The Edinburgh Addiction Cohort: recruitment and follow-up of a primary care based sample of injection drug users and non drug-injecting controls

The aim of the present prospective observational study was to assess uptake and success of hepatitis C virus (HCV) treatment among a group of former and current injection drug users with chronic HCV infection at the Street Health Centre in Kingston, Ontario. The Street Health Centre offers hepatitis C education, assessment and treatment within a multidisciplinary, integrated and collaborative treatment model of care delivered by primary care professionals. The study enrolled a convenience sample of 34 patients. Seventy per cent of study patients had no postsecondary education, 85% were unemployed and one-third were unstably housed. A majority of study patients self-reported mental health problems. Of the 14 patients who initiated antiviral treatment in the study period, eight (57%) achieved sustained virological response. Regardless of virological outcome, patients who initiated treatment showed positive trends toward increased social and psychiatric stability, and decreases in high-risk behaviours. These results suggest that not only is successful treatment of chronic HCV infection in current and former injection drug users with concurrent psychiatric disorders possible, but the benefits of such treatment delivered in a community-based, multidisciplinary, primary care model may extend beyond narrowly defined virological outcomes.

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Research Note: Acceptability and Utility of a Hand-Held Syringe Disposal Device for Active Injection Drug Users

Journal of Drug Issues ◽

10.1177/002204260303300211 ◽

2003 ◽

Vol 33 (2) ◽

pp. 519-532

Author(s):

Grace E. Macalino ◽

Rachel S. Weston ◽

Francis A. Wolf ◽

Stephanie L. Sanford-Colby ◽

Michelle M. McKenzie ◽

...

Keyword(s):

Injection Drug Users ◽

Drug Users ◽

Research Note ◽

Injection Drug ◽

Needlestick Injuries ◽

Syringe Disposal ◽

Almost All ◽

Better Than

Efforts to prevent the spread of HIV and hepatitis among injection drug users (IDUs) by improving access to sterile syringes can raise questions about syringe disposal. This study sought to evaluate the acceptability and utility of the Voyager, a newly approved, hand-held syringe disposal device for active injection drug users (IDUs). We offered the Voyager to active IDUs (n = 97), and interviewed them upon receiving the device and one month later. Almost all (90%) accepted the device. At follow-up, 78% had used the Voyager and 44% reported using it all the time; 65% reported they would like to continue using the Voyager and 77% rated the device “somewhat better” or “much better” than other methods of syringe disposal. Many IDUs care about safe syringe disposal and are willing and able to use a convenient disposal device such as the Voyager. Communities concerned about needlestick injuries and re-use of contaminated syringes should explore increasing the availability of such a device for IDUs as part of an overall approach to prevent improperly discarded syringes.

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Utilization of HIV/AIDS treatment services: comparing injecting drug users and other clients

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2006000400019 ◽

2006 ◽

Vol 22 (4) ◽

pp. 803-813 ◽

Cited By ~ 5

Author(s):

Angelita Cristine de Melo ◽

Waleska Teixeira Caiaffa ◽

Cibele Comini César ◽

Ricardo Vieira Dantas ◽

Bernard François Couttolenc

Keyword(s):

Viral Load ◽

Healthcare Utilization ◽

Injection Drug Users ◽

Drug Users ◽

Injection Drug ◽

Treatment Services ◽

Differential Outcomes ◽

Cd4 Lymphocyte ◽

Hiv Aids

This study compared healthcare utilization by injection drug users (IDUs) and non-IDUs. Data were abstracted from patients' medical records, admitted on HIV/AIDS treatment centers, between 1986 and 2002, forming a non-concurrent cohort study. Variables included: sociodemographics, HIV/AIDS exposure group, healthcare utilization (consultations, procedures, and prescriptions). Descriptive analyses included age-period and cohort effects. Out of 170 patients, with an average age of 30 years, 39.4% were IDUs, 71.8% were males and had low levels of education. At the first consultation, 86.5% neither received an ARV prescription nor had a request for CD4 or viral load. Injection drug users, as compared to non-IDUs, were less likely to receive ARV prescriptions and requests for CD4 lymphocyte and viral load counts, even though the number of consultations did not differ between the two groups. Healthcare utilization increased in calendar-year in the non-IDUs group, parallel to the implementation of the Brazilian health policy of universal care. However, this favorable trend was not observed among IDUs. Differential outcomes for HIV/AIDS among IDUs, towards worse prognosis, suggest difficulties in terms of adherence and follow-up of ARV therapy in this population.

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