heroin and Sexually-Transmitted-Diseases

Medical complications of heroin overdose and the diseases of addicts play an increasingly important role in the daily routine of hospital medical departments. The percentage of drug-related admissions to the Medical Clinic of the University Hospital, Zürich, increased from 0.18% to 4.45% between 1972 and 1983. During this 12-year period, 492 patients were admitted 569 times because of heroin overdose or intoxications combined with other drugs, and 191 drug addicts were hospitalized 226 times for a variety of medical problems. Certain complications, such as heroin pulmonary edema and talc granulomas of the lung, occur only in parenteral drug addiction. Other diseases such as right heart endocarditis, Candida-endophthalmitis, septic arthritis and osteomyelitis are almost exclusively observed in intravenous drug abusers. Sexually transmitted infections and hepatitis B are frequently diagnosed in addicts.

Topics: Adolescent; Adult; Age Factors; Arthritis, Infectious; Candidiasis; Cardiovascular Diseases; Endocarditis, Bacterial; Female; Hepatitis, Viral, Human; Heroin; Heroin Dependence; Humans; Length of Stay; Lung Diseases; Male; Nervous System Diseases; Osteomyelitis; Pulmonary Edema; Rhabdomyolysis; Sex Factors; Sexually Transmitted Diseases; Skin Diseases; Switzerland

This study assessed the prevalence and patterns of drug use among people living with HIV (PLHIV) in Spain. We conducted an observational cross-sectional study including 1401 PLHIV. Data were collected through 33 sites across Spain using an online computer-assisted self-administered interview. The survey measured use of illicit drugs and other substances, treatment adherence and health-related variables. To analyse patterns of drug use we performed cluster analysis in two stages. The most frequently consumed substances were: alcohol (86.7%), tobacco (55.0%), illicit drugs (49.5%), other substances (27.1%). The most prevalent illicit drugs used were cannabis (73.8%), cocaine powder (53.9%), and poppers (45.4%). Results found four clusters of PLHIV who used drugs. Two of them were composed mainly of heterosexuals (HTX): Cluster 1 (n = 172) presented the lowest polydrug use and they were mainly users of cannabis, and Cluster 2 (n = 84) grouped mostly men who used mainly heroin and cocaine; which had the highest percentage of people who inject drugs and presented the lowest level of treatment adherence (79.8±14.2; p < .0001). The other two clusters were composed mainly of men who have sex with men (MSM), who were mostly users of recreational drugs. Cluster 3 (n = 285) reported moderate consumption, both regarding frequency and diversity of drugs used, while Cluster 4 (n = 153) was characterized by the highest drug polyconsumption (7.4±2.2; p < .0001), and 4 grouped MSM who injected recreational drugs, and who reported the highest frequency of use of drugs in a sexual context (2.6±0.8; p < .0001) and rates of sexually transmitted infections (1.8±1.1; p < .01). This is the largest multi-centre cross-sectional study assessing the current prevalence and patterns of drug use among PLHIV in Spain. The highest prevalence of drug use was found among MSM, although HTX who used heroin and cocaine (Cluster 2) had the most problems with adherence to HIV treatment and the worst health status.

Topics: Adult; Cannabis; Cocaine; Cross-Sectional Studies; Female; Heroin; HIV Infections; Humans; Illicit Drugs; Male; Middle Aged; Patient Compliance; Prevalence; Sexually Transmitted Diseases; Spain; Substance-Related Disorders; Surveys and Questionnaires

In Europe, the highest proportion of HIV diagnoses are in gay men and other men who have sex with men (MSM). Globally, HIV prevalence is particularly high among males who report selling sex, but rates among men who buy sex from other men are less clear. This study analyzed the association of transactional sex (TS) and HIV diagnosis, sexually transmitted infection (STI) diagnoses, and various drug use; and examined the variations in TS by payment direction.. We conducted a cross-sectional, non-randomized, observational study. This European MSM Internet Survey recruited MSM from 38 European countries. For descriptive purposes we stratified according to TS behavior (frequently selling sex, frequently buying sex, neither frequently selling nor buying sex in the previous 12 months), and we constructed separate multivariable logistic regression models to investigate whether engaging in TS accounted for some of the HIV- and STI diagnoses and drug use in this population.. Of almost 161,000 sexually active MSM, 12.2% engaged in TS. The multivariable logistic regression results showed that relative to not frequently engaging in TS, frequently selling sex was independently associated with a higher odds of reporting diagnosed HIV (ever, adjusted odds ratio [aOR] 1.60, confidence interval [CI] 95% 1.39 to 1.85), bacterial STIs (past 12 months, aOR 1.75 CI 95% 1.54 to 2.00), using heroin or crack cocaine or injecting drugs (aOR 3.17, CI 95% 2.70 to 3.73), and using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). Compared to men not engaging in frequent TS, frequently buying sex was associated with a higher odds of using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41).. MSM who frequently sell sex suffer greater sexual- and substance use risks than other MSM, but both men who frequently sell and those who buy sex are more likely to use benzodiazepines. MSM who sell sex to other men constitute an important at-risk population who must be offered targeted health services.

Topics: Adult; Crack Cocaine; Cross-Sectional Studies; Europe; Heroin; HIV Infections; Homosexuality, Male; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Risk Factors; Sex Work; Sexual and Gender Minorities; Sexual Behavior; Sexually Transmitted Diseases; Substance-Related Disorders; Young Adult

HIV prevalence in Vietnam is currently concentrated among injection drug users (IDUs). The extent to which this core risk group represents a potential for broader HIV transmission to the general population is currently unknown.. A community-based cross-sectional study among IDUs in Vietnam assessed sexually transmitted disease (STD) prevalence and behavioral risk factors. Qualitative interview data enhanced quantitative findings.. The prevalence of any STDs among 272 IDUs was 30% (chlamydia, 9%; herpes simplex virus type 2 [HSV-2], 22%; gonorrhea, 0%; and syphilis, 1%). Part-time work or unemployment (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 1.1 to 6.9), sex with > or =2 sex workers in the past year (OR = 4.9, 95% CI: 1.91 to 12.6), having ever smoked heroin (OR = 4.5, 95% CI: 1.1 to 18.3), and injecting less frequently than daily (OR = 3.9, 95% CI: 1.43 to 10.6) were independently associated with chlamydial infection. Urban residency (OR = 4.0, 95% CI: 1.4 to 11.0) and daily injecting (OR = 2.2, 95% CI: 1.1 to 4.4) were independently associated with HSV-2. Odds of HSV-2 among older (> or =28 years of age) IDUs who had sex with <2 sex workers in the past year was higher than among younger IDUs who had sex with more sex workers (OR = 6.4, 95% CI: 2.1 to 18.4).. High STD prevalence and high-risk sexual and parenteral behaviors among IDUs indicate the potential for HIV/STD transmission to the general Vietnamese population.

Topics: Chlamydia Infections; Cross-Sectional Studies; Female; Gonorrhea; Heroin; Herpes Simplex; Humans; Interviews as Topic; Male; Prevalence; Risk Factors; Sexual Behavior; Sexually Transmitted Diseases; Smoking; Substance Abuse, Intravenous; Syphilis; Unemployment; Urban Population; Vietnam

To assess whether human immunodeficiency virus (HIV)-infected and/or hepatitis C virus (HCV)-infected noninjecting heroin users (NIUs) are a potential sexual transmission bridge to "lower risk" partners, 180 HIV- or HCV-infected NIUs recruited in New York City were interviewed about their sexual behaviors and partnerships. Sixty-two percent were former injecting drug users (IDUs). Partners reported not to be HIV infected, IDUs, or men who have sex with men were defined as lower risk. Among 54 HIV-infected NIUs, lower risk partners were reported by 54% of never IDUs and 23% of former IDUs (P=.02). Among 155 HCV-infected NIUs, lower risk partners were reported by 54% of never IDUs and 45% of former IDUs (not significant). Engaging in unprotected vaginal or anal sex and having lower risk partners was reported by 29% of HIV-infected never IDUs, 12% of HIV-infected former IDUs, 29% of HCV-infected never IDUs, and 34% of HCV-infected former IDUs. HIV-infected NIUs, particularly never IDUs, and, possibly, HCV-infected NIUs, are a potential sexual transmission bridge.

Topics: Adult; Anal Canal; Ethnicity; Female; Hepatitis C; Heroin; Heroin Dependence; Heterosexuality; HIV Infections; HIV Seropositivity; Homosexuality, Male; Humans; Male; New York City; Probability; Risk Factors; Sexually Transmitted Diseases; Socioeconomic Factors; Substance Abuse, Intravenous; Vagina

From June 1986 to March 1990, a prospective seroprevalence survey and questionnaire of individuals at risk for HIV infection was conducted with volunteers in Winnipeg. Of 610 individuals enrolled, 146 were injected drug users (IDU). Fifteen IDU were in a methadone treatment program and all were seronegative. Three of 131 remaining IDU were HIV-1 seropositive (2.3%), a rate similar to 2.2% positive (20+ of 927) in diagnostic specimens from IDU tested in the province. Demographics and behaviour of 131 IDU were compared with 335 individuals, of whom 112 were gay/bisexual [24 of whom also had sexually transmitted diseases (STD)] and 223 heterosexuals who had STD. Males enrolled were significantly older than females. Multivariate analysis showed that factors independently associated with IDU were: a younger age, less education, mental health counselling, unemployment, and a history of jaundice or hepatitis. Drugs most commonly used were Ritalin/Talwin, cocaine, and heroin. Over 90% of individuals admitted to sharing needles. In spite of the low seroprevalence of HIV-1 infections, these individuals are important for the potential spread of HIV because of multiple means of acquiring and transmitting HIV and a high rate of needle sharing.

Topics: Acquired Immunodeficiency Syndrome; Adult; Cocaine; Female; Heroin; HIV Seropositivity; HIV Seroprevalence; Homosexuality; Humans; Male; Manitoba; Needle Sharing; Prospective Studies; Risk Factors; Sexually Transmitted Diseases; Substance Abuse, Intravenous; Surveys and Questionnaires

The prevalence, risk factors, and incidence of hepatitis C virus (HCV) infection were studied in a cohort of drug users in Amsterdam. In intravenous drug users, the seroprevalence was 74% (224/304) versus 10% (4/42) in nonintravenous drug users. Risk factors independently associated with HCV antibody seropositivity were history and duration of intravenous drug use and frequency of injections. Daily smoking of heroin in the previous 6 months was independently associated with the absence of HCV antibodies. Periods of fever, tiredness, and diarrhea in the preceding 6 months were associated with HCV antibodies even after correction for human immunodeficiency virus infection. The incidence rate of HCV infection appeared high and stable over the years 1986 to 1989. Thus, HCV infections are common among intravenous drug users and are mainly due to the intravenous use of drugs.

Topics: Adult; Analysis of Variance; Cohort Studies; Female; Follow-Up Studies; Hepatitis Antibodies; Hepatitis C; Hepatitis, Viral, Human; Heroin; Homosexuality; Humans; Incidence; Longitudinal Studies; Male; Multivariate Analysis; Netherlands; Prevalence; Regression Analysis; Risk Factors; Sex Work; Sexually Transmitted Diseases; Substance Abuse, Intravenous; Substance-Related Disorders

The authors compared a groups of heroin-dependent American servicemen stationed in Thailand with a matched control groups of men not dependent on heroin. The data gathered regarding social history, attitudes, work record, previous drug use, personality, and intelligence show significant differences between the heroin-dependent men and the control group in four areas: intelligence, work record, number of years of schooling and number of drug used before using heroin. The data suggest that many of the heroin-dependent men had difficulties related to a distant or negative relationship to their fathers; however, in contrast to previous studies of heroin addicts, they do not confirm a relationship between heroin dependence and any particular personality pattern.

Topics: Adolescent; Adult; Educational Status; Family Characteristics; Father-Child Relations; Heroin; Heroin Dependence; Humans; Intelligence; Intelligence Tests; Juvenile Delinquency; Male; Military Medicine; MMPI; Personal Satisfaction; Personality; Sexual Behavior; Sexually Transmitted Diseases; Social Adjustment; Substance-Related Disorders; Thailand; United States; Urban Population; Work

Topics: Adolescent; Adult; Age Factors; Aged; Alcohol Drinking; Amphetamine; Barbiturates; Black or African American; Cannabis; Cocaine; Crime; Family Characteristics; Female; Florida; Health Surveys; Hepatitis; Heroin; Humans; Lysergic Acid Diethylamide; Male; Middle Aged; Prisons; Sex Factors; Sexually Transmitted Diseases; Socioeconomic Factors; Substance-Related Disorders

Topics: Adult; Age Factors; Amenorrhea; Endocarditis; Female; France; Gangrene; Hepatitis; Heroin; Humans; Injections; Male; Middle Aged; Morphinans; Pharmaceutic Aids; Sepsis; Sexually Transmitted Diseases; Skin Manifestations; Social Behavior Disorders; Social Conditions; Substance-Related Disorders

Topics: Barbiturates; Hepatitis B; Heroin; Humans; Morphine; Nutrition Disorders; Opium; Respiratory Tract Infections; Sexually Transmitted Diseases; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Age Factors; Amphetamine; Cannabis; Female; Heroin; Humans; Male; Sex Factors; Sexually Transmitted Diseases; Substance-Related Disorders