives a presentation in Atlanta at the Annual conference of the American Public Health Association. The title of the presentation is: Physical Activity, Acculturation, and Sexual Risk Behaviors Among Latinas: A Longitudinal Community Based Study
There is a need for health and human service professionals to understand the connection with substance abuse and infectious disease in women. It is important for them to:
understand and an appreciate the issues facing substance abuse treatment and prevention specialists, public health specialists and child welfare workers working with addicted women and their children.
Social integration and the mental health needs of lgbtq asylum seekers in nor...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
This infographic shows highlights of the evidence that health communication can make an impact on other HIV prevention strategies, such as partner reduction and cross-generational sex.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: John F. Ryan, Director, European Commission, DG SANTE
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
RESEARCH ARTICLEWill Combined Prevention Eliminate Racia.docxronak56
RESEARCH ARTICLE
Will "Combined Prevention" Eliminate Racial/
Ethnic Disparities in HIV Infection among
Persons Who Inject Drugs in New York City?
Don Des Jarlais1*, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1,
Holly Hagan2, Hannah Cooper3, Aimee Campbell4, Susan Tross4, David Perlman1
1 The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York,
New York, United States of America, 2 College of Nursing, New York University, New York, New York,
United States of America, 3 Rollins School of Public Health at Emory University, Atlanta, Georgia, United
States of America, 4 Department of Psychiatry, Columbia University, New York, New York, United States of
America
* [email protected]
Abstract
It has not been determined whether implementation of combined prevention programming
for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine
racial/ethnic disparities in New York City among persons who inject drugs after implementa-
tion of the New York City Condom Social Marketing Program in 2007. Quantitative inter-
views and HIV testing were conducted among persons who inject drugs entering Mount
Sinai Beth Israel drug treatment (2007–2014). 703 persons who inject drugs who began in-
jecting after implementation of large-scale syringe exchange were included in the analyses.
Factors independently associated with being HIV seropositive were identified and a pub-
lished model was used to estimate HIV infections due to sexual transmission. Overall HIV
prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted
odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI
1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced
HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6–
0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Ra-
cial/ethnic disparities among persons who inject drugs were not significantly different from
previous disparities. Reducing these persistent disparities may require new interventions
(treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Introduction
Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID)
have been observed in many countries, with ethnic minority group members [1] and females
[2] typically having higher HIV prevalence. There are effective interventions to reduce HIV
transmission among PWID, and the logic of “combined” prevention programming is that
PLOS ONE | DOI:10.1371/journal.pone.0126180 May 12, 2015 1 / 11
OPEN ACCESS
Citation: Des Jarlais D, Arasteh K, McKnight C,
Feelemyer J, Hagan H, Cooper H, et al. (2015) Will
"Combined Prevention" Eliminate Racial/Ethnic
Disparities in HIV Infection among Persons Who
Inject Drugs in New York City? PLoS ONE 10(5):
e0126180. doi:10.1371/journal.pone.0126 ...
Running head: ASSIGNMENT 3 1
ASSIGNMENT 3
4
Assignment 3
Diamond Fulton-Hicks
Saint Leo University-HCA:402
Mrs.Claudette Andrea
04/05/2020
According to the CDC, Youth Risk Behaviors are used in monitoring the six groups of health-associated practices that are contributing to the top causes of deaths and disability amongst youths and adults. Some of these behaviors are those which are contributing to unintended injuries and violent behavior; sexual practices which lead to unintentional pregnancies and sexually transmitted infections; alcohol and other drug use; tobacco use; detrimental dietary practices; and the insufficient engagement in the physical exercise. This paper is therefore based on discussing these health behaviors top factors associated with the increased death and disability rates amongst youths and adults (Centers for Disease Control and Prevention, n.d).
Alcohol and other drug use
Alcohol and other illicit drug are used by the majority of the youths as compared to tobacco use. It is contributing to about 41 percent of all deaths that are caused by motor vehicles. When compared to other behaviors that put human at risk concerning health, alcohol is causing a wider variety of injuries and it is approximated that 100,000 deaths occurs as a result alcohol consumption every year in the U.S. About 46 percent of Americans have been intoxicated in the previous years and roughly 4 percent have been intoxicated weekly (Kann, et al., 2014).
Behaviors causing unplanned injuries and violence such as suicide
The injuries and violent behavior are considered to be amongst the top causes of death amongst the youth of ages 10 to 24 years. The motor vehicle crashes are contributing to 30 percent of deaths and other accidental injuries contribute to 15 percent. Homicide and suicide are contributing to 15 and 12 percent death cases respectively (Centers for Disease Control and Prevention, n.d).
Tobacco Use
It is estimated that there are about 3,600 adolescents of ages 12 to 17 years in the United States who have tried their first cigarette. The use of cigarettes is contributing to 1 to every 5 deaths (Centers for Disease Control and Prevention, n.d).
Unhealthy Dietary Behaviors
Healthy eating is linked to the reduction in the risks of diseases that exposes individuals to death and these diseases include heart disease. In 2009, it was reported that about 23.3 percent of the high school learners reported increased habit of consuming fruits and vegetables five or more times every day. Studies have shown the relationship in the habit of eating the restaurant foods and the increased BMI thus exposing individuals to diseases such as obesity and other cardiovascular diseases (Kann, et al., 2014).
Physical Inactivity
The decline in physical activity is common among children when they get older. Most of the youths are spending their time in a sedentary lifestyle such as watching television with less participation in physical ...
PrEP, or Pre-Exposure Prophylaxis, is a once a day pill that can be taken by an HIV negative individual to prevent HIV infection. This presentation reviews current statistics, research and policy regarding PrEP.
Poor Outcomes in a Cohort of HIV-Infected Adolescents Undergoing Treatment fo...Dr.Samsuddin Khan
Abstract
BACKGROUND:
Little is known about the treatment of multidrug-resistant tuberculosis (MDR-TB) in HIV-co-infected adolescents. This study aimed to present the intermediate outcomes of HIV-infected adolescents aged 10-19 years receiving second-line anti-TB treatment in a Médecins Sans Frontières (MSF) project in Mumbai, India.
METHODS:
A retrospective review of medical records of 11 adolescents enrolled between July 2007 and January 2013 was undertaken. Patients were initiated on either empirical or individualized second-line ambulatory anti-TB treatment under direct observation.
RESULTS:
The median age was 16 (IQR 14-18) years and 54% were female. Five (46%) adolescents had pulmonary TB (PTB), two (18%) extrapulmonary disease (EPTB) and four (36%) had both. Median CD4 count at the time of MDR-TB diagnosis was 162.7 cells/µl (IQR: 84.8-250.5). By January 2013, eight patients had final and 3 had interim outcomes. Favourable results were seen in four (36.5%) patients: one was cured and three were still on treatment with negative culture results. Seven patients (64%) had poor outcomes: four (36.5%) died and three (27%) defaulted. Three of the patients who died never started on antiretroviral and/or TB treatment and one died 16 days after treatment initiation. Two of the defaulted died soon after default. All patients (100%) on-treatment experienced adverse events (AEs): two required permanent discontinuation of the culprit drug and two were hospitalized due to AEs. No patient required permanent discontinuation of the entire second-line TB or antiretroviral regimens.
CONCLUSIONS:
Early mortality and mortality after default were the most common reasons for poor outcomes in this study. Early mortality suggests the need for rapid diagnosis and prompt treatment initiation, and adolescents might benefit from active contact-tracing and immediate referral. Default occurred at different times, suggesting the need for continuous, intensified and individualized psychosocial support for co-infected adolescents. Operational research among co-infected adolescents will be especially important in designing effective interventions for this vulnerable group.
1. References:
1. Centers for Disease Prevention and Control. District of Columbia Enhanced Comprehensive HIV Prevention Plan 2011. Web. 14 Nov 2012. <http://www.cdc.gov/hiv/strategy/echpp/pdf/workbook_dc_1.pdf>
2. "Substance Abuse/Use." Substance Abuse/Use. N.p., n.d. Web. 3 Nov. 2012. <http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/substance-abuse-use/>.
3. Hammett, T.M., Harmon, M.P., Rhode, W. The burden of infectious disease among inmates of and releases from US correctional facilities, 1997. Am J Public Health 2002; 92:1789-94.
4. Arana, George W., J. F. Rosenbaum, and Steven E. Hyman. Handbook of Psychiatric Drug Therapy. Philadelphia: Lippincott Williams & Wilkins, 2000
The current study relies on Sayles and colleagues’ 28-item internalized HIV stigma measure (administered by researchers at
baseline) to assess stigma as perceived and experienced by each participant. Stigma regarding HIV status was assessed across four
composite items: stereotypes, disclosure concerns, social relationships, and self-acceptance. The overall Project STRIDE study
design is below; during the randomization process, baseline questions are administered just prior to randomization.
HIV Stigma Among Opioid-Dependent Individuals
Under Community Supervision
Authors: Mary Mbaba, MPH (George Mason University); Suneeta Kumari, MPH, MD (Howard University); Alese
Wooditch, MA (George Mason University); William Lawson, MD, PhD (Howard University); Amy Murphy, MPP (George
Mason University); Faye Taxman, PhD (George Mason University); Frederick Altice, MD, MA (Yale School of Medicine)
HIV Stigma Among Opioid-Dependent Individuals
Under Community Supervision
Authors: Mary Mbaba, MPH (George Mason University); Suneeta Kumari, MPH, MD (Howard University); Alese
Wooditch, MA (George Mason University); William Lawson, MD, PhD (Howard University); Amy Murphy, MPP (George
Mason University); Faye Taxman, PhD (George Mason University); Frederick Altice, MD, MA (Yale School of Medicine)
In the District of Columbia, an estimated 3.2% of the population is diagnosed and living with HIV/AIDS, the highest incidence
rate in the nation1
. One leading mode of HIV transmission was injection drug use, accounting for 11% of new cases. Opioid
dependence is associated with adverse medical and psychosocial consequences, including the transmission of HIV through
unprotected sex or sharing needles used for intravenous injection. Additionally, being under the influence of drugs may lead
persons to engage in risky sex behaviors, including transactional sex2
.
HIV/AIDS and substance use disorders are disproportionately represented within the criminal justice system (CJS). The US has
the highest rate of incarceration worldwide:
• 2.4 million people are behind bars at any one time;
• Annually 10 million people are released from a correctional facility to the community; and
• Nearly 8 million individuals are under community supervision including, around 1 million on pretrial supervision3
.
A disproportionate number of CJS-involved individuals are HIV+ and substance abusers, who, when returning back to the
community, may impact the health of the general public. Because abused opioids are generally expensive and short-acting,
persons using these drugs frequently suffer withdrawal symptoms and may go to criminal extremes such as robbery,
prostitution, or drug dealing to prevent withdrawal and sustain drug habits4
. Drug treatment for these persons may potentially
decrease transmission of HIV by preventing drug relapse, decreasing the risk of unprotected sex when under the influence of
drugs, and decreasing overall recidivism rates.
Subjects are HIV-positive participants from the research study, Project STRIDE. Descriptive statistics were conducted on an initial
sample of 16 patients who were first enrolled in Project STRIDE. The analyses below explore differences in stigma by gender (male
n=11; female n=5) and sexual orientation (heterosexual n=12, homosexual n=4).
Gender M (SD) t Sexual Orientation M (SD) t
Disclosure Concerns Disclosure Concerns
Male 34 (30) -2.0* Heterosexual 37 (35) -1.6
Female 68 (35) Homosexual 64 (26)
Social Relationships Social Relationships
Male 21 (27) 0.3 Heterosexual 17 (24) -0.8
Female 17 (15) Homosexual 27 (23)
Self-Acceptance Self-Acceptance
Male 44 (20) -2.2** Heterosexual 54 (21) 1.0
Female 65 (10) Homosexual 42 (13)
Stereotypes Stereotypes
Male 47 (23) -1.1 Heterosexual 48 (25) -0.8
Female 50 (20) Homosexual 58 (11)
Overall Stigma Overall Stigma
Male 36 (20) -1.7 Heterosexual 30 (31) -1.1
Female 52 (13) Homosexual 48 (9)
*Significant at the p<.10 level. **Significant at the p<.05 level.
The findings suggest that the females in our sample have significantly higher HIV disclosure concerns (t= -2.1; p<.10), while males
in the sample had significantly lower stigma self-acceptance than females (t=-2.2; p<.05). The mean overall stigma score was 41.3
out of 100 (SD=18.9). Females also had considerably higher overall HIV stigma than males (36 vs 52). Homosexuals had higher
disclosure concerns (64 vs 37) and overall stigma (48 vs 30) than heterosexuals.
As part of the National Institute of Drug’s (NIDA) Seek, Test ,Treat, and Retain initiative, we recruited a sample of 16
participants (pilot and post-pilot) using field recruitment and respondent-driven sampling methods. The aim of Project STRIDE
(based at Howard University Hospital, PIs: Rick Altice, MD, MA, Yale School of Medicine; Faye Taxman, PhD, George Mason
University; William Lawson, MD, PhD, Howard University) is to test the effectiveness of continuous Buprenorphine treatment
versus placebo among HIV-positive, opioid-dependent individuals who are under community supervision in DC, with the goal of
improving adherence to HIV medication regimens to decrease or stabilize viral loads. In this double-blind study, patients receive
one year of treatment, including medication or placebo and group counseling, with study staff conducting interviews, collecting
biological data, and monitoring health outcomes, such as viral loads, as well as drug use and criminal activity. A secondary study
objective is to determine the degree of HIV stigma perceived by participants who face a number of social challenges as a result of
their involvement in the criminal justice system, their use of illicit drugs, and their HIV status.
SIGNIFICANCE/BACKGROUND
OBJECTIVE
RESEARCH METHODS
RESULTS
It is crucial to combat the stigma and discrimination against people who are affected by HIV/AIDS in order to prevent and
control the global epidemic. Our preliminary results indicate that HIV stigma is present among marginalized groups
with high rates of other stigmatized issues. The Project STRIDE study population faces stigma in terms of their
criminal justice system involvement, their substance abuse, and their positive HIV status. These additional stigmas
may potentially exacerbate stigma associated with HIV status and vice versa. Further, HIV stigma may serve as a
barrier in the patient-doctor relationship and may prevent persons from seeking sufficient healthcare and treatment.
Fear of disclosing status may increase risky behaviors, such as sharing needles and engaging in unprotected sex.
Decreasing HIV stigma may also enable persons to be more willing to learn their HIV status and engage in safer sex
and drug use practices.
It is important to reduce HIV stigma that may in turn reduce HIV risk and prevalence rates among particularly susceptible
and marginalized populations. Project STRIDE works to reduce the amount of stigma experienced by study subjects
by addressing the stigma in group counseling sessions. While the counseling treatment is a manualized form of
cognitive-behavioral therapy with motivational enhancement therapy that is not specifically targeted to HIV+
individuals, we address HIV and HIV stigma with a series of adapted vignettes in each session.
Funding Source: NIDA R01 DA030768Funding Source: NIDA R01 DA030768
CONCLUSIONS