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PubMed2006

Initiation of opiate addiction in a Canadian prison: a case report.

BACKGROUND: In North America, the harms of illicit drug use have been responded to primarily through law enforcement interventions. This strategy has resulted in record populations of addicted individuals being incarcerated in both Canada and the United States. The incarceration of non-violent drug offenders has become increasingly controversial as studies demonstrate the harms, including elevated HIV risk behavior, of incarcerating injection drug users. Other harms, such as the initiation of illicit drug use by prison inmates who previously did not use drugs, have been less commonly described. CASE PRESENTATION: We report on the case of an individual who initiated non-injection opiate use in a Canadian prison and developed an addiction to the drug. Upon release into the community, the individual continued using opiates and sought treatment at a clinic. The patient feared that he might initiate injection use of opiates if his cravings could not be controlled. The patient was placed on methadone maintenance therapy. CONCLUSION: While anecdotal reports indicate that initiation in prison of the use of addictive illicit substances is frequent, documentation through clinical experience is rare, and the public health implications of this behavior have not been given sufficient attention in the literature. Strategies of incarcerating non-violent drug offenders and attempting to keep illicit drugs out of prisons have not reduced the harms and costs of illicit drug use. Effective, practical alternatives are urgently needed; expanded community diversion programs for non-violent drug offenders deserve particular attention.

Journal Article↗
PubMed1997

Prevalence of sexual risk behaviour and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City.

We aim to assess the prevalence of HIV sexual risk behaviours and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City. Survey data were examined from 775 runaway and homeless adolescents recruited from street settings and youth agencies during 1992/1993. Nearly all (98%) reported having engaged in sexual intercourse, of whom 49% first had intercourse by the age of 13. Condom use during all vaginal intercourse in the previous 3 months was reported by 42%. Among males, 23% indicated that they had exchanged sex for money, as did 14% of the females. Ninety-seven per cent had used alcohol or drugs and 21% had injected drugs. Overall, 75% reported having had sex while under the influence of alcohol or drugs. Systematic epidemiological studies of this population and the development of innovative interventions are essential to reduce the threat of HIV among runaway and homeless youth.

Adolescent↗
PubMed1993

Women and AIDS: social determinants of sex-related activities.

Female sexual partners of injection drug users are at risk for AIDS because of their association with street drug cultures and all their concomitant risks, including their own non-injecting drug use. This study examines a model of the social determinants of HIV-associated sexual risk behaviors. Multiple linear regression analysis was used to analyze the data for 207 female sexual partners who had never injected drugs. The findings show that crack cocaine use is the strongest contributor to the model, which explains fourteen percent of the variance of sexual risk behavior. The findings suggest that the risks associated with sexual practices are much greater for crack cocaine users than among non users of crack.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Childhood sexual abuse and women's substance abuse: national survey findings.

OBJECTIVE: Clinical studies have found elevated rates of childhood sexual abuse (CSA) in women seeking treatment for alcohol or drug abuse, and elevated rates of alcohol and drug disorders among female psychiatric patients with histories of CSA. The present study examines the relationship of CSA to women's use of alcohol and other drugs in a large, nationally representative sample of U.S. women. METHOD: As part of a national survey of women's drinking, 1,099 women were asked about sexual experiences occurring before age 18. Women who reported sexual experiences classified as abusive were compared to women without histories of CSA on nine measures of substance use, self-perception of anxiousness, the occurrence of one or more lifetime depressive episodes, five measures of sexual dysfunction, and early onset of masturbation and consensual sexual intercourse. RESULTS: Results of logit analyses, controlling for age, ethnicity and parental education, indicated that women with histories of CSA were significantly more likely than women without CSA histories to report recent alcohol use, intoxication, drinking-related problems and alcohol dependence symptoms; lifetime use of prescribed psychoactive drugs and illicit drugs; depression and anxiety; pain that prevented intercourse; and consensual sexual intercourse before age 15. CONCLUSIONS: Findings from this U.S. national sample support those of previous clinical studies and suggest that women's experience of sexual abuse in childhood may be an important risk factor for later substance abuse, psychopathology and sexual dysfunction. Implications of these findings for future research, treatment and prevention are discussed.

Adult↗
PubMed1991

AIDS in Thailand.

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Acquired Immunodeficiency Syndrome↗
PubMed1995

The "battering syndrome": prevalence and clinical characteristics of domestic violence in primary care internal medicine practices.

OBJECTIVES: To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. DESIGN: Cross-sectional, self-administered, anonymous survey. SETTING: 4 community-based, primary care internal medicine practices. PATIENTS: 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. MEASUREMENTS: The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. RESULTS: 108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% CI, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [CI, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [CI, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 +/- 0.38 compared with 4.6 +/- 0.08; P < 0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P < 0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [CI, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [CI, 1.9 to 10.4]) or alcohol (PR, 3.1 [CI, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [CI, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [CI, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present. CONCLUSIONS: In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.

Adolescent↗
PubMed1999

AIDS knowledge, condom attitudes, and risk-taking sexual behavior of substance-abusing juvenile offenders on probation or parole.

AIDS knowledge, condom attitudes, and sexual behavior were examined in a sample of 193 substance-abusing juvenile offenders on probation or parole. The majority of these youths reported being sexually active, and many admitted to early onset of sexual activity as well as unsafe sexual practices. Potential predictors of condom use by these juveniles were examined including age, condom use at first sexual experience, number of sexual partners in the last 6 months, locus of control, AIDS knowledge, condom attitudes, perceived risk for AIDS, self-efficacy for avoiding HIV, condom use by peers, delinquency risk, race, and gender. General attitudes toward condoms and the reported use of a condom at first sexual intercourse experience were the only statistically significant predictors of subsequent condom use. The relevance of these findings to the development of AIDS prevention programs for juvenile offenders is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS in El Salvador.

The 1st case of AIDS in El Salvador was diagnosed at Rosales Hospital in San Salvador in October 1985, in a bisexual man who had recently returned from the US. Since that time there have been 110 cases at Rosales Hospital, 81% in men. Of these patients, 54% report exclusively heterosexual histories; 42% report no travel outside El Salvador, 33% report travel to the US, 12% to Honduras, and 7% to Mexico. Risk factors include multiple sexual partners in 61%, prostitution in 7%, and injected drug use in 5%. To date, 52% are known to have died, 18% are alive, and the fate of the remainder is unknown. 5 children with symptomatic HIV infection have been seen at the Benjamin Bloom National Children's Hospital. As of September 1991, 504 persons nationwide were known to be HIV-seropositive, 63% of whom lived in San Salvador. Seropositivity among blood donors at Rosales Hospital has increased from 0% in 1988, when screening began, to 0.265 in 1991.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The global epidemiology and projected short-term demographic impact of AIDS.

This paper summarizes the natural history, surveillance, and global patterns of infections with the human immunodeficiency virus (HIV), the etiologic agent of AIDS The focus is primarily on HIV-1 because surveillance of HIV-2, which has recently been recognized as a separate type of the virus, is only just beginning. The natural progress of the disease is described, from acute infection through asymptomatic phase to the clinical illness phase. Available evidence on the speed of progression from infection to AIDS and possible co-factors in that progression are reviewed. The 3 patterns of AIDS which are described characterize the experience of different regions according to the types of transmission ( i.e., homosexual versus heterosexual, contaminated blood, drug use) and demographic characteristics of the affected persons. An epidemiologically based short-term forecasting model for AIDS cases is presented and used to project the demographic impact of AIDS in a hypothetical central African country. In that hypothetical setting, the impact of AIDS is shown to be disproportionately felt in urban areas, where the projected increase in population will decrease by 30% due to AIDS deaths by 1997; the growth rate of the rural population will be only slightly affected. In conclusion, the global prevalence of the disease, and prospects and implications for the future are discussed. Without effective drugs for treatment and no vaccine for prevention of HIV infections, the short-term outlook is not good. HIV/AIDS is expected to be an increasing public-health problem in the next 2 decades.

Acquired Immunodeficiency Syndrome↗
PubMed1989

For our mutual benefit.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗