VIROLOGY 2008

VIROLOGY 2008 <171>

Database EMBASE

Accession Number 2008520299

Authors Oxford J.S.

Institution

(Oxford) Centre for Infectious Diseases, Retroscreen Virology Ltd., Bart's and The London, Queen Mary's School of

Medicine and Dentistry, 2 Royal College Street, London NW1 0NH, United Kingdom.

Country of Publication

United Kingdom

Title

The end of the beginning: Vaccines for the next 25 years.

Source

Vaccine. 26(49)(pp 6179-6182), 2008. Date of Publication: 18 Nov 2008.

Publisher

Elsevier Ltd

Abstract

The first virus vaccines against smallpox and rabies proved their effectiveness even before the ultra microscopic viruses had been identified as a new world of infectious agents. To date most antibacterial and antiviral vaccines have not been designed but rather built step by step.

Designer vaccines with T cell epitopes and adjuvants which stimulate innate or acquired immune responses to will are now under serious investigation but have yet to impact on the practical world of infection. The latter is not small, with millions of deaths annually in the world from not uncommon microbes such as enterforms, pneumococci, respiratory and hepatitis viruses and HIV. But can vaccines be used in more social directions to control birth or prevent addiction? Polio should join smallpox this year in the pantheon of eradicated viruses. The infectious disease community can then turn attention to hepatitis B. War has been declared on pandemic influenza but with this zoonotic virus containment is key, with vaccines used alongside antivirals and social distancing. Undoubtedly "we have the guns, and now we can finish the job". copyright 2008 Elsevier Ltd. All rights reserved.

ISSN 0264-410X

Publication Type Journal: Review

Journal Name Vaccine

Volume 26

Issue Part 49

Page 6179-6182

Year of Publication 2008

Date of Publication 18 Nov 2008

VIROLOGY 2008 <263>

Database EMBASE


Authors Sunthornchart S. Linkins R.W. Natephisarnwanish V. Levine W.C. Maneesinthu K. Lolekha R. Tappero J.W.

Trirat N. Muktier S. Chancharastong P. Fox K. Donchalermpak S. Vitek C. Supawitkul S.

Institution

(Sunthornchart, Natephisarnwanish, Maneesinthu, Trirat, Chancharastong, Donchalermpak) Department of Health

Services, Bangkok Metropolitan Administration, Thailand.

(Linkins, Lolekha, Tappero, Muktier, Fox, Supawitkul) Thailand MOPH - US CDC Collaboration, Nonthaburi,

Thailand.

(Linkins) Division of HIV/AIDS Program, Centers for Disease Control and Prevention, Atlanta, GA, United States.

(Levine, Tappero, Fox, Vitek) Global AIDS Program, National Center for HIV/AIDS, Viral Hepatitis, STD and TB

Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.

(Linkins) Thailand MOPH - US CDC Collaboration, DDC7 Building, Ministry of Public Health, Soi 4, Nonthaburi

11000, Thailand.


United Kingdom

Title

Prevalence of hepatitis B, tetanus, hepatitis A, human immunodeficiency virus and feasibility of vaccine delivery among injecting drug users in Bangkok, Thailand, 2003-

2005.

Source

Addiction. 103(10)(pp 1687-1695), 2008. Date of Publication: October 2008.

Publisher

Blackwell Publishing Ltd

Abstract

Objectives: To estimate the prevalence of hepatitis B virus (HBV), tetanus, hepatitis A virus

(HAV) and human immunodeficiency virus (HIV) in injecting drug users (IDUs), risk factors associated with infection and the feasibility of HBV vaccine delivery in HBV seronegatives.

Methods: Cross-sectional seroprevalence survey of 1535 IDUs recruited from 17 Bangkok

Metropolitan Administration (BMA) methadone clinics and HBV vaccination of seronegatives.

Results: Prevalence of antibody to HBV, tetanus, HAV and HIV was 87.8%, 68.1%, 60.2% and 35.9%, respectively. Prevalence of HBV and HAV increased with increasing age; prevalence of tetanus decreased with increasing age. Being HIV seropositive was related inversely to income and being tetanus seronegative. Of the 189 HBV seronegative IDUs,

81.0% completed the vaccine series. IDUs with HIV had a 6.5-fold odds of vaccine nonresponse. Conclusions: These data underscore the need for, and feasibility of, vaccine delivery in this population and support targeting efforts at high-risk age groups. copyright

2008 Society for the Study of Addiction.

ISSN 0965-2140

Publication Type Journal: Article

Journal Name Addiction

Volume 103

Issue Part 10

Page 1687-1695


Date of Publication October 2008

VIROLOGY 2008 <271>

Database EMBASE


Authors Piot P. Bartos M. Larson H. Zewdie D. Mane P.

Institution

(Piot, Bartos) Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.

(Larson) Department of International Development, Community and Environment, Clark University, Worcester, MA,

United States.

(Larson) Center for Population and Development Studies, Harvard School of Public Health, Harvard University,

Cambridge, MA, United States.

(Zewdie) The World Bank, Washington, DC, United States.

(Mane) United Nations Population Fund (UNFPA), NY, United States.


United Kingdom

Title

Coming to terms with complexity: a call to action for HIV prevention.

Source

The Lancet. 372(9641)(pp 845-859), 2008. Date of Publication: 20080906/12.

Publisher

Elsevier Limited

Abstract

A quarter of a century of AIDS responses has created a huge body of knowledge about HIV transmission and how to prevent it, yet every day, around the world, nearly 7000 people become infected with the virus. Although HIV prevention is complex, it ought not to be mystifying. Local and national achievements in curbing the epidemic have been myriad, and have created a body of evidence about what works, but these successful approaches have

not yet been fully applied. Essential programmes and services have not had sufficient coverage; they have often lacked the funding to be applied with sufficient quality and intensity.

Action and funding have not necessarily been directed to where the epidemic is or to what drives it. Few programmes address vulnerability to HIV and structural determinants of the epidemic. A prevention constituency has not been adequately mobilised to stimulate the demand for HIV prevention. Confident and unified leadership has not emerged to assert what is needed in HIV prevention and how to overcome the political, sociocultural, and logistic barriers in getting there. We discuss the combination of solutions which are needed to intensify HIV prevention, using the existing body of evidence and the lessons from our successes and failures in HIV prevention. copyright 2008 Elsevier Ltd. All rights reserved.

ISSN 0140-6736


Journal Name The Lancet

Volume 372

Issue Part 9641

Page 845-859


Date of Publication 20080906/12

VIROLOGY 2008 <299>

Database EMBASE


Authors Abou-Saleh M. Davis P. Rice P. Checinski K. Drummond C. Maxwell D. Godfrey C. John C. Corrin B. Tibbs

C. Oyefeso A. de Ruiter M. Ghodse H.

Institution

(Abou-Saleh, Rice, Checinski, Drummond, Maxwell, John, Corrin, Oyefeso, Ghodse) Division of Mental Health, St.

George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.

(Davis) Substance Misuse Services, Camden and Islington NHS Foundation Trust, London, United Kingdom.

(Godfrey) Department of Health Sciences, The University of York, York, United Kingdom.

(de Ruiter) Addictions, Surrey and Borders Partnership NHS Foundation Trust, Chertsey, Surrey, United Kingdom.

(Tibbs) Department of Gastroenterology, Royal Surrey County Hospital, Guildford, United Kingdom.


United Kingdom

Title

The effectiveness of behavioural interventions in the primary prevention of Hepatitis

C amongst injecting drug users: A randomised controlled trial and lessons learned.

Source

Harm Reduction Journal. 5, 2008. Article Number: 25. Date of Publication: 31 Jul 2008.

Publisher

BioMed Central Ltd.

Abstract

Aim: To develop and evaluate the comparative effectiveness of behavioural interventions of enhanced prevention counselling (EPC) and simple educational counselling (SEC) in reducing hepatitis C viral (HCV) infection in sero-negative injecting drug users (IDU). Design:

Randomised controlled trial (RCT) of EPC intervention in comparison with simple educational counselling (SEC). Setting Specialised: Drug services in London and Surrey, United Kingdom.

Participants and Measurements: Ninety five IDUs were recruited and randomised to receive

EPC (n = 43) or SEC (n = 52). Subjects were assessed at baseline using the Addiction

Severity Index (ASI), the Injecting Risk Questionnaire (IRQ), and Drug Injecting Confidence

Questionnaire (DICQ). The primary outcome was measured by the rate of sero-conversion at

6 months and 12 months from baseline and by the ASI, IRQ and DICQ at 6 months from baseline. Hepatitis C testing was undertaken by the innovative test of the dried blood spot

(DBS) test which increased the rate of testing by 4 fold compared to routine blood testing.

Findings Seventy: Eighty two subjects (82%) out of the 95 recruited were followed up at 6 months and 62 (65%) were followed up at 12 months. On the primary outcome measure of the rate of seroconversion, 8 out of 62 patients followed-up at twelve months seroconverted, three in the EPC group and five in the SEC group, indicating incidence rates of 9.1 per 100

person years for the EPC group, 17.2 per 100 person years for the SEC group, and 12.9 per

100 person years for the cohort as a whole. Analysis of the secondary outcome measures on alcohol use, risk behaviour, psychological measures, quality of life, showed no significant differences between the EPC and the SEC groups. However, there were significant changes on a number of measures from baseline values indicating positive change for both groups.

Conclusion: We were not able to prove the efficacy of EPC in comparison with SEC in the prevention of hepatitis C in IDUs. This was related to low recruitment and retention rates of the participants. Moreover there was a low adherence rate to EPC. The study provided the benefits of developing and introducing behavioural interventions of the EPC and SEC and the

DBS screening for Hepatitis C. Moreover the main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment, and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions. copyright 2008 Abou-Saleh et al; licensee BioMed Central Ltd.


Journal Name Harm Reduction Journal

Volume 5


Date of Publication 31 Jul 2008

VIROLOGY 2008 <333>

Database EMBASE


Authors Samet J.H. Krupitsky E.M. Cheng D.M. Raj A. Egorova V.Y. Levenson S. Meli S. Bridden C. Verbitskaya

E.V. Kamb M.L. Zvartau E.E.

Institution

(Samet, Meli, Bridden) Boston University School of Medicine/Boston Medical Center, Department of Medicine,

Clinical Addiction Research and Education (CARE) Unit, United States.

(Samet, Raj) Boston University School of Public Health, Department of Social and Behavioral Sciences, MA, United

States.

(Krupitsky, Egorova, Verbitskaya, Zvartau) St. Petersburg State Pavlov Medical University, St Petersburg, Russian

Federation.

(Cheng) Boston University School of Public Health, Department of Biostatistics, MA, United States.

(Levenson) Boston University School of Public Health, Data Coordinating Center, MA, United States.

(Kamb) Centers for Disease Control and Prevention (CDC), Division of STD Prevention, Atlanta, GA, United States.

(Samet) Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA

02118, United States.


United Kingdom

Title

Mitigating risky sexual behaviors among Russian narcology hospital patients: The

PREVENT (Partnership to Reduce the Epidemic Via Engagement in Narcology

Treatment) randomized controlled trial.

Source

Addiction. 103(9)(pp 1474-1483), 2008. Date of Publication: September 2008.

Publisher


Abstract

Aim: To assess the effectiveness of a sexual risk reduction intervention in the Russian narcology hospital setting. Design, setting and participants: This was a randomized controlled trial from October 2004 to December 2005 among patients with alcohol and/or heroin dependence from two narcology hospitals in St Petersburg, Russia. Intervention: Intervention subjects received two personalized sexual behavior counseling sessions plus three telephone booster sessions. Control subjects received usual addiction treatment, which did not include sexual behavior counseling. All received a research assessment and condoms at baseline.

Measurements: Primary outcomes were percentage of safe sex episodes (number of times

condoms were used / by number of sexual episodes) and no unprotected sex (100% condom use or abstinence) during the previous 3 months, assessed at 6 months. Findings:

Intervention subjects reported higher median percentage of safe sex episodes (unadjusted median difference 12.7%; P = 0.01; adjusted median difference 23%, P = 0.07); a significant difference was not detected for the outcome no unprotected sex in the past 3 months

[unadjusted odds ratio (OR) 1.6, 95% confidence interval (CI) 0.8-3.1; adjusted OR 1.5, 95%

CI 0.7-3.3]. Conclusions: Among Russian substance-dependent individuals, sexual behavior counseling during addiction treatment should be considered as one potential component of efforts to decrease risky sexual behaviors in this HIV at-risk population. copyright 2008 The

Authors.

ISSN 0965-2140



Volume 103

Issue Part 9

Page 1474-1483


Date of Publication September 2008

VIROLOGY 2008 <334>

Database EMBASE


Authors Lawrinson P. Ali R. Buavirat A. Chiamwongpaet S. Dvoryak S. Habrat B. Jie S. Mardiati R. Mokri A.

Moskalewicz J. Newcombe D. Poznyak V. Subata E. Uchtenhagen A. Utami D.S. Vial R. Zhao C.

Institution

(Lawrinson, Ali, Buavirat, Chiamwongpaet, Dvoryak, Habrat, Jie, Mardiati, Mokri, Moskalewicz, Newcombe,

Poznyak, Subata, Uchtenhagen, Utami, Vial, Zhao) Discipline of Pharmacology, University of Adelaide, World Hlth.

Org. Collaborating Centre for Research in the Treatment of Drug and Alcohol Problems, Australia.

(Lawrinson) University of Adelaide, World Hlth. Org. Collaborating Centre for Research in the Treatment of Drug and Alcohol Problems, Medical School South, Adelaide, SA 5005, Australia.


United Kingdom

Title

Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS.

Source

Addiction. 103(9)(pp 1484-1492), 2008. Date of Publication: September 2008.

Publisher


Abstract

Aims: Opioid substitution treatment has been studied extensively in industrialized countries, but there are relatively few studies in developing/transitional countries. The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries. Design: Longitudinal cohort study. Setting: Purposively selected OST sites in Asia

(China, Indonesia, Thailand), Eastern Europe (Lithuania, Poland, Ukraine), the Middle East

(Iran) and Australia. Participants: Seven hundred and twenty-six OST entrants.

Measurements: Participants were interviewed at treatment entry, 3 and 6 months.

Standardized instruments assessed drug use, treatment history, physical and psychological health, quality of life, criminal involvement, blood-borne virus (BBV) risk behaviours and prevalence of human immunodeficiency virus (HIV) and hepatitis C. Findings: Participants were predominantly male, aged in their early 30s and had attained similar levels of education.

Seroprevalence rates for HIV were highest in Thailand (52%), followed by Indonesia (28%) and Iran (26%), and lowest in Australia (2.6%). Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general

wellbeing over the course of the study. Conclusions: OST can achieve similar outcomes consistently in a culturally diverse range of settings in low- and middle-income countries to those reported widely in high-income countries. It is associated with a substantial reduction in

HIV exposure risk associated with IDU across nearly all the countries. Results support the expansion of opioid substitution treatment. copyright 2008 World Health Organization.

ISSN 0965-2140



Volume 103

Issue Part 9

Page 1484-1492


Date of Publication September 2008

VIROLOGY 2008 <342>

Database EMBASE


Authors Malta M. Strathdee S.A. Magnanini M.M.F. Bastos F.I.

Institution

(Malta) Social Science Department, Sergio Arouca School of Public Health (DCS/ENSP), Oswaldo Cruz

Foundation, Rio de Janeiro, Brazil.

(Strathdee) Division of International Health and Cross Cultural Medicine, Department of Family and Preventive

Medicine, University of California, San Diego (UCSD) School of Medicine, San Diego, CA, United States.

(Magnanini) Institute of Public Health Studies, Federal University of Rio de Janeiro (IESC/UFRJ), Rio de Janeiro,

Brazil.

(Bastos) Health Information Department, Center for Scientific and Technological Information (DIS/CICT), Oswaldo

Cruz Foundation, Rio de Janeiro, Brazil.

(Malta) Oswaldo Cruz Foundation, Rua Leopoldo Bulhoes, 1480, Manguinhos, Rio de Janeiro, RJ 21041-210,

Brazil.


United Kingdom

Title

Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: A systematic review.

Source

Addiction. 103(8)(pp 1242-1257), 2008. Date of Publication: August 2008.

Publisher


Abstract

Aims: Adherence to highly active antiretroviral therapy (HAART) is a key predictor of survival for human immunodeficiency virus (HIV)-infected people. Suboptimal adherence among marginalized populations such as HIV-positive drug users could be associated with clinical failure and the emergence of viral resistance. Objective: To conduct a systematic review of studies assessing adherence to HAART among HIV-positive drug users (DU) and identify factors associated with non-adherence to HIV treatment. Data sources: Seven electronic databases were searched for peer-reviewed papers published in English, French, Spanish or

Portuguese, from 1996 to 2007. Study selection and data abstraction: Studies were excluded if they presented only qualitative data, were reviews themselves or assessed other populations without disaggregating data on DU. Findings on adherence were extracted and summarized. Data synthesis: Forty-one studies were considered, which studied a total of 15

194 patients, the majority of whom were HIV-positive DU (n = 11 628, 76.5%). Twenty-two studies assessed adherence using patient self-reports, eight used pharmacy records, three used electronic monitoring [i.e. Medication Event Monitoring Systems (MEMS) caps], six studies used a combination of patient self-report, clinical data and MEMS-caps, and two analyzed secondary data. Overall, active substance use was associated with poor adherence, as well as depression and low social support. Higher adherence was found in patents receiving care in structured settings (e.g. directly observed therapy) and/or drug addiction

treatment (especially substitution therapy). Conclusion: While lower than other populations - especially among users of stimulants, incarcerated DU and patients with psychiatric comorbidities - adherence to HAART among HIV-positive DU can be achieved. Better adherence was identified among those engaged in comprehensive services providing HIV and addiction treatment with psychosocial support. copyright 2008 The Authors.

ISSN 0965-2140



Volume 103

Issue Part 8

Page 1242-1257


Date of Publication August 2008

VIROLOGY 2008 <450>

Database EMBASE


Authors Wong F.L. Rotheram-Borus M.J. Lightfoot M. Pequegnat W. Comulada W.S. Cumberland W. Weinhardt L.S.

Remien R.H. Chesney M. Johnson M. Ehrhardt A.A. Kelly J.A.

Institution

(Wong, Rotheram-Borus, Lightfoot, Comulada, Cumberland) University of California, Los Angeles, CA, United

States.

(Pequegnat) National Institute of Mental Health, Bethesda, MD, United States.

(Weinhardt, Kelly) Medical College of Wisconsin, Milwaukee, WI, United States.

(Remien, Ehrhardt) New York State Psychiatric Institute, Columbia University, New York, NY, United States.

(Chesney, Johnson) University of California, San Francisco, CA, United States.

(Rotheram-Borus) 10920 Wilshire Boulevard, Los Angeles, CA 90024, United States.


United Kingdom

Title

Effects of behavioral intervention on substance use among people living with HIV:

The Healthy Living Project randomized controlled study.

Source

Addiction. 103(7)(pp 1206-1214), 2008. Date of Publication: Jul 2008.

Abstract

Aim: Reductions in substance use were examined in response to an intensive intervention with people living with human immunodeficiency virus (HIV) (PLH). Design, setting and participants: A randomized controlled trial was conducted with 936 PLH who had recently engaged in unprotected sexual risk acts recruited from four US cities: Milwaukee, San

Francisco, New York and Los Angeles. Substance use was assessed as the number of days of use of 19 substances recently (over the last 90 days), evaluated at 5-month intervals over

25 months. Intervention: A 15-session case management intervention was delivered to PLH in the intervention condition; the control condition received usual care. Measurements: An intention-to-treat analysis was conducted examining reductions on multiple indices of recent substance use calculated as the number of days of use. Findings: Reductions in recent substance use were significantly greater for intervention PLH compared to control PLH: alcohol and/or marijuana use, any substance use, hard drug use and a weighted index adjusting for seriousness of the drug. While the intervention-related reductions in substance use were larger among women than men, men also reduced their use. Compared to controls, gay and heterosexual men in the intervention reduced significantly their use of alcohol and marijuana, any substance, stimulants and the drug severity-weighted frequency of use index.

Gay men also reduced their hard drug use significantly in the intervention compared to the control condition. Conclusions: A case management intervention model, delivered individually, is likely to result in significant and sustained reductions in substance use among PLH. copyright 2008 The Authors.

ISSN 0965-2140



Volume 103

Issue Part 7

Page 1206-1214


Date of Publication Jul 2008

VIROLOGY 2008 <468>

Database EMBASE


Authors Habermann B. Eberhardt C. Kurth A.A.

Institution

(Habermann, Eberhardt, Kurth) Department of Orthopaedic Surgery, University Hospital Frankfurt/Main,

Marienburgstr. 2, 60528 Frankfurt/Main, Germany.


United Kingdom

Title

Total joint replacement in HIV positive patients.

Source

Journal of Infection. 57(1)(pp 41-46), 2008. Date of Publication: Jul 2008.

Abstract

Background: Recent HIV therapies have improved life expectancy in HIV positive patients.

For the purpose of the following retrospective investigation, we analyzed the results of total joint replacement in HIV positive patients. This study exemplifies orthopaedic treatment options and perioperative problems in HIV positive patients. Our population included a high proportion of hemophilic patients. Design and methods: Between 1988 and 2000, we performed 55 endoprosthetic procedures (20 total hip replacements (THR), 33 total knee replacements (TKR), two shoulder replacements) in 41 patients suffering form HIV. Thirty patients are afflicted with hemophilia, seven patients were intravenous drug addicts. The mean follow-up was 81 months (2-14) years. Patients were seen annually; either the Harris

Hip Score or the Knee Society Rating System was applied. Results: The following septic complications were observed: a mycotic abscess of both hips 5/10 months after bilateral THR, two early infections following coxitis in patients with intravenous drug abuse, and one further case of septic loosening after 15 months in one patient after THR. Furthermore, one aseptic loosening of a THR after 14 months in a hemophilic patient was seen. After TKR, two early infections in patients with intravenous drug addiction were seen. The total complication rate was 12.7%. A coherency between the infection rate and the CD4+ count was not seen.

Discussion: An analysis of the results shows that the complications occurred in patients living under difficult social circumstances. Whereas total joint replacement in hemophilic patients with or without HIV seems to be a fairly safe procedure concerning the postoperative infection rate, intravenous drug abuse increases the risk. Functional outcome does not differ from an

HIV negative population both in the TKR and THR groups. copyright 2008 The British

Infection Society.

ISSN 0163-4453


Journal Name Journal of Infection

Volume 57

Issue Part 1

Page 41-46



VIROLOGY 2008 <524>

Database EMBASE


Authors Springer S.A. Bruce R.D.

Institution

(Springer, Bruce) Yale School of Medicine, New Haven, CT, United States.


United Kingdom

Title

A pilot survey of attitudes and knowledge about opioid substitution therapy for HIVinfected prisoners.

Source

Journal of Opioid Management. 4(2)(pp 81-86), 2008. Date of Publication: Mar 2008.

Abstract

A majority of inmates in the state of Connecticut Department of Corrections use opioids or are opioid dependent before incarceration. None of the state's prisons offer opioid substitution therapy other than for detoxification or maintenance therapy for women during pregnancy. On release to the community, most prisoners relapse to drug use and this has been associated with higher recidivism rates, and less adherence to antiretroviral medications for HIV-infected persons. Nationally and internationally, methadone (METH) and buprenorphine (BUP) have been found to decrease relapse to drug use, decrease recidivism rates, improve adherence to antiretroviral medications, decrease HIV-risk taking behaviors, and improve mortality.

However, the general knowledge about opioid substitution therapy among correctional facility staff has been reported as substandard. This pilot study compiled results of answers to anonymous surveys from 27 individuals who work directly with inmates in a patient-care capacity for the Connecticut Department of Corrections (CT DOC) and CT DOC casemanagement referral program (Project TLC) in the year 2006. The surveys included questions regarding current attitudes and knowledge about, opioid substitution therapy for prisoners. A minority of respondents refer released prisoners with a history of opioid dependency to METH or BUP treatment. The majority of correctional workers and case-management referral workers did not have knowledge about BUP or METH's ability to improve health and decrease

HIV risk taking behaviors. This study found that more education of individuals treating and caring for HIV-infected opioid dependent prisoners is needed.

ISSN 1551-7489


Journal Name Journal of Opioid Management

Volume 4

Issue Part 2

Page 81-86


Date of Publication Mar 2008

VIROLOGY 2008 <528>

Database EMBASE


Authors Macias J. Palacios R.B. Claro E. Vargas J. Vergara S. Mira J.A. Merchante N. Corzo J.E. Pineda J.A.

Institution

(Macias, Palacios, Vergara, Mira, Merchante) Servicio de Medicina Interna, Hospital Universitario de Valme, Ctra de

Cadiz s/n, 41014 Seville, Spain.

(Claro) Centro de Drogodependencias 'Antaris', Seville, Spain.

(Vargas) Servicio de Microbiologia, Hospital Universitario de Valme, Seville, Spain.

(Macias, Corzo, Pineda) Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Seville, Spain.


United Kingdom

Title

High prevalence of hepatitis C virus infection among noninjecting drug users:

Association with sharing the inhalation implements of crack.

Source

Liver International. 28(6)(pp 781-786), 2008. Date of Publication: Jul 2008.

Abstract

Background: Most of the prevalent cases of hepatitis C virus (HCV) infection are attributable to intravenous drug using. However, a substantial number of individuals, particularly noninjecting drug users (NIDU), report no identifiable source of HCV exposure. This may be interpreted as inaccurate reporting of past intravenous exposure or as the presence of an unidentified source of HCV infection. Because of this, we evaluated the prevalence of and factors associated with HCV infection among NIDU. Methods: One hundred and eighty-two individuals who were attended from 2003 to 2004 in a drug addiction facility because of noninjecting drug use were included. Results: HCV infection was detected in 23 (12.6%) participants. Sharing the inhalation tube of crack cocaine [adjusted odds ratio (AOR) 3.6, 95% confidence interval (CI) 1.3-9.8, P =0.01], presence of tattoos (AOR 3.5, 95% CI 1.3-9.1, P

=0.02) and age [greater-than or equal to]34 years (AOR 3.9, 95% CI 1.3-11.6, P =0.01) 3.9 were independently associated with HCV infection. Conclusion: The prevalence of HCV infection in NIDU is higher than in general population. HCV infection is more likely among older drug users, those with tattoos and crack cocaine users that share the inhalation implements. copyright 2008 The Authors. Journal compilation copyright 2008 Blackwell

Munksgaard.

ISSN 1478-3223


Journal Name Liver International

Volume 28

Issue Part 6

Page 781-786



VIROLOGY 2008 <546>

Database EMBASE


Authors Novick D.M. Kreek M.J.

Institution

(Novick) Digestive Specialists, Inc., 999 Brubaker Drive, Kettering, OH 45429, United States.

(Novick, Kreek) Rockefeller University, New York, NY, United States.

(Novick) Kettering Medical Center, Kettering, OH, United States.

(Novick) Wright State University Boonshoft School of Medicine, Dayton, OH, United States.


United Kingdom

Title

Critical issues in the treatment of hepatitis C virus infection in methadone maintenance patients.

Source

Addiction. 103(6)(pp 905-918), 2008. Date of Publication: Jun 2008.

Abstract

Aims: Hepatitis C virus (HCV) infection is a common chronic complication of injection drug use. Methadone maintenance programs contain large numbers of patients infected with HCV.

This paper reviews HCV infection with emphasis on the medical care of HCV-infected, or

HCV and human immunodeficiency virus co-infected, patients on methadone or buprenorphine maintenance. Methods: Literature searches using PubMed, PsycINFO and

SocINDEX were used to identify papers from 1990-present on antiviral therapy for HCV in methadone maintenance patients and on liver transplantation in methadone maintenance patients. Results: Injection drug use is the most significant risk factor for HCV infection in most western countries. The prevalence of HCV antibody is high in injection drug users (53-

96%) and in patients enrolled in methadone maintenance programs (67-96%). Studies of antiviral therapy for HCV in methadone maintenance patients show rates of sustained virological response (SVR), defined as negative HCV-RNA 24 weeks after the end of treatment, of 28-94%. In studies with contrast groups, no significant differences in SVR between methadone and contrast groups were found. Excellent completion rates of antiviral therapy (72-100%) were found in five of six studies. There are many barriers to methadone

maintenance patients' receiving antiviral therapy, and research on overcoming barriers is discussed. Liver transplantation has been successful in methadone maintenance patients but has not been utilized widely. Conclusion: High quality medical care for all aspects of HCV infection can be provided to methadone maintenance patients. The literature supports the effectiveness of such services, but the reality is that most patients do not receive them. copyright 2008 The Authors.

ISSN 0965-2140



Volume 103

Issue Part 6

Page 905-918


Date of Publication Jun 2008

VIROLOGY 2008 <586>

Database EMBASE


Authors Friedman S.R. Mateu-Gelabert P. Sandoval M. Hagan H. Jarlais D.C.D.

Institution

(Friedman, Mateu-Gelabert, Sandoval, Hagan, Jarlais) National Development and Research Institutes, Inc., 71

West 23d Street, New York, NY 10010, United States.

(Friedman) Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore,

MD, United States.

(Jarlais) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY,

United States.


United Kingdom

Title

Positive deviance control-case life history: A method to develop grounded hypotheses about successful long-term avoidance of infection.

Source

BMC Public Health. 8, 2008. Article Number: 94. Date of Publication: 2008.

Abstract

Background. Prevalence rates for long-term injection drug users in some localities surpass

60% for HIV and 80% for HCV. We describe methods for developing grounded hypotheses about how some injectors avoid infection with either virus. Methods. Subjects: 25 drug injectors who have injected drugs 8 - 15 years in New York City. 17 remain without antibody to either HIV or HCV; 3 are double-positives; and 5 are positive for HCV but not HIV. "Staying

Safe" methodology compares serostatus groups using detailed biographical timelines and narratives; and information about how subjects maintain access to physical resources and social support; their strategies and tactics to remain safe; how they handle problems of addiction and demands by drug dealers and other drug users; and how their behaviors and strategies do or do not become socially-embedded practices. Grounded theory and life-history analysis techniques compare and contrast doubly-uninfected with those infected with both viruses or only with HCV. Results. Themes and initial hypotheses emerging from analyses included two master hypotheses that, if confirmed, should help shape preventive interventions: 1) Staying uninfected is not simply a question of social structure or social position. It involves agency by drug injectors, including sustained hard work and adaptation to changing circumstances. 2) Multiple intentionalities contribute to remaining uninfected. These conscious goals include balancing one's need for drugs and one's income; developing ways to avoid drug withdrawal sickness; avoiding situations where other drug users importune you to share drugs; and avoiding HIV (and perhaps HCV) infection. Thus, focusing on a single goal in prevention might be sub-optimal. Other hypotheses specify mechanisms of enacting these intentionalities. One example is finding ways to avoid extreme social ostracism.

Conclusion. We have identified strategies and tactics that some doubly-uninfected IDUs have developed to stay safe. Staying Safe methodology develops grounded hypotheses. These

can be tested through cohort studies of incidence and prevention trials of hypothesis-based programs to help drug injectors make their injection and sexual careers safer for themselves and others. This positive deviance control-case life history method might be used to study avoiding other infections like genital herpes among sex workers. copyright 2008 Friedman et al; licensee BioMed Central Ltd.


Journal Name BMC Public Health

Volume 8


Date of Publication 2008

VIROLOGY 2008 <608>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 18671853

Status In-Data-Review

Authors Abou-Saleh M. Davis P. Rice P. Checinski K. Drummond C. Maxwell D. Godfrey C. John C. Corrin B.

Tibbs C. Oyefeso A. de Ruiter M. Ghodse H.

Authors Full Name Abou-Saleh, Mohammed. Davis, Paul. Rice, Philip. Checinski, Ken. Drummond, Colin.

Maxwell, Douglas. Godfrey, Christine. John, Christopher. Corrin, Betsy. Tibbs, Christopher. Oyefeso, Adenekan. de Ruiter, Marian. Ghodse, Hamid.

Institution

Division of Mental Health, St, George's, University of London, Cranmer Terrace, Tooting, London, SW17 0RE, UK. mabousal@sgul.ac.uk.

Title

The effectiveness of behavioural interventions in the primary prevention of Hepatitis

C amongst injecting drug users: a randomised controlled trial and lessons learned.

Source

Harm Reduction Journal. 5:25, 2008.

Journal Name

Harm Reduction Journal

Other ID

Source: NLM. PMC2531167


England

Abstract

ABSTRACT: AIM: To develop and evaluate the comparative effectiveness of behavioural interventions of enhanced prevention counselling (EPC) and simple educational counselling

(SEC) in reducing hepatitis C viral (HCV) infection in sero-negative injecting drug users (IDU).

DESIGN: Randomised controlled trial (RCT) of EPC intervention in comparison with simple educational counselling (SEC). SETTING SPECIALISED: Drug services in London and

Surrey, United Kingdom. PARTICIPANTS AND MEASUREMENTS: Ninety five IDUs were recruited and randomised to receive EPC (n = 43) or SEC (n = 52). Subjects were assessed at baseline using the Addiction Severity Index (ASI), the Injecting Risk Questionnaire (IRQ), and Drug Injecting Confidence Questionnaire (DICQ). The primary outcome was measured by the rate of sero-conversion at 6 months and 12 months from baseline and by the ASI, IRQ and DICQ at 6 months from baseline. Hepatitis C testing was undertaken by the innovative test of the dried blood spot (DBS) test which increased the rate of testing by 4 fold compared to routine blood testing. FINDINGS SEVENTY: Eighty two subjects (82%) out of the 95 recruited were followed up at 6 months and 62 (65%) were followed up at 12 months. On the primary outcome measure of the rate of seroconversion, 8 out of 62 patients followed-up at twelve months seroconverted, three in the EPC group and five in the SEC group, indicating incidence rates of 9.1 per 100 person years for the EPC group, 17.2 per 100 person years for the SEC group, and 12.9 per 100 person years for the cohort as a whole. Analysis of the secondary outcome measures on alcohol use, risk behaviour, psychological measures, quality of life, showed no significant differences between the EPC and the SEC groups.

However, there were significant changes on a number of measures from baseline values indicating positive change for both groups. CONCLUSION: We were not able to prove the

efficacy of EPC in comparison with SEC in the prevention of hepatitis C in IDUs. This was related to low recruitment and retention rates of the participants. Moreover there was a low adherence rate to EPC. The study provided the benefits of developing and introducing behavioural interventions of the EPC and SEC and the DBS screening for Hepatitis C.

Moreover the main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment, and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions.

Publication Type Journal Article.



Volume 5

Page 25

VIROLOGY 2008 <769>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 18366699

Status MEDLINE

Authors Friedman SR. Mateu-Gelabert P. Sandoval M. Hagan H. Des Jarlais DC.

Authors Full Name Friedman, Samuel R. Mateu-Gelabert, Pedro. Sandoval, Milagros. Hagan, Holly. Des Jarlais,

Don C.

Institution

National Development and Research Institutes, Inc, 71 West 23d Street, 8th floor, New York, NY 10010, USA. sam4wp@netscape.net

Title

Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection.

Source

BMC Public Health. 8:94, 2008.

Journal Name

BMC Public Health

Other ID

Source: NLM. PMC2329618


England

Abstract

BACKGROUND: Prevalence rates for long-term injection drug users in some localities surpass 60% for HIV and 80% for HCV. We describe methods for developing grounded hypotheses about how some injectors avoid infection with either virus. METHODS: Subjects:

25 drug injectors who have injected drugs 8 - 15 years in New York City. 17 remain without antibody to either HIV or HCV; 3 are double-positives; and 5 are positive for HCV but not HIV.

"Staying Safe" methodology compares serostatus groups using detailed biographical timelines and narratives; and information about how subjects maintain access to physical resources and social support; their strategies and tactics to remain safe; how they handle problems of addiction and demands by drug dealers and other drug users; and how their behaviors and strategies do or do not become socially-embedded practices. Grounded theory and life-history analysis techniques compare and contrast doubly-uninfected with those infected with both viruses or only with HCV. RESULTS: Themes and initial hypotheses emerging from analyses included two master hypotheses that, if confirmed, should help shape preventive interventions: 1) Staying uninfected is not simply a question of social structure or social position. It involves agency by drug injectors, including sustained hard work and adaptation to changing circumstances. 2) Multiple intentionalities contribute to remaining uninfected. These conscious goals include balancing one's need for drugs and one's income; developing ways to avoid drug withdrawal sickness; avoiding situations where other drug users importune you to share drugs; and avoiding HIV (and perhaps HCV) infection. Thus, focusing on a single goal in prevention might be sub-optimal. Other hypotheses specify

mechanisms of enacting these intentionalities. One example is finding ways to avoid extreme social ostracism. CONCLUSION: We have identified strategies and tactics that some doublyuninfected IDUs have developed to stay safe. Staying Safe methodology develops grounded hypotheses. These can be tested through cohort studies of incidence and prevention trials of hypothesis-based programs to help drug injectors make their injection and sexual careers safer for themselves and others. This positive deviance control-case life history method might be used to study avoiding other infections like genital herpes among sex workers.

Publication Type Journal Article. Research Support, N.I.H., Extramural.



Volume 8

Page 94

VIROLOGY 2008 <665>

Database EMBASE


Authors Walubo A.

Institution

(Walubo) University of the Free State, Department of Pharmacology, PO Box 339 (G6), Bloemfontein 9300, South

Africa.


United Kingdom

Title

The role of cytochrome P450 in antiretroviral drug interactions.

Source

Expert Opinion on Drug Metabolism and Toxicology. 3(4)(pp 583-598), 2007. Date of

Publication: Aug 2007.

Abstract

As millions of patients with HIV/AIDS are put on treatment with the highly active antiretroviral therapy (HAART), drug interactions have become a major concern for healthcare providers.

The use of HAART as a combination of 3 - 4 drugs creates potential for antiretroviral (ARV) drug interactions, and this is complicated by the addition of other drugs for treatment of other ailments such as comorbid chronic conditions and/or opportunistic infections. It has been observed that most ARV drug interactions involve drugs that interact with CYP enzymes.

Specifically, protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors

(NNRTIs) are the most implicated in ARV drug interactions and are metabolised by CYP isoenzymes. Because PIs and NNRTIs can also inhibit and induce some of the CYP isoenzymes, they often interfere with the metabolism of several drugs eliminated by CYP isoenzymes, and the converse is true. The drug groups most implicated in CYP-mediated interactions with ARV drugs include: rifamycins; statins; antibiotics; antifungals; antiulcer drugs; contraceptives; immunosuppressant drugs; drugs for erectile dysfunction; drugs of abuse; drugs for treatment of addiction; benzodiazepines; anticonvulsants; psychotropic agents; herbal products; antiarrhythmias; antimalarials; anticoagulants; and antiasthma drugs.

Unfortunately, this information is published in different resources where it may not be accessible to many, and is also liable to misinterpretation if read in isolation. Here, this information has been pooled and discussed with a hope that it will enable appropriate use in patients with HIV/AIDS. The review was confined to CYP-associated ARV drug interactions to emphasise that prevention of ARV drug interactions requires thorough knowledge of CYP function and regulation by healthcare providers. copyright 2007 Informa UK Ltd.

ISSN 1742-5255


Journal Name Expert Opinion on Drug Metabolism and Toxicology

Volume 3

Issue Part 4

Page 583-598


Date of Publication Aug 2007

CHILDREN AND YOUNG PEOPLE 2008 / VIROLOGY 2008 <672>

Database EMBASE

Accession Number2008088045

Authors Brook D.W. Brook J.S. Rubenstone E. Zhang C. Castro F.G. Tiburcio N.

Institution

(Brook, Brook, Rubenstone, Zhang) New York University School of Medicine,

(Castro) Arizona State University,

(Tiburcio) Graduate Center, City University New York,

(Brook) New York University School of Medicine, 215 Lexington Ave., New York, NY 10016, United States.


United Kingdom

Title

Risk factors for distress in the adolescent children of HIV-positive and HIV-negative drug-abusing fathers.

Source

AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 20(1)(pp 93-100),

2008. Date of Publication: Mar 2008.

Abstract

In contrast to previous research on parental drug abuse, the present study examined comorbid drug addiction and HIV infection in the father as related to his adolescent child's psychological distress. Individual structured interviews were administered to 505 HIV-positive and HIV-negative drug-abusing fathers and one of their children, aged 12-20. Structural equation modelling tested an hypothesized model linking paternal latent variables, ecological factors and adolescent substance use to adolescent distress. Results demonstrated a direct pathway between paternal distress and adolescent distress, as well as an indirect pathway; namely, paternal distress was linked with impaired paternal teaching of coping skills to the child, which in turn was related to adolescent substance use and, ultimately, to the adolescent's distress. There was also an association between paternal drug addiction/HIV and adolescent distress, which was mediated by both ecological factors and adolescent substance use. Findings suggest an increased risk of distress in the adolescent children of fathers with comorbid drug addiction and HIV/AIDS, which may be further complicated by paternal distress. Results suggest several opportunities for prevention and treatment programmes for the children of drug-abusing fathers. copyright 2008 Taylor & Francis.

ISSN 0954-0121


Journal Name AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

Volume 20

Issue Part 1

Page 93-100


Date of Publication Mar 2008

VIROLOGY 2008 <714>

Database EMBASE


Authors Ghitza U.E. Epstein D.H. Preston K.L.

Institution

(Ghitza, Epstein, Preston) Clinical Pharmacology and Therapeutics Branch, Treatment Section, Intramural

Research Program (IRP), Baltimore, MD, United States.


United Kingdom

Title

Contingency management reduces injection-related HIV risk behaviors in heroin and cocaine using outpatients.

Source

Addictive Behaviors. 33(4)(pp 593-604), 2008. Date of Publication: Apr 2008.

Abstract

Intravenous drug use is a major vector of HIV transmission. We assessed whether contingency management (CM), in which participants earn reinforcers for drug abstinence, reduces HIV risk behaviors in methadone-maintained opiate- and cocaine-using outpatients.

Participants (n = 116) were randomly assigned to prize-based CM or to receipt of prize draws noncontingently on a schedule yoked to the CM group. Both groups received methadone and individual counseling throughout treatment. The HIV-Risk Taking Behaviour Scale was administered in written questionnaire form at 2-week intervals (HRBS; [Darke, S., Hall, W.,

Heather, N., Ward, J., & Wodak, A. (1991). The reliability and validity of a scale to measure

HIV risk-taking behaviour among intravenous drug users. AIDS, 5, 181-185]). A mediation analysis was conducted to determine whether abstinence from opiates and cocaine mediated the effect of CM on HRBS scores. Changes in HRBS scores over time differed significantly by treatment (F(9,334) = 2.4, p < 0.05), with HRBS scores decreasing over time in the CM group to a greater extent than in the noncontingent control group. Participants in the CM group had significantly lower rates of simultaneous cocaine/opiate-positive urine specimens than those in the noncontingent control group during CM treatment (F(1,111) = 6.8, p = 0.01). The relationship between treatment condition and HRBS scores was mediated by abstinence. CM targeted toward cocaine and heroin use produces significant reductions in injection-related drug-taking behaviors associated with heightened risk for getting or transmitting HIV.

ISSN 0306-4603


Journal Name Addictive Behaviors

Volume 33

Issue Part 4

Page 593-604


Date of PublicationApr 2008

VIROLOGY 2008 <779>

Database EMBASE


Authors Martin-Santos R. Diez-Quevedo C. Castellvi P. Navines R. Miquel M. Masnou H. Soler A. Ardevol M. Garcia

F. Galeras J.A. Planas R. Sola R.

Institution

(Martin-Santos, Navines) Drug Abuse and Psychiatry Department, Hospital del Mar, Institut Municipal d'Investigacio

Medica, Barcelona, Spain.

(Diez-Quevedo) Psychiatry Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.

(Diez-Quevedo) Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain.

(Castellvi) Adults, Adolescents and Child Psychopatology Department, Facultat de Psicologia, Universitat Autonoma de Barcelona, Barcelona, Spain.

(Castellvi, Galeras, Sola) Liver Section, Hospital del Mar, Universitat Autonoma de Barcelona, Barcelona, Spain.

(Miquel, Masnou, Planas) Liver Section, Department of Gastroenterology, Hospital Universitari Germans Trias I

Pujol, Badalona, Spain.

(Soler, Garcia) Department of Clinical Pharmacology, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.

(Ardevol) Department of Pharmacy, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.

(Sola) Liver Section, Hospital del Mar, C/ Passeig Maritim 25-29, 08003 Barcelona, Spain.


United Kingdom

Title

De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C.

Source

Alimentary Pharmacology and Therapeutics. 27(3)(pp 257-265), 2008. Date of Publication:

Feb 2008.

Abstract

Background: Depression and anxiety have been associated with interferon treatment and low treatment adherence. Aim: To study the incidence and associated risk factors of depressive and anxiety disorders during pegylated interferon plus ribavirin and treatment

adherence in a prospective cohort of 176 patients with chronic hepatitis C patients. Methods:

Patients were interviewed at baseline using the Structured Clinical Interview for DSM-IV

Mental Disorders and the Patient Health Questionnaire and the Hospital Anxiety and

Depression Scale were completed. Both questionnaires were completed also after 4, 12 and

24 weeks of treatment. Results: De novo depressive and/or anxiety disorders were diagnosed in 53 (36%) patients, in whom antidepressants and/or anxiolytics were administered. Higher baseline depression-subscale score (OR = 27.8, 95% CI = 2.82-333), primary education level

(OR = 3.1, 95% CI = 1.40-7.03) and being an immigrant (OR = 3.2, 95% CI = 1.12-9.47) were predictors of psychiatric disorders during anti-viral therapy. The percentage of patients with good adherence was lower in those with depression and/or anxiety (79% vs. 90%, P < 0.04).

Only one patient (1%) discontinued treatment because of a major depressive episode.

Depression and/or anxiety disorders had no effect on attainment of sustained virological response. Conclusion: Early detection and treatment of depressive and anxiety disorders favours good adherence to anti-viral treatment in hepatitis C. copyright 2008 The Authors.

ISSN 0269-2813


Journal Name Alimentary Pharmacology and Therapeutics

Volume 27

Issue Part 3

Page 257-265


Date of Publication Feb 2008

VIROLOGY 2008 <251>

Database EMBASE


Authors Kresina T.F. Bruce R.D. Lubran R. Clark H.W.

Institution

(Kresina, Lubran, Clark) Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services

Administration, Rockville, MD, United States.

(Bruce) Yale University School of Medicine, New Haven, CT, United States.


United Kingdom

Title

Integration of viral hepatitis services into opioid treatment programs.

Source

Journal of Opioid Management. 4(6)(pp 369-381), 2008. Date of Publication:

November/December 2008.

Publisher

Weston Medical Publishing

Abstract

Opioid treatment programs (OTPs) dispense methadone and buprenorphine under specific federal regulations to individuals diagnosed with opioid dependence. OTPs can provide a comprehensive therapeutic milieu, often including primary medical care, psychosocial counseling, vocational rehabilitation, ongoing performance monitoring, and other vital services. Because of the high prevalence of infectious diseases, particularly hepatitis C virus infection, model OTPs are developing comprehensive care and treatment programs that integrate general medical and infectious disease-related medical care with substance abuse and mental health services. Integrating hepatitis care services in the substance abuse treatment settings fosters access to care for patients with multiple comorbidities, many who otherwise would not receive needed care. Improving health related outcomes for this patient population with complex medical problems requires an advanced integrated model of care for

OTPs that can be exemplified through establishing resources needed to prevent hepatitis infection as standard of care. Outcomes management becomes possible through enhancing current capability of existing dispensing programs. This may serve as a national model for highly cost-efficient healthcare that has a measurable outcome of improved health.

ISSN 1551-7489


Journal Name Journal of Opioid Management

Volume 4

Issue Part 6

Page 369-381


Date of Publication November/December 2008

VIROLOGY 2008 <266>

Database EMBASE


Authors Sabin L.L. DeSilva M.B. Hamer D.H. Keyi X. Yue Y. Wen F. Tao L. Heggenhougen H.K. Seton L. Wilson I.B.

Gill C.J.

Institution

(Sabin, DeSilva, Hamer, Heggenhougen, Gill) Center for International Health and Development, Boston University,

Boston, United States.

(Sabin, DeSilva, Hamer, Heggenhougen, Gill) Department of International Health, Boston University School of

Public Health, Boston, United States.

(Hamer, Gill) Infectious Diseases Section, Department of Medicine, Boston University School of Medicine, Boston,

United States.

(Keyi) Department of STDs and Dermatology, Ditan Hospital, Beijing, China.

(Yue, Wen) Horizon Research Group, Beijing, China.

(Tao, Seton) Boston University School of Public Health, Boston, United States.

(Wilson) Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston,

United States.


United Kingdom

Title

Barriers to adherence to antiretroviral medications among patients living with HIV in southern China: A qualitative study.

Source

AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 20(10)(pp 1242-1250),

2008. Date of Publication: November 2008.

Publisher

Routledge

Abstract

Although China's government is rapidly expanding access to antiretroviral therapy, little is known about barriers to adherence among Chinese HIV-infected patients, particularly among injection drug users. To better understand barriers to antiretroviral treatment adherence, we conducted a qualitative research study, using both focus group and key informant methods, among 36 HIV-positive men and women in Dali, in southwestern China. All interviews utilized semi-structured question guides and were conducted in Mandarin, audio-recorded and translated into English for analysis. The most commonly cited adherence challenges were stigma, including secondary stigma experienced by family members; mental health issues; and economic concerns, particularly related to finding and maintaining employment.

Distinctive gender differences emerged, partly due to previous heroin use among male respondents. Optimizing adherence may require that antiretroviral therapy programs be linked to other services, including drug addiction treatment, mental health services and vocational treatment and support. HIV care and service providers and policy makers in China responsible for HIV treatment should be aware of these important barriers to adherence. copyright 2008 Taylor & Francis.

ISSN 0954-0121


Journal Name AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

Volume 20

Issue Part 10

Page 1242-1250


Date of Publication November 2008

VIROLOGY 2008 <323>

Database EMBASE


Authors Razali S.M.

Institution

(Razali) Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150,

Kelantan, Malaysia.


United Kingdom

Title

Drug substitution therapy: A new approach in preventing the spread of HIV/AIDS in

Malaysia.

Source

Tropical Doctor. 38(2)(pp 109-110), 2008. Date of Publication: April 2008.

Publisher

Royal Society of Medicine Press Ltd

Abstract

The prevalence of HIV/AIDS among drug addicts in Malaysia is high, especially among intravenous drug users. The present treatment and rehabilitation of drug addiction is considered as a failure. The government finally decided to start on Drug Substitution Therapy in early 2005 as an effort to prevent the spread of HIV/AIDS in the country.

ISSN 0049-4755


Journal Name Tropical Doctor

Volume 38

Issue Part 2

Page 109-110


Date of Publication April 2008

VIROLOGY 2008

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