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G M Hunter

Publications and source records attributed to G M Hunter.

16 recordsLinked to original sources
PubMed2000

Measuring injecting risk behaviour in the second decade of harm reduction: a survey of injecting drug users in England.

AIMS: To measure risk behaviour among injecting drug users (IDUs) using the Injecting Risk Questionnaire (IRQ). METHODS: Data were analysed from the first multi-site survey of injecting risk behaviour among IDUs not in contact with drug services in England. A total of 1214 IDUs were recruited from community settings in seven sites. FINDINGS: Fifty-two per cent reported sharing injecting equipment in the previous 4 weeks in response to a single question on sharing. This rose to 78% when asked more detailed and multiple questions on injecting risk practices. Levels of injecting risk behaviour did not differ substantially by gender, age, length of injecting career, main drug of injection, previous treatment contact or geographical location. However, sharing partners were restricted to a median of two others. CONCLUSION: These data raise questions concerning the extent to which levels of injecting risk behaviour have increased over recent years, or the extent to which previous monitoring systems underestimated levels of risk. None the less, the data confirm that the promotion of safer injecting continues to be an important public health issue with regard to reducing blood-borne infections.

Adolescent↗
PubMed1999

HIV prevalence and risk behaviour among female injecting drug users in London, 1990 to 1996.

OBJECTIVE: To describe trends in HIV prevalence among female injecting drug users (IDU) in London between 1990 and 1996. DESIGN: HIV prevalence and risk behaviour were measured yearly between 1990 and 1993, and in 1996, in point prevalence HIV surveys of IDU recruited from both drug-treatment and community-based settings within Greater London. Sample sizes were 173 in 1990, 111 in 1991, 128 in 1992, 146 in 1993 and 200 in 1996. METHODS: Each survey used structured questionnaires and common sampling and interview strategies. Oral fluid specimens were collected for testing for antibodies to HIV (anti-HIV). Multiple logistic regression was used to assess the trend in HIV prevalence. RESULTS: The percentage of female IDU testing positive for antibodies to HIV showed a marked decline over the study period, from 15.0% in 1990 to 1.0% in 1996 (P < 0.001). This trend was independent of all other variables examined. Each year, higher HIV prevalences were found among IDU recruited from community settings compared with treatment agencies. CONCLUSIONS: These results concur with those of IDU recruited from treatment sites, although the yearly estimates in this study are higher. London benefits from low prevalence of HIV infection among IDU, coupled with behaviour change facilitated by early intervention. Continued surveillance of injectors recruited from both community and treatment settings is necessary in order properly to assess HIV prevalence among IDU.

Data Collection↗
PubMed1996

Prevalence of markers for hepatitis B virus and HIV-1 among drug injectors in London: injecting careers, positivity and risk behaviour.

Concerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community-recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva shows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti-HBc). Approximately half of the drug injectors confirmed as anti-HBc positive were unaware that they had been infected with hepatitis. Anti-HIV-1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti-HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV-1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti-HBc positivity, there were no associations between HIV-1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV-1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV.

Adolescent↗
PubMed1996

HIV-1 prevalence in community-wide samples of injecting drug users in London, 1990-1993.

OBJECTIVE: To provide time-trend estimates of HIV-1 prevalence among injecting drug users (IDU) in London. DESIGN: HIV-1 prevalence and HIV testing behaviour were measured in four serial point prevalence surveys of IDU recruited at multiple sites in community-based non-treatment and drug treatment settings between 1990 and 1993. METHODS: Community subjects were recruited through social network sampling by trained indigenous interviewers; treatment subjects were interviewed at agencies. With informed consent, subjects responded to a structured questionnaire covering risk behaviour. Volunteered saliva samples were tested anonymously for anti-HIV-1. Statistical comparisons across years were examined using mixed binomial logistic and log-linear models. Pearson's chi 2 and Fisher's exact tests were also used for some two-group comparisons. RESULTS: Similar samples were recruited each year. HIV-1 prevalence rate declined from 12.8% in 1990, 9.8% in 1991, 7.0% in 1992, to 6.9% in 1993. The statistical modelling suggested that the overall trend in prevalence rates was one of decelerating decline. There was no difference in prevalence rate by gender and length of injecting. Less than one-half (46%) had received a named HIV test. Over one-half of the HIV-positive IDU were unaware of their status. CONCLUSIONS: The pattern of decline in HIV prevalence rate is attributed to changes in risk behaviour following HIV prevention interventions.

Adult↗
PubMed1995

Crack use and injection on the increase among injecting drug users in London.

Fears of a crack 'epidemic' in the United Kingdom of the kind experienced in the United States remain unfounded. However, findings from an ongoing serial point HIV prevalence study indicate that the use and injection of crack cocaine among injecting drug users (IDUs) in London is on the increase. Data on patterns of drug use and drug injection were collected over 4 years (1990-93), from IDUs recruited from both drug treatment and community-based settings. All respondents were asked about their drug use in the 6-month period prior to interview. The use of crack cocaine increased significantly from 16% in 1990 to 59% in 1993 and the injection of crack cocaine from 1% to 27%, respectively. The findings suggest that crack cocaine is being injected more regularly, with increases over the 4-year period in those who reported injecting the drug at least once per week. In response this paper considers both the health implications of, and the treatment response to, the increasing use and injection of crack cocaine among IDUs in London.

Adult↗
PubMed1995

Changes in the injecting risk behaviour of injecting drug users in London, 1990-1993.

OBJECTIVE: To describe changes in the injecting risk behaviour of injecting drug users (IDU) in London between 1990 and 1993. DESIGN: Injecting risk behaviour was measured over 4 years (1990-1993) in a serial point HIV prevalence study of 2062 IDU recruited in both drug treatment and non-treatment community-based settings within greater London. The study used a structured questionnaire and common sampling and interview strategy developed by a World Health Organization technical group and implemented in 13 cities. METHODS: Log-linear models were used to assess patterns of change over years and of differences in injecting risk behaviour, including syringe sharing and syringe hygiene between 1990 and 1993. The log likelihood chi 2 statistic, G2, was used to test statistical significance. Changes in the mean values were assessed first using parametric tests assuming normality and the results were compared with Kruskal-Wallis (non-parametric) tests. Pearsons chi 2 was used to measure differences in frequency of sharing occasions and partner selectivity. RESULTS: An overall reduction in injecting risk behaviour was observed during the first 2 years of this study, including a decline in syringe sharing (both accepting and passing on used syringes), the number of sharing partners and the frequency of sharing occasions. Most sharers restricted sharing to sexual partners and close friends. The majority of sharers reported always cleaning injecting equipment. Main source of sterile equipment was pharmacies and syringe exchanges. Indirect sharing (of spoons, filters, and by front- or backloading) was reported. Since 1991 there has been a stabilization in risk behaviour. CONCLUSIONS: The data indicate that IDU in London have made positive reductions in risk behaviour. Levels of syringe sharing were substantially lower than those reported up to 1987 before AIDS awareness and the introduction of HIV prevention measures. The majority did not share syringes or confined their sharing to close friends and sexual partners, and if shared, cleaned their syringes. Continuation of indirect sharing indicates the need for more detailed prevention messages. While the initial decline in syringe-sharing rates may be attributed to the wide availability of sterile injecting equipment and other preventive measures, it may now be necessary to look beyond current intervention initiatives to develop interventions which seek to change the social etiquette of sharing and move towards the long-term maintenance of low levels of injecting risk behaviour.

Adult↗
PubMed1993

HIV prevalence and HIV risk behaviour among injecting drug users in London and Glasgow.

This paper reports on the British findings from a cross-national study of HIV prevalence and HIV risk behaviour among 1,037 injecting drug users (IDUs) recruited from a variety of treatment- and community-based settings during 1990. Confirmed HIV saliva test results show 12.8% (63) of London respondents and 1.8% (8) of Glasgow respondents to be HIV antibody positive. Among London respondents, a higher rate of prevalence was found in those with no experience of drug treatment. A greater proportion of Glasgow respondents (68%) than London respondents (47%) reported sharing used injecting equipment in the 6 months prior to interview. The majority (88% in both cities) attempted cleaning borrowed equipment, although less than a third (31% in London and 30% in Glasgow) usually used bleach. The majority of respondents (71% in London and 82% in Glasgow) were sexually active with partners of the opposite sex in the last 6 months, and respondents had a mean number of 2.4 non-commercial sexual partners in London and 2.1 in Glasgow. Levels of reported condom use were comparable with reports in the heterosexual population as a whole, with 70% of London respondents and 75% of Glasgow respondents never using condoms with primary partners, and 34% of London and 52% of Glasgow respondents never using condoms with casual partners. Half (48%) of London respondents and 42% of Glasgow respondents reported sexual intercourse with non-injecting private sexual partners, while 14% of female respondents in London and 22% in Glasgow had engaged in prostitution. Levels of risk-taking in each of the two cities indicate the potential for further transmission of HIV among drug injectors, and their sexual and sharing partners.

Adult↗
PubMed1993

HIV testing and unreported HIV positivity among injecting drug users in London.

OBJECTIVE: To assess the importance of community-recruited drug injectors with no treatment experience and no previous testing history when estimating HIV prevalence among drug injectors. DESIGN: HIV testing behaviour and prevalence were measured in a serial point prevalence study of drug injectors recruited in community-based non-treatment and treatment settings. METHODS: Pearson's chi 2 and Fisher's exact tests were used to measure differences between treatment groups and non-treatment groups in demographic characteristics, including age and length of injecting career, recent drug use, recent syringe sharing, uptake of previous HIV testing, confirmed HIV-antibody status by saliva and self-reported HIV status. RESULTS: Rates of HIV-antibody testing were significantly lower in community-recruited drug injectors with no experience of treatment than those previously or currently in treatment. Confirmed HIV prevalence by saliva was highest in drug injectors with no experience of treatment. HIV-antibody-positive drug injectors with no treatment experience were less likely to be aware of their antibody status than injectors who were, or who had been, in treatment. CONCLUSIONS: Previous studies of HIV prevalence among drug injectors may be biased by drawing on samples primarily from treatment settings. Drug injectors with no treatment experience and no previous history of HIV testing should be included in HIV prevalence studies. Regular and repeat HIV testing in low-threshold community-based programmes should be considered a necessary part of interventions which seek to provide better access to treatment and other HIV prevention services.

Adult↗
PubMed1993

Continued risk behaviour among HIV positive drug injectors in London: implications for intervention.

Findings are reported on the risk behaviour of 104 confirmed HIV-1 antibody positive drug injectors in London. Findings indicate that 41.3% of respondents had never received treatment or help for their drug use, and that 52.0% had never received a named test for HIV antibodies. The majority of confirmed HIV positive respondents (70.1%) were unaware of their HIV positive status. Respondents unaware of their HIV positive status were less likely to use condoms with primary sexual partners than respondents aware of their HIV status, and were marginally (though not significantly) more likely to report borrowing and lending used injecting equipment. Overall levels of risk-taking were similar to those reported in UK studies of injecting drug use as a whole. The paper concludes by emphasising the high potential for HIV transmission among the equipment sharing and sexual partners of HIV positive drug injectors and by stressing the importance of low-threshold HIV testing, education and treatment interventions in the community. If significant proportions of HIV positive drug injectors remain unaware of their antibody status, and if they also continue to engage in behaviours of risk to others, the spread of HIV among drug injectors and their partners may escape current efforts of prevention and prevalence control.

Adult↗
PubMed1982

Two-dose comparison of chlormezanone in sleep disturbance due to anxiety.

A double-blind, crossover, multi-centre study was carried out in general practice on 76 patients with mild neurotic anxiety and associated sleep disturbance to compare the effectiveness of chlormezanone given as a single night-time dose of 200 mg or 400 mg, each given for a period of 1 week. There was a significant improvement in the quality and duration of sleep with both dosages, and this was significantly greater with the higher dose. Both doses produced a similarly significant improvement in the frequency of awakening refreshed, and reduction in anxiety rating. The higher dose was considered overall more effective, and significantly more patients preferred it.

Anxiety Disorders↗
PubMedDate not supplied

Murder by morphine.

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Forensic Medicine↗