Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis
| Autor: | David N. Burns, Jeremy Sugarman, Scott Rose, Susan H. Eshleman, Oleksandr Zeziulin, William Clarke, Lisa E. Sunner, Tran Viet Ha, Irving F. Hoffman, Samsuridjal Djauzi, Michael G. Hudgens, Sergii Dvoriak, Paul G. Richardson, Carl A. Latkin, Nguyen Van Vuong, Estelle Piwowar-Manning, Kostyantyn Dumchev, Zubairi Djoerban, Steffanie A. Strathdee, Nirupama Sista, Kathryn E. Lancaster, Brett Hanscom, Katie R. Mollan, Laura McKinstry, Jonathan Lucas, Deborah Donnell, Erica L. Hamilton, Vivian F. Go, Bui D Duong, Tetiana Kiriazova, Sarah A. Reifeis, Hptn (PopART) Study Team, Chu Viet Ahn, Lynda Emel, Hepa Susami, William C. Miller, Riza Sarasvita, David S. Metzger |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Psychological intervention HIV Infections law.invention Heroin Cohort Studies 0302 clinical medicine injection drug use Randomized controlled trial law Medicine 030212 general & internal medicine Substance Abuse Intravenous Research Articles Alcohol Use Disorders Identification Test Substance Abuse Viral Load Middle Aged 3. Good health Infectious Diseases Cohort Public Health and Health Services Female treatment as prevention Intravenous 0305 other medical science Psychosocial ART Research Article medicine.drug Adult Adolescent Sexual Behavior Clinical Sciences HPTN 074 Study Team substance use treatment Young Adult 03 medical and health sciences Humans PWID 030505 public health business.industry Public Health Environmental and Occupational Health HIV Treatment as prevention CD4 Lymphocyte Count Other Medical And Health Sciences business Demography Methadone |
| Zdroj: | Lancaster, Kathryn E; Hoffman, Irving F; Hanscom, Brett; Ha, Tran Viet; Dumchev, Kostyantyn; Susami, Hepa; et al.(2018). Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis. JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, 21(10), e25195. doi: 10.1002/jia2.25195. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/5rw0p7w6 Journal of the International AIDS Society, vol 21, iss 10 Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| Popis: | Author(s): Lancaster, Kathryn E; Hoffman, Irving F; Hanscom, Brett; Ha, Tran Viet; Dumchev, Kostyantyn; Susami, Hepa; Rose, Scott; Go, Vivian F; Reifeis, Sarah A; Mollan, Katie R; Hudgens, Michael G; Piwowar-Manning, Estelle M; Richardson, Paul; Dvoriak, Sergii; Djoerban, Zubairi; Kiriazova, Tetiana; Zeziulin, Oleksandr; Djauzi, Samsuridjal; Ahn, Chu Viet; Latkin, Carl; Metzger, David; Burns, David N; Sugarman, Jeremy; Strathdee, Steffanie A; Eshleman, Susan H; Clarke, William; Donnell, Deborah; Emel, Lynda; Sunner, Lisa E; McKinstry, Laura; Sista, Nirupama; Hamilton, Erica L; Lucas, Jonathan P; Duong, Bui D; Van Vuong, Nguyen; Sarasvita, Riza; Miller, William C; HPTN 074 Study Team | Abstract: IntroductionPeople who inject drugs (PWID) experience high HIV incidence and face significant barriers to engagement in HIV care and substance use treatment. Strategies for HIV treatment as prevention and substance use treatment present unique challenges in PWID that may vary regionally. Understanding differences in the risk structure for HIV transmission and disease progression among PWID is essential in developing and effectively targeting intervention strategies of HIV treatment as prevention.MethodsWe present a baseline analysis of HIV Prevention Trials Network (HPTN) 074, a two-arm, randomized controlled trial among PWID in Indonesia (n = 258), Ukraine (n = 457) and Vietnam (n = 439). HPTN 074 was designed to determine the feasibility, barriers and uptake of an integrated intervention combining health systems navigation and psychosocial counselling for the early engagement of antiretroviral therapy (ART) and substance use treatment for PWID living with HIV. Discordant PWID networks were enrolled, consisting of an HIV-positive index and their HIV-negative network injection partner(s). Among the enrolled cohort of 1154 participants (502 index participants and 652 network partners), we examine regional differences in the baseline risk structure, including sociodemographics, HIV and substance use treatment history, and injection and sexual risk behaviours.ResultsThe majority of participants were male (87%), with 82% of the enrolled females coming from Ukraine. The overall mean age was 34 (IQR: 30, 38). Most commonly injected substances included illegally manufactured methadone in Ukraine (84.2%), and heroin in Indonesia (81.8%) and Vietnam (99.5%). Injection network sizes varied by region: median number of people with whom participants self-reported injecting drugs was 3 (IQR: 2, 5) in Indonesia, 5 (IQR: 3, 10) in Ukraine and 3 (IQR: 2, 4) in Vietnam. Hazardous alcohol use, assessed using the Alcohol Use Disorders Identification Test - Alcohol Consumption Questions (AUDIT-C), was prominent in Ukraine (54.7%) and Vietnam (26.4%). Reported sexual risk behaviours in the past month, including having two or more sex partners and giving/receiving money or drugs in exchange for sex, were uncommon among all participants and regions.ConclusionsWhile regional differences in risk structure exist, PWID particularly in Ukraine need immediate attention for risk reduction strategies. Substantial regional differences in risk structure will require flexible, tailored treatment as prevention interventions for distinct PWID populations. |
| Databáze: | OpenAIRE |
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