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Biomedical subjects

S Darke

Publications and source records attributed to S Darke.

72 records · Page 4Linked to original sources
PubMed1992

Benzodiazepine use and HIV risk-taking behaviour among injecting drug users.

This paper examines the prevalence of benzodiazepine use, and its relationship to other drug use and HIV risk-taking among a sample of 1245 injecting drug users (IDU). Approximately a third (36.6%) of the sample had used benzodiazepines during their last typical month of injecting. Benzodiazepine users had injected more frequently, injected more heroin and amphetamines, and had more poly-drug use than other IDU. They also had higher levels of HIV risk-taking, having shared injecting equipment more frequently and with more people. There were no differences between groups in number of sexual partners or condom use, although benzodiazepine users were more likely to have been paid for sex. The demographic and drug use variables indicate that benzodiazepine users are a more dysfunctional subgroup of IDU who require particular attention in HIV interventions.

Adult↗
PubMed1992

Mad, bad and dangerous to know: dimensions and measurement of attitudes toward injecting drug users.

Attitudes toward injecting drug users were assessed using a 53-item questionnaire which was administered to 143 workers at a drug and alcohol research unit and an AIDS treatment facility. Factor analysis revealed three interpretable dimensions: intravenous drug use as a matter of both public concern and personal inadequacy; intravenous drug users as criminals who should be removed from society; and social avoidance of, and personal distaste for, intravenous drug users. The scale and subscales had good test-retest reliability and internal consistency. Its potential use as a measure of attitudes toward injecting drug users for both treatment research and AIDS research is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Drug use and HIV risk-taking behaviour among clients in methadone maintenance treatment.

Current drug use and HIV risk-taking behaviour of a sample of 95 methadone maintenance clients was investigated. Subjects had been on their current programme for an average of 70.9 weeks with a mean daily dose of methadone of 65.6 mg. Two-thirds had injected heroin, and 82% had injected a street drug in the month prior to interview. Over 20% of subjects had shared a needle in the month before interview, all with only one other person. Subjects who had injected cocaine in the month before interview had significantly higher levels of injecting risk-taking behaviour than those subjects who had injected but not used cocaine. Condom use among subjects was low, particularly in regular relationships. While knowledge concerning HIV was high among subjects, there was no relation between level of knowledge and actual behaviour. It is concluded that knowledge alone is not sufficient to ensure behaviour change.

Adolescent↗
PubMed1992

Injecting drug users and the Human Immunodeficiency Virus: what do we know?

This article examines the results of 10 years of research on the relationship between injecting drug use and the Human Immunodeficiency Virus (HIV). The two main transmission modes of HIV among injecting drug users (IDU)-parenteral drug use and sexual behaviour-are examined in detail, as well as the efficacy of attempted interventions to reduce the spread of HIV among this population.

Journal Article↗
PubMed1992

The measurement of outcome in opiate treatment evaluation studies.

One of the major contributors to the fragmentation of the opiate treatment outcome literature has been the plethora of measurement techniques employed by researchers. This has led to a situation where direct comparability between studies is often extremely difficult, if not impossible. In this article the measurement methodologies employed in the major treatment outcome studies are reviewed, and the implications for future research discussed.

Journal Article↗
PubMed1992

Methadone maintenance and the human immunodeficiency virus: current issues in treatment and research.

This paper examines the changes that have occurred in methadone maintenance programmes in response to the advent of HIV and the adoption of harm minimization policies, and the implications of these changes for research. A need for the use of more rigorous research methods is identified and recommendations are made that take into account both the ethical and practical difficulties of conducting research in this area. Both old, unanswered questions that have resurfaced with the recent massive growth in methadone programmes in some countries, and new questions that need to be answered in order to improve the effectiveness of methadone maintenance in the fight against HIV infection are identified as future areas in need of research.

HIV Infections↗
PubMed1992

Development and validation of a multi-dimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index.

This article presents a new instrument with which to assess the effects of opiate treatment. The Opiate Treatment Index (OTI) is multi-dimensional in structure, with scales measuring six independently measured outcome domains: drug use; HIV risk-taking behaviour; social functioning; criminality; health; and psychological adjustment. Psychometric properties of the Index are excellent, suggesting that the OTI is a relatively quick, efficient means of obtaining reliable and valid data on opiate users undergoing treatment over a range of relevant outcome domains.

Adolescent↗
PubMed1991

The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users.

The initiation and maintenance of substantial behaviour change is required to reduce the spread of HIV infection among the intravenous drug-using population. In order to ascertain the efficacy of interventions aimed at reducing HIV-related risk-taking behaviour among this population, valid and reliable (yet preferably short) instruments for measuring such behaviour are required. The HIV risk-taking behaviour scale (HRBS) is a brief 11-item interviewer-administered scale which examines the behaviour of intravenous drug users in relation to both injecting and sexual behaviour. This paper describes the construction of the scale, in addition to data evaluating its reliability and validity. Initial analyses indicate that the scale has satisfactory psychometric properties.

Adolescent↗
PubMed1991

Estimating drug consumption in opioid users: reliability and validity of a 'recent use' episodes method.

The efficient and accurate measurement of recent drug use is an essential component of treatment and research among opioid users. Urinalysis results alone will not give sufficient information to either the clinician or researcher, due to limitations in detection and an inability to distinguish extent of use. The present paper describes a 'recent use episodes method', adapted from the measurement of alcohol consumption, for obtaining self-reported drug use in eleven different drug categories. Reliability and validity data indicate that the method provides a quick means by which accurate information may be obtained on the overall recent drug use of opioid users.

Adult↗
PubMed1991

A scale for estimating the health status of opioid users.

The health status of injecting drug users has both clinical and research relevance. In order to evaluate the impact of treatments for opiate dependence on drug users' health status we need valid and reliable instruments which are short and easily administered by non-medical personnel. This paper describes the construction of a brief interviewer administered scale for assessing the current health status of injecting drug users. Data evaluating its reliability and validity are presented which indicate that the scale has excellent psychometric properties.

Adolescent↗
PubMed1990

Intravenous drug users who present to the Albion Street (AIDS) Centre for diagnosis and management of human immunodeficiency virus infection.

Intravenous drug users who presented to the Albion Street (AIDS) Centre for human immunodeficiency virus (HIV) antibody screening during the period March 1, 1985 to January 31, 1989, were included in this study. Information on medical history and HIV risk-related behaviour was collected by means of a standardized, computer-coded medical record. Of the 1222 intravenous drug users in this study, 72.3% were men, 26.9% were women and 0.8% were transsexual, with 60.1% of the total claiming exclusive heterosexuality. Of the sample, 40.2% were current intravenous drug users, and 86.8% recorded having shared needles and syringes. Among this sample, the over-all prevalence of HIV seropositivity was 14.5%. Of subjects who were diagnosed as HIV seropositive, 43.8% were homosexual men, 13.1% were bisexual men and 5.3% were heterosexual men. Of all intravenous drug users, 49.9% had a history of at least one sexually-transmitted disease, with 21.8% reporting a history of more than one. Fifty-two per cent of the sample reported that they had been infected with hepatitis B previously. There was no over-all increase in the annual rate of HIV infection among this population of intravenous drug users. The sexual activity and prevalence of hepatitis and other sexually-transmitted diseases among this group are suggestive of widespread, continuing risk behaviour.

Adult↗
PubMed1990

Drug use, injecting practices and sexual behaviour of opioid users in Sydney, Australia.

This paper examines drug use, injection practices, and sexual behaviour in a sample of 100 opioid users, both in and out of current opiate treatment. Approximately three-quarters of subjects reported that they had used more than one illicit substance in the month prior to being interviewed. Needle sharing was common, with 29% of subjects having used a needle in the past month after it had been used by someone else, and 25% having passed on a needle after they had used it. The level of condom use was low, with 66.7% of subjects never having used a condom with their regular partner in the month prior to interview, and 20.7% of subjects who had engaged in sex with a casual partner during this period not having used a condom. Variables which were predictive of HIV risk-taking behaviour in relation to needle use were poly-drug use, not being in current treatment, and level of heroin use. Only age was predictive of risky sexual behaviour, with younger subjects being associated with more risk-taking behaviour. It was concluded that while opiate treatment was associated with lower levels of risky injecting practices, there was no association between treatment and safer sexual practices. Given the importance of sexual transmission of HIV more attention needs to be given to the sexual risk-taking behaviour of intravenous drug users.

Adult↗
PubMed1989

Femoro-popliteal versus femoro-distal bypass grafting for limb salvage in patients with an "isolated" popliteal segment.

In a prospective, multicentre trial, 59 patients with an ischaemic limb and an "isolated" popliteal segment on angiography were randomised to undergo infrainguinal bypass grafting to either the popliteal segment or to a reconstituted distal vessel lower in the calf. Limb salvage was attained with 88% of the femoro-popliteal grafts and 80% of the femoro-distal grafts. There was no difference in the one year graft patency rate between the femoro-popliteal group (79%) and the femoro-distal group (70%). Mean postoperative increase in ankle/brachial pressure index was similar in the two groups despite the presence of occluded or significantly diseased vessels distal to the popliteal anastomoses. Technical difficulties were encountered in 8% of the popliteal group and 24% of the distal group. Femoro-distal bypass grafting confers no apparent benefit over femoral bypass grafting into a patent popliteal segment, even though the popliteal run-off is impaired or occluded.

Aged↗
PubMed1988

Effects of anxiety on inferential reasoning task performance.

Three experiments were conducted in which high anxiety and low anxiety subjects were required to construct inferences. In Experiment 1 there was no anxiety-related performance deficit when inferring a necessary anaphoric relation, a process argued to be automatic. Experiments 2 and 3 involved the verification of unnecessary inferences, a process argued to involve the utilization of the working memory system. In both Experiments 2 and 3 there was an anxiety-related performance deficit. The results are consistent with a working memory-oriented account of anxiety-related performance effects, as deficits were restricted to capacity-demanding tasks.

Anxiety↗