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"Opioid" and "HIV"

J Leston, C Crisp, C Lee, E Rink
OBJECTIVES: The primary objective of this study was to work with tribal communities to define and develop their own healthcare services and strategies for positive change regarding injection drug use, human immunodeficiency virus (HIV), and hepatitis C virus (HCV) infection. The secondary objective of this study was to incorporate community capacity building strategies to develop and sustain programming and resources to optimize tribal communities' responsiveness to reduce health disparities...
February 11, 2019: Public Health
Winston E Abara, Melissa G Collier, Anne Moorman, Danae Bixler, Jefferson Jones, Pallavi Annambhotla, James Bowman, Marilyn E Levi, John T Brooks, Sridhar V Basavaraju
The ongoing U.S. opioid crisis has resulted in an increase in drug overdose deaths and acute hepatitis C virus (HCV) infections, with young persons (who might be eligible organ donors) most affected.*, † In 2013, the Public Health Service released a revised guideline to reduce the risk for unintended organ transplantation-associated hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV) transmission (1). The guideline describes criteria to categorize donors at increased risk (increased risk donors [IRDs]) for transmitting these viruses to recipients (1)...
January 25, 2019: MMWR. Morbidity and Mortality Weekly Report
Annette Opitz-Welke, Marc Lehmann, Peter Seidel, Norbert Konrad
BACKGROUND: Infectious diseases, substance dependencies, and dental diseases are the most important health problems affecting incarcerated persons. In Germany, for example, prisoners are 48 to 69 times more likely to be infected with the hepatitis C virus (HCV) than the general population, and 7 to 12 times more likely to be infected with the human immunodeficiency virus (HIV). The prevalence of mental illnesses is also markedly higher in the incarcerated than in the general population...
November 30, 2018: Deutsches Ärzteblatt International
Rachel M Murdock, Marisa B Brizzi, Omar Perez, Melissa E Badowski
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection among persons who inject drugs (PWID) is a major public health concern. There are limited data in clinical trials on the use of direct-acting antiviral (DAA) therapy for treatment of HCV in co-infected PWID. It is critical for these patients to gain access to treatment in order to decrease progression of liver disease and decrease transmission of both HIV and HCV. Additional harm reduction interventions, including needle and syringe programs and opioid substitution treatment, should be made available to this vulnerable population...
January 3, 2019: Infectious Diseases and Therapy
Andrew Radley, Marijn de Bruin, Sarah K Inglis, Peter T Donnan, John F Dillon
INTRODUCTION: Hepatitis C virus (HCV) infection affects 0.7% of the general population, and up to 40% of people prescribed opioid substitution therapy (OST) in Scotland. In conventional care, less than 10% of OST users are tested for HCV and less than 25% of these initiate treatment. Community pharmacists see this group frequently to provide OST supervision. This study examines whether a pharmacist-led 'test & treat' pathway increases cure rates for HCV. METHODS AND ANALYSIS: This protocol describes a cluster-randomised trial where 60 community pharmacies provide either conventional or pharmacy-led care...
December 14, 2018: BMJ Open
Hildi Hagedorn, Marie Kenny, Adam J Gordon, Princess E Ackland, Siamak Noorbaloochi, Wei Yu, Alex H S Harris
BACKGROUND: In the US, emergency room visits and overdoses related to prescription opioids have soared and the rates of illicit opioid use, including heroin and fentanyl, are increasing. Opioid use disorder (OUD) is associated with higher morbidity and mortality, higher HIV and HCV infection rates, and criminal behavior. Opioid agonist therapy (OAT; methadone and buprenorphine) is proven to be effective in treating OUD and decreasing its negative consequences. While the efficacy of OAT has been established, too few providers prescribe OAT to patients with OUD due to patient, provider, or system factors...
December 13, 2018: Addiction Science & Clinical Practice
Song Cai, Shreya Sai Bellampalli, Jie Yu, Wennan Li, Yingshi Ji, E M Kithsiri Wijeratne, Angie Dorame, Shizhen Luo, Zhiming Shan, May Khanna, Aubin Moutal, John M Streicher, A A Leslie Gunatilaka, Rajesh Khanna
For an affliction that debilitates an estimated 50 million of U.S. adults, the current chronic pain management approaches are inadequate. The Centers for Disease Control and Prevention have called for a minimization in opioid prescription and use for chronic pain conditions, and thus, it is imperative to discover alternative non-opioid based strategies. For the realization of this call, a library of natural products was screened in search of pharmacological inhibitors of both voltage-gated calcium channels and voltage-gated sodium channels, excellent targets due to their well-established roles in nociceptive pathways...
December 7, 2018: ACS Chemical Neuroscience
Christopher Akiba, Jeremy C Kane, Stephanie Skavenski van Wyk, Ravi Paul, Chombalelo Mukunta, Laura K Murray
Introduction: Although the World Health Organization (WHO) has recommended guidelines for the treatment of opioid dependence, there are myriad challenges to successfully implementing such guidelines in resource constrained settings, such as in low and middle-income countries (LMICs). To highlight these challenges, this paper presents a clinical case study of an adolescent study participant in a randomized controlled trial comparing two counseling programs in Lusaka, Zambia. Case description: This 15 year-old male reported smoking marijuana and heroin daily, and injecting heroin monthly (while needle sharing)...
December 2018: Addictive Behaviors Reports
Helen Laycock, Vanessa Crawford, Andrew Sc Rice, Sarah Cox
People living with HIV represent a unique aging population, living with a chronic condition associated with significant pain. A number take high dose, long-term opioids to manage moderate to severe chronic pain, presenting specific risks. This article highlights the size and impact of this problem and outlines the service objectives and set up of a specialist clinic to manage people living with HIV on high dose opioids, alongside its successes and learning points.
December 3, 2018: Pain Management
Colleen L Barry, Susan G Sherman, Elizabeth Stone, Alene Kennedy-Hendricks, Jeff Niederdeppe, Sarah Linden, Emma E McGinty
BACKGROUND: Safe consumption sites are spaces where people can legally use pre-obtained drugs under medical supervision and are currently in operation in Canada, Australia and Western Europe. These sites are effective in reducing opioid overdose mortality and other harms associated with opioid use, such as HIV infection, and increasing drug treatment entry. Various U.S. communities are considering establishing safe consumption sites, however, only 29% of U.S. adults support their legalization...
November 20, 2018: International Journal on Drug Policy
Robert Heimer, Kathryn Hawk, Sten H Vermund
The current opioid crisis in the United States has emerged from higher demand for and prescribing of opioids as chronic pain medication. This led to massive diversion of prescription opioids into illicit markets. A peculiar tragedy is that many health professionals prescribed opioids in a misguided response to legitimate concerns that pain was under-recognized and undertreated. The crisis grew not only from over-prescribing, but also from other sources, including a lack of research into non-opioid pain management, ethical lapses in corporate marketing, historical stigmas directed against people who use drugs, and failures to deploy evidence-based therapies for opioid addiction and to comprehend the limitations of supply side regulatory approaches...
November 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Natalia Gnatienko, Jennifer A Wagman, Debbie M Cheng, Angela R Bazzi, Anita Raj, Elena Blokhina, Olga Toussova, Leah S Forman, Dmitry Lioznov, Carly Bridden, Meg Sullivan, Kendall Bryant, Jeffrey H Samet, Judith I Tsui
OBJECTIVE: To describe the frequency of being partnered and having an HIV-negative partner, and whether this differed by gender, among a cohort of persons living with HIV (PLWH) who have ever injected drugs; to describe awareness of HIV pre-exposure prophylaxis (PrEP) and perceived partner interest in PrEP. SETTING: Secondary analyses of an observational cohort study of PLWH who have ever injected drugs in St. Petersburg, Russia. METHODS: Primary outcomes were 1) being partnered and 2) being in a serodiscordant partnership...
2018: PloS One
Matthew A Miclette, Jared A Leff, Isabella Cuan, Jeffrey H Samet, Brendan Saloner, Gary Mendell, Yuhua Bao, Michael A Ashburn, Marcus A Bachhuber, Bruce R Schackman, Daniel E Polsky, Zachary F Meisel
Drug overdose deaths involving opioids have surged in recent years and the economic cost of the opioid epidemic is estimated to be over $500 billion annually. In the midst of calls for declaring a national emergency, health policy decision makers are considering the best ways to allocate resources to curb the epidemic. On June 9, 2017, 116 invited health researchers, clinicians, policymakers, health system leaders, and other stakeholders met at the University of Pennsylvania to discuss approaches to address the gaps in evidence-based substance use disorder policy and practice, with an emphasis on the opioid epidemic...
November 13, 2018: Addiction Science & Clinical Practice
Arune Kontautaite, Daria Matyushina-Ocheret, Maria Plotko, Mikhail Golichenko, Mart Kalvet, Lena Antonova
BACKGROUND: Estonia continues to have the highest prevalence of HIV among people who inject drugs, and the highest overdose mortality, in the European Union. In August 2017, the Eurasian Harm Reduction Association (EHRA), the Canadian HIV/AIDS Legal Network (CHALN), and the Estonian Association of People Who Use Psychotropic Substances (LUNEST) conducted a study in Estonia to assess the situation regarding the human rights of women who use drugs and/or living with HIV. METHODS: The research methodology, developed by EHRA and CHALN, comprised in-depth interviews with 38 drug-dependent women conducted between August 8 and 14, 2017, in Tallinn and Ida-Viru county...
November 6, 2018: Harm Reduction Journal
Joseph W Ditre, Lisa R LaRowe, Peter A Vanable, Martin J De Vita, Michael J Zvolensky
Pain, tobacco cigarette smoking, and prescription opioid misuse are all highly prevalent among persons living with HIV (PLWH). Smoking and pain medication misuse can lead to deleterious outcomes, including more severe pain and physical impairment. However, we are not aware of any interventions that have attempted to address these issues in an integrated manner. Participants (N = 68) were recruited from an outpatient infectious disease clinic and randomized to either a computer-based personalized feedback intervention (Integrated PFI) that aimed to increase motivation, confidence, and intention to quit smoking, and decrease intentions to misuse prescription analgesic medications, or a Control PFI...
October 27, 2018: Behaviour Research and Therapy
Carlos Del Rio, Wendy S Armstrong
In no field of medicine has advocacy, including physician advocacy, been more crucial in shaping policy for delivery of care than in HIV/AIDS. Although the historic tradition is strong, there is an urgent need to re-energize advocacy efforts nationally and internationally to support programs that fund care, change policies that perpetuate stigma and discrimination, and change the public perception that the HIV/AIDS crisis is over. Established programs that require ongoing advocacy attention include the Ryan White Comprehensive AIDS Resources Emergency Act, a US program that serves as a payer of last resort for care for patients with HIV infection, and international programs like the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria...
September 2018: Topics in Antiviral Medicine
R Douglas Bruce
Available data indicate that opioid substitution treatment can successfully reduce rates of HIV transmission and that patients receiving such treatment can adhere to therapies for HIV, hepatitis C, and tuberculosis infection. Integration of opioid substitution treatment into the HIV clinic setting can make such treatment easier and improve retention in treatment. This article summarizes a presentation by R. Douglas Bruce, MD, MA, MS, at the IAS-USA continuing education program held in Chicago, Illinois, in May 2018...
September 2018: Topics in Antiviral Medicine
Ansley Lemons, Nicholas DeGroote, Alejandro Peréz, Jason Craw, Margaret Nyaku, Dita Broz, Christine L Mattson, Linda Beer
BACKGROUND: People living with HIV are prescribed opioids more often and at higher doses than people who do not have HIV, and disproportionately experience risk factors for substance use disorder, which suggests they could be at increased risk for the misuse of opioids. Researchers also suggest that opioid misuse negatively affects various HIV clinical outcomes, increasing the risk of transmission to partners with an HIV-negative status. METHODS: We calculated weighted percentages and 95% confidence intervals to estimate substance use characteristics among a probability sample of 28,162 HIV-positive adults receiving medical care in the US who misused opioids (n=975)...
October 23, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Roman Shrestha, Frederick L Altice, Michael M Copenhaver
BACKGROUND: Opioid agonist therapies with methadone are associated with higher levels of adherence to antiretroviral therapy (ART), yet no studies have explored factors associated with optimal ART levels in HIV-positive patients on methadone maintenance treatment (MMT), including explanatory pathways using mediation analysis. SETTING: Participants included 121 HIV-positive, methadone-maintained patients who reported HIV-risk behaviors and were taking ART. METHODS: Participants were assessed using an audio-computer assisted self-interview (ACASI)...
October 23, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Andrew H Talal, Phyllis Andrews, Anthony Mcleod, Yang Chen, Clewert Sylvester, Marianthi Markatou, Lawrence S Brown
Background and aims: Despite high hepatitis C virus (HCV) prevalence, opioid use disorder (OUD) patients on methadone rarely engage in HCV treatment. We investigated the effectiveness of HCV management via telemedicine in an opioid substitution therapy (OST) program. Methods: OUD patients on methadone underwent biweekly telemedicine sessions between a hepatologist and physician assistant during the entire HCV treatment course. All pretreatment labs (HCV RNA, genotype and noninvasive fibrosis assessments) were obtained onsite and direct acting antivirals were co-administered with methadone using modified directly observed therapy...
October 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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