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Biomedical subjects

S Deren

Publications and source records attributed to S Deren.

At least 37 records · Page 2Linked to original sources
PubMed1997

A multisite study of sexual orientation and injection drug use as predictors of HIV serostatus in out-of-treatment male drug users.

The risk groups of men who have sex with men and injection drug users (IDUs) together account for 90% of all male AIDS cases. The extent to which each risk behavior contributes to seroprevalence among IDUs has not been determined and is critical for intervention development. Analysis of data on sexual orientation, injection drug use, and HIV serostatus was undertaken in a multisite study of 3002 male drug injectors and crack smokers recruited for HIV prevention projects. Overall HIV seroprevalence was 8.4%; 57.1% for gay men, 25.4% for bisexual men, and 7.4% for heterosexuals (p = 0.001). Logistic regression analyses indicated being gay (OR = 24.08) and coming from an area where seroprevalence is high among IDUs (OR = 4.07) were the best predictors of serostatus. Ever having injected was significant only in interaction with moderate (OR = 3.09) or high (OR = 4.71) IDU seroprevalence areas. Among this multisite sample of drug users, being a gay drug user is the strongest predictor of serostatus. Drug injection is significant only in areas of moderate or high seroprevalence among injectors. This indicates the importance of targeted outreach and intervention efforts.

Adult↗
PubMed1997

Crack users in east Harlem, New York and Philadelphia, Pennsylvania: HIV-related risk behaviors and predictors of serostatus.

Crack use has been associated with increased risk for HIV seropositivity. This study was undertaken to examine HIV-related risk behaviors among crack users in East Harlem, New York and Philadelphia, Pennsylvania, two northeastern communities which have reported extensive crack use. Crack users recruited in East Harlem (n = 1434) and Philadelphia (n = 694) were compared on demographics, drug and sex-related risk behaviors, health-related behaviors, and HIV serostatus. Many significant differences were found, and seropositivity was higher in the New York sample (25% vs. 11%, chi 2 = 36.28, p < .001). Being a recent drug injector was a significant predictors of seropositivity in both communities, and differences between communities were found in additional predictors of serostatus. Results suggest that tailored HIV interventions may be needed for different communities. In addition, aggregate data across communities, even those that may be in geographical proximity, may obfuscate differences important to incorporate in developing prevention/intervention efforts.

Adult↗
PubMed1997

Gender differences and other factors associated with HIV testing in a national sample of active drug injectors.

Gender, health, HIV risk, and demographic factors were examined with chi-square and logistic regression analyses to assess which of these factors are most predictive of active injection drug users' (IDUs') getting tested for HIV. Analyses were based on 36,898 IDUs recruited to participate in a nationwide multisite HIV prevention project. Women IDUs were recently tested (prior 6 months) more than men IDUs. Health factors, particularly for women IDUs, predicted who got tested for HIV more than risk or demographic factors. HIV testing usually occurred when disease symptomatology developed, after a long period of being capable of transmitting HIV to others, and when the benefits of AZT and other interventions may be reduced. Preventive interventions with IDUs are needed that emphasize the possible benefits of HIV testing and that encourage testing before symptoms develop.

AIDS Serodiagnosis↗
PubMed1996

HIV-related concerns and behaviors among Hispanic women.

Hispanic women whose sexual partners have other sexual partners may be at risk for HIV. A structured interview was administered to 106 Dominican and Puerto Rican women who reported that they knew or suspected that their partner had other partners. A subsample participated in qualitative interviews. The study assessed concern about HIV and predictors of condom use. The majority of women reported that they worried about getting HIV and almost half had been HIV-tested. Most of the women discussed HIV/AIDS concerns with their partners, and one-third reported some condom use. Predictors of condom use were: born in the Dominican Republic/Puerto Rico, having talked with their partner about being tested, and belief that he used condoms with others. Although the women were concerned about HIV, condom use was infrequent. Results suggested methods to address this discrepancy: introducing condoms early in the relationship, developing women-controlled methods, and directly influencing men's behavior.

Adult↗
PubMed1996

HIV risk behaviors among Dominican brothel and street prostitutes in New York City.

Latina women are overrepresented among AIDS cases in the United States. To assist in developing appropriate prevention and intervention programs, information regarding HIV risk behaviors is needed on the many diverse Latina subgroups. This study examined sociodemographic characteristics and HIV risk behaviors of Dominican female prostitutes, comparing those who worked primarily in brothels with those who were street workers. A total of 77 Dominican prostitutes (54 brothel; 23 street) were recruited in New York City to participate in a structured interview and were offered HIV testing. Ethnographic interviews were conducted with a subscale. Results indicated that there were many significant differences in demographics and risk behaviors between the two groups, and those working in brothels engaged in lower levels of risk behaviors. In addition, those working in brothels had closer ties to the Dominican and Spanish cultures. Implications for AIDS prevention efforts are discussed.

AIDS Serodiagnosis↗
PubMed1995

Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. The National AIDS Research Consortium.

From 1988 to 1991, 6,882 drug injectors in 15 US cities were interviewed and had serum samples collected. The interviews and samples were analyzed for determination of significant predictors of human immunodeficiency virus (HIV) seroconversion in the 10 low seroprevalence cities and the five high seroprevalence cities. The unit of analysis was the period of observation between consecutive paired interviews/blood samples. In Cox proportional hazards regression, significant predictors of seroconversion in the low seroprevalence cities were: not being in drug treatment, injecting in outdoor settings or abandoned buildings, using crack cocaine weekly or more frequently, engaging in woman-to-woman sex, being of non-Latino race/ethnicity, and city seroprevalence. Predictors in high seroprevalence cities were: injecting with potentially infected syringes, not being in drug treatment, and having a sex partner who injected drugs. These findings suggest that HIV may be concentrated in sociobehavioral pockets of infection in low seroprevalence cities. For reducing HIV transmission, these results suggest: 1) in low seroprevalence cities, localized monitoring to detect specific emerging sociobehavioral pockets of infection, and quick implementation of appropriate targeted interventions if necessary; 2) in high seroprevalence cities, relatively more emphasis on locality-wide outreach and syringe-exchange projects to reduce risky behavior; and 3) in both types of cities, considerable expansion of drug treatment programs.

Adult↗
PubMed1995

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation↗
PubMed1995

Outcomes of a risk-reduction intervention with high-risk populations: the Harlem AIDS project.

Many studies of interventions with high-risk populations have reported reductions in risk behaviors. To assess effectiveness of interventions, data are also needed on the characteristics of subjects lost to follow-up, and on follow-up risk behaviors for subjects who were not participants in the intervention. This paper reports on a study conducted in Harlem, New York, recruiting 1,770 injection drug users (IDUs) and sex partners of IDUs, randomly assigned to two interventions. Repeated-measures analyses for the two intervention groups and those who participated in no intervention indicated that all groups reported significant reductions in risk behaviors, with no group effect. Comparisons of those followed-up and not followed-up indicate that those followed-up were less likely to: be homeless, be Latinos, and to use "shooting galleries." The discussion focuses on the need to assess outcomes for all types of participants, and to distinguish the impact of interventions from other explanations for behavior changes.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Demonstration of a direct effect on hepatic acyl CoA: cholesterol acyl transferase (ACAT) activity by an orally administered enzyme inhibitor in the hamster.

Orally active inhibitors of acyl CoA:cholesterol acyl transferase (ACAT), such as Lederle CL277082 (LE), are known to reduce plasma and hepatic cholesteryl ester levels, although the mechanisms are not well understood. Several groups have reported the inhibition of cholesterol absorption upon oral ACAT inhibitor administration. In this study, we used 7-day dietary and drug treatments of hamsters to examine the possible effects of LE on hepatic ACAT. ACAT assays were performed using liver homogenates in the absence and presence of a saturating level of exogenously added cholesterol. LE (100 mg/kg/day) treatment of chow or 0.5% cholesterol-fed animals caused reductions in ACAT activity without additional cholesterol as compared with non-treated animals. When a saturating level of cholesterol was added to the assays, reductions in ACAT activity upon LE treatment of chow- or cholesterol-fed animals were also observed. Treatment of cholesterol-fed animals with cholestyramine in the diet reduced ACAT activity in the absence of added cholesterol. However, ACAT activities similar to those of non-treated animals were observed at a saturating level of cholesterol. This latter effect demonstrates that inhibition of cholesterol absorption reduces cholesterol delivery to the liver but does not reduce cholesterol esterifying capacity since cholestyramine is not absorbed and has no direct effect on the liver. The decreased ACAT activity in homogenates from LE-treated animals could also be mimicked in a dose-dependent manner by the addition of exogenous LE to liver homogenates from non-treated animals. These results indicate that hepatic ACAT activity is regulated by the availability of free cholesterol, and that orally administered LE has a direct effect on hepatic ACAT activity in the liver. In addition, the data are consistent with LE activity in the liver as being responsible, in part, for the reduced hepatic and plasma cholesteryl esters in treated animals.

Animals↗
PubMed1994

The risk of HIV infection in a national sample of women with injection drug-using partners.

OBJECTIVES: This study reports on a large, national cohort of women with injection drug-using sex partners. Information is provided on demographic characteristics; human immunodeficiency virus (HIV) risk factors, including unprotected sex and incidence of sexually transmitted diseases; use of noninjected drugs; HIV serostatus; and other selected health variables. METHODS: A sample of 5162 heterosexual women was recruited for a national acquired immunodeficiency syndrome (AIDS) research and demonstration project. A structured interview was administered, and the women had the option of undergoing HIV testing. Statistical analyses compared three groups on variables of interest: women with single sex partners, women with multiple partners, and women with multiple partners who exchanged sex for drugs and/or money. RESULTS: These groups differed significantly on virtually all of the demographic and risk variables examined. Women with multiple partners who exchanged sex for drugs and/or money were at higher risk for HIV than women in the other groups, even when selected demographic variables were controlled. CONCLUSIONS: Research is needed on the efficacy of prevention efforts involving these diverse groups of women at risk for AIDS.

Adult↗
PubMed1993

HIV risk factors among pregnant and non-pregnant high-risk women in New York City.

A comparison of high-risk pregnant (n = 55) and non-pregnant (n = 598) women from Harlem, New York City on HIV-related drug and sexual risk behaviors was undertaken to identify appropriate prevention and intervention policy recommendations. Clients were recruited for an AIDS risk reduction research demonstration project and were either intravenous drug users (IVDUs) or sexual partners of IVDUs. There was a higher percentage of IVDUs among the non-pregnant women, and no significant differences were found between pregnant and non-pregnant IVDUs in terms of needle risk behaviors. The two groups were also similar in non-injected drug use behaviors. Pregnant women were significantly less likely to use condoms. Recommendations focused on the need for increased HIV risk reduction among high-risk women in general, and increased education efforts among pregnant high-risk women regarding condom use as protection from HIV and the potential consequences of maternal substance use for their children.

Female↗
PubMed1992

AIDS outreach workers: an exploratory study of job satisfactions/dissatisfactions.

AIDS outreach workers operate at the frontlines of the AIDS epidemic to provide information and education to high-risk individuals. Recent reports indicate that these workers have been effective in helping to reduce high-risk behaviors. However, a review of retention data for 62 outreach workers employed from 1986 to 1988 at a private nonprofit research institute indicated a high rate of turnover, especially among males. The literature provides little information regarding the demographic characteristics of outreach workers and their sources of job satisfaction and dissatisfaction. This exploratory investigation was undertaken to address these topics. Structured interviews were conducted with 20 currently active outreach workers. Results indicate that altruistic motives were most frequently cited as reasons why people became outreach workers and also provided the primary source of satisfaction. Stress was most frequently mentioned as a source of dissatisfaction and also as a reason previous workers had left outreach work. Conclusions focus on the outreach workers' suggestions for job improvements. These included: improvement in the terms of employment (e.g., salary, benefits); more education and training opportunities; and more support groups or help with recovery.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Daily marijuana use and problem behaviors among adolescents.

Previous research by Johnston has shown that high school seniors who are daily marijuana users are distinct from the larger population of seniors in a variety of ways. This paper focuses on adolescent daily marijuana users. It replicates Johnston's work and also qualifies it in an important way. We find that level of marijuana use does not make a significant independent contribution to school problems when such critical factors as lifetime cigarette smoking, lifetime multiple drug use, whether respondent has ever used an illicit drug, rebelliousness, and gender, are taken into account. It is concluded that use of marijuana is only one element in a large and complex picture of interrelated problems and behaviors.

Achievement↗
PubMed1987

Obstacles to the utilization of vocational services: an analysis of the literature.

While employment has been linked to positive clinical outcomes with drug abusers, research suggests that many treatment programs do not emphasize vocational services and under-utilize vocational resources. This article summarizes potential client-, program-, and societal-level obstacles to vocational rehabilitation service delivery identified in past studies with both substance abusers and other related client groups. Obstacles identified for related groups are integrated with issues relevant to drug treatment clients. This analysis is based on literature published over the last 20 years.

Counseling↗
PubMed1986

Children of substance abusers: a review of the literature.

The proportion of women in substance abuse treatment programs or in need of substance abuse treatment has been increasing. Concern with female substance abusers has led to increased attention on identifying the problems and needs of children of substance abusers, particularly on neonates. This literature review summarizes the contents of the research on children of substance abusers (COSAs) available through 1985. Areas requiring further research and methodological problems in the research are identified. The literature has been organized into several areas: estimates of the numbers of COSAs, and research on pregnant addicts, neonates, infants, older children, and parenting issues.

Adolescent↗
PubMed1977

Risk-taking related to drug use: an application of the shift-to-risk design.

The utility of the shift-to-risk design for studying the influence of peer groups on drug taking was investigated. Two studies using this design with drug content were conducted, varying the level of information provided about a drug. Subjects were from two college classes consisting of 26 and 28 students. Results indicated that the specification of possible harmful drug effects which are somewhat minimal lead to a significantly greater willingness to recommend trying the drug. In addition, a tendency for a shift-to-caution was found. It was concluded that the shift-to-risk designwas useful for studying decision-making regarding drug use, and that both users and nonusers of drugs should be included in future research.

Adolescent↗