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PubMed2003

The relationship between depressive symptoms and nonfatal overdose among a sample of drug users in Baltimore, Maryland.

Nonfatal drug overdoses are common among heroin users. While several factors that increase risk of overdose have been identified, there is little research on the role of mental health status. The purpose of this study was to examine the association between depressive symptoms and history of overdose. A sample of 729 opiate and cocaine users completed a cross-sectional survey. Of the sample, 65% reported never having overdosed, 31% had overdosed longer than 12 months before the interview, and 4% had overdosed within the past 12 months. Results indicate that a high score on the Center for Epidemiological Studies Depression Scale (CES-D), a measure of depressive symptoms, was associated with having overdosed within the past 12 months (relative risk ratio [RRR] = 3.06; 95% confidence interval [CI], 1.33 to 7.05) after adjusting for age, gender, injection frequency, and physical health impairment. These results suggest that drug users with depressive symptoms should be targeted for overdose prevention programs.

Adult↗
PubMed1991

HIV seroconversion and disinfection of injection equipment among intravenous drug users, Baltimore, Maryland.

To examine the putative protective effect of disinfectant use on HIV seroconversion among intravenous drug users, we conducted a nested case-control study comparing 22 black heterosexual HIV seroconverters with 95 persistent seronegatives matched on gender, use of cocaine, date of study entry, and duration of follow-up. For intravenous drug users who reported using disinfectant all the time, the odds of seroconversion was 0.77 (95% CI: 0.25-2.38) compared with those who reported no use of disinfectants; for those who used disinfectants some of the time, the corresponding odds ratio was 0.91 (95% CI: 0.26-3.31). The odds ratio for use of disinfectant all the time was 0.63 (95% CI: 0.10-3.91) for those injecting at galleries and 1.08 (95% CI: 0.35-3.11) for those not injecting at galleries. These data suggest a limited protective effect of disinfectant use in the field which may be more beneficial to those injecting in shooting galleries.

Adult↗
PubMed2005

Exploring the role of needle selling in a drug-using community in Baltimore, Maryland.

Needle exchange programs (NEPs) play a critical role in reducing the spread of HIV in injection drug users (IDUs). However, many IDUs do not access NEPs and rely on needle sellers. This study examined differences between needle sellers and others in a drug-using community and assessed sources and quantity of needles sold by needle sellers. The study also explored factors associated with needle selling. Compared with nonsellers, needle sellers were more likely to be homeless, HIV-positive, and unemployed. The NEP was the most frequent source of needles for needle sellers. Needle sellers were more likely to share their needles with sex partners and strangers than were nonsellers. Within the whole sample, needle selling was associated with injecting drugs and the number of roles in the drug economy. For injectors, needle selling was associated with obtaining needles from the NEP and having >1 role in the drug economy. Because needle sellers frequently interact with IDUs, training needle sellers may be an effective strategy for risk reduction and HIV prevention. However, because some needle sellers disseminate used needles, all injectors need to be educated about proper disposal techniques.

Adult↗
PubMed2005

Prevalence and correlates of chlamydia trachomatis, neisseria gonorrhoeae, trichomonas vaginalis infections, and bacterial vaginosis among a cohort of young injection drug users in Baltimore, Maryland.

OBJECTIVES: Injection drug users (IDUs) consistently demonstrate high-risk behaviors for sexually transmitted infections (STIs). This study examines STI prevalence and correlates among young IDUs. STUDY: This cross-sectional study recruited IDUs aged 18 to 30 years. Participants completed a behavioral risk assessment and were tested for chlamydia, gonorrhea, and trichomoniasis by nucleic acid amplification methods. Women were also tested for bacterial vaginosis (BV). Gender-specific analyses were done comparing infected with noninfected participants using chi-square, Mann-Whitney tests, and logistic regression. RESULTS: Of the 115 (35.3%) women and 211 (64.7%) men in the study, STI prevalence, respectively, was: chlamydia, 5.3% and 3.3%; gonorrhea, 3.5% and 0%; and trichomoniasis, 8.6% and 1.9%. Most (68.0%) participants had 2 or more sex partners in the past 3 months, of whom fewer than half consistently used condoms. Independent correlates for prevalent STIs included douching (adjusted odds ratio [AOR], 4.9; 95% confidence interval [CI], 1.5-23.6) for women and anal sex with female partners (AOR, 6.3; 95% CI, 1.5-25.8) for men. BV prevalence was 56.3% and was associated with douching (OR, 2.5; 95% CI, 1.1-5.7). CONCLUSIONS: Despite high sexual risk, STI prevalence among young IDUs was similar to that of the general population. BV prevalence was high, suggesting that future STI assessments among female IDUs should include BV.

Adult↗
PubMedDate not supplied

A targeted testing program for tuberculosis control and prevention among Baltimore city's homeless population.

OBJECTIVE: To identify cases of latent tuberculosis infection (LTBI) and improve access to TB treatment among the inner-city homeless. DESIGN: This is an intervention study describing the impact of a public health program on TB prevention and control. SAMPLE: The target population for the project was residents and recent graduates of a residential addictions recovery program in a faith-based, inner-city mission. INTERVENTION: Faculty and student nurses administered purified protein derivative (PPD) tuberculin skin tests and TB symptom assessments on site to homeless Mission residents. Residents testing positive for TB infection were referred to the local city health department for follow-up. Residents placed on prophylactic therapy received intensive tracking and coaching interventions to encourage adherence to the 9-month regimen. RESULTS: Ninety-eight percent of the target population was screened for LTBI. Ninety percent of residents requiring treatment for LTBI successfully accessed treatment services. Thirty-three percent of residents completed at least 6 months of treatment. CONCLUSION: The program demonstrated a modest improvement in treatment completion among the inner-city homeless when compared with local City Health Department treatment completion rates. This program demonstrates how a faith-based organization, an academic institution, and local government can successfully partner together to meet community needs.

Baltimore↗