heroin and Syphilis

Three women, aged 21, 20 and 30 years, were cocaine users and pregnant. There had been no prenatal monitoring until they reported with uterine contractions. Blood of the first two women was then tested; serology revealed active syphilis infections: their children had died in utero. The blood of the third woman had been tested as part of a street project; it revealed an active syphilitic infection but she could not be found for treatment. After delivery, the child showed withdrawal symptoms. The first and third women and the child of the third woman were treated with benzylpenicillin. The system for screening and treating drug-addicted pregnant women should be intensified.

Topics: Adult; Cocaine; Female; Fetal Death; Heroin; Humans; Incidence; Infant, Newborn; Mass Screening; Netherlands; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Sex Work; Social Control Policies; Substance Abuse, Intravenous; Syphilis; Syphilis, Congenital

Data on recent human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis prevalence among drug users in the Southwest China are sparse despite the high burden of drug use. This study aims at assessing the prevalence trends and related factors of HIV, HCV and syphilis infection among different drug users in the China-Vietnam border area.. A continuous cross-sectional survey was conducted among drug users from 2010 to 2020 in the China-Vietnam border area. Chi-square trend tests were used to assess the trend of HIV, HCV and syphilis prevalence and the proportion for drug type used by drug users. Multivariate logistic regression was used to identify associated factors of HIV, HCV and syphilis infection in different drug users.. In this study, a total of 28,951 drug users were included, of which 27,893 (96.45%) male, 15,660 (54.09%) aged 13-34 years, 24,543 (84.77%) heroin-only users, 2062 (7.12%) synthetic drug-only (SD-only) users and 2346 (8.10%) poly-drug users. From 2010 to 2020, the proportion of heroin-only users decreased from 87.79% to 75.46%, whereas SD-only users and poly-drug users increased from 5.16% to 16.03%, and from 7.05% to 8.52%, respectively. The prevalence of HIV, HCV, and syphilis during the study period declined from 12.76%, 60.37% and 5.72% to 4.35%, 53.29% and 4.53%, respectively, among heroin-only users and declined from 18.30%, 66.67% and 15.69% to 6.95%, 27.81% and 5.35%, respectively, among poly-drug users; however, the prevalence of HIV and HCV among SD-only users increased from 0.89% and 8.93% to 2.84% and 18.75%, respectively. Having ever injected drugs and needle sharing were common associated factors for both HIV and HCV infection among poly-drug users and heroin-only users. Aged ≥ 35 years old was an associated factor for HIV, HCV and syphilis infection among the SD-only users. Female drug users were at high risk of contracting syphilis among three different drug users.. The prevalence of HIV, HCV and syphilis among heroin-only users and poly-drug users decreased during the study period. However, the prevalence of HIV and HCV among SD-only users increased. Comprehensive intervention strategies, particularly focusing on the SD-only users are needed in order to bring down the disease burden in this population in the China-Vietnam border areas.

Topics: Adolescent; Adult; China; Cross-Sectional Studies; Drug Users; Female; Hepacivirus; Hepatitis C; Heroin; HIV Infections; Humans; Male; Syphilis; Vietnam; Young Adult

The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8-3.4]; 2.3, [1.6-3.1]) and syphilis infection (AOR = 4.1, [2.1-6.9]; 3.9, [1.8-5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.

Topics: Adult; China; Drug Users; Epidemics; Female; Hepatitis C; Heroin; HIV Infections; Humans; Male; Population Surveillance; Prevalence; Risk Factors; Sexual Behavior; Socioeconomic Factors; Substance-Related Disorders; Synthetic Drugs; Syphilis; Young Adult

Despite low HIV prevalence in the South Caucasus region, transmission is volatile. Little data are available from this region about addiction and infectious diseases among prisoners who transition back to communities.. A nation-wide randomly sampled biobehavioral health survey was conducted in 13 non-specialty Azerbaijani prisons among soon-to-be-released prisoners. After informed consent, participants underwent standardized health assessment surveys and testing for HIV, hepatitis B and C, and syphilis.. Of the 510 participants (mean age = 38.2 years), 11.4% were female, and 31.9% reported pre-incarceration drug injection, primarily of heroin. Prevalence of HCV (38.2%), HIV (3.7%), syphilis (3.7%), and HBV (2.7%) was high. Among the 19 HIV-infected inmates, 14 (73.7%) were aware of their HIV status, 12 (63.2%) were receiving antiretroviral therapy (ART), and 5 (26.3%) had CD4 < 350 cells/mL (4 of these were on ART). While drug injection was the most significant independent correlate of HCV (AOR = 12.9; p = 0.001) and a significant correlate of HIV (AOR = 8.2; p = 0.001), both unprotected sex (AOR = 3.31; p = 0.049) and working in Russia/Ukraine (AOR = 4.58; p = 0.008) were also correlated with HIV.. HIV and HCV epidemics are concentrated among people who inject drugs (PWIDs) in Azerbaijan, and magnified among prisoners. A transitioning HIV epidemic is emerging from migration from high endemic countries and heterosexual risk. The high diagnostic rate and ART coverage among Azerbaijani prisoners provides new evidence that HIV treatment as prevention in former Soviet Union (FSU) countries is attainable, and provides new insights for HCV diagnosis and treatment as new medications become available. Within prison evidence-based addiction treatments with linkage to community care are urgently needed.

Topics: Adult; Azerbaijan; Communicable Diseases; Female; Health Surveys; Hepatitis B; Heroin; HIV Infections; Humans; Male; Narcotics; Prevalence; Prisoners; Substance-Related Disorders; Syphilis; USSR

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

Topics: Adult; Female; Heroin; Humans; Italy; Male; Seroepidemiologic Studies; Sex Work; Substance Abuse, Intravenous; Syphilis; Syphilis Serodiagnosis

Little is known about the epidemiology of human herpesvirus 8 (HHV-8) infections among women. A cross-sectional study was conducted of HHV-8 infection among human immunodeficiency virus (HIV)-infected and high-risk HIV-uninfected women. Serological tests with noninduced (latent) and induced (lytic) HHV-8 antigens were used to detect infection among 2483 participants of a multisite cohort. Reactivity to latent antigen was present in 4.1% and to induced antigens in 12.0% of women. Seven of 8 women who reported Kaposi's sarcoma had HHV-8 antibodies. Among HIV-positive women, HHV-8 infection was associated with use of crack, cocaine, or heroin (76% vs. 65%; P<.001), past syphilis (29% vs. 20%; P<.001), an injection drug-using male sex partner (61% vs. 53%; P=.014), black race (P=.010), and enrollment site (P=.015). In multivariate analysis, HIV infection, older age, past syphilis, black race, and enrollment site were independently associated with HHV-8 infection. In this cohort of North American women, HHV-8 infection was associated with HIV infection, drug use, and risky sexual behavior.

Topics: Adult; Antibodies, Viral; California; Cocaine; Cohort Studies; Crack Cocaine; Cross-Sectional Studies; District of Columbia; Female; Heroin; Herpesviridae Infections; Herpesvirus 8, Human; HIV Infections; HIV Seronegativity; HIV Seropositivity; Humans; New York; Prevalence; Risk Factors; Sarcoma, Kaposi; Seroepidemiologic Studies; Sex Factors; Substance Abuse, Intravenous; Syphilis

A blinded seroprevalence survey for HIV-1 infection was conducted among individuals entering New York City (NYC) prisons in 1989. Data collected included age group, race/ethnicity, syphilis serologic results and self-admitted drug use. Remnant serum specimens were tested for HIV-1 antibody by enzyme-linked immunosorbent assay and confirmed by Western blot. Of 2236 inmates surveyed, 413 (18.5%) were HIV-1 positive. Rates varied by subgroup, and were higher for women than men (25.8 versus 16.1%; odds ratio 1.8; P less than 0.01), for drug users than inmates who denied drug use (25 versus 14%; odds ratio 2.3; P less than 0.01), for intravenous heroin users (43 versus 15% in drug users not using heroin), and for inmates with positive rapid plasma reagin test (RPR) results (34.5 versus 16.1% in RPR-negative inmates). Use of intravenous heroin was most strongly related, by logistic regression, to HIV-1 seropositivity. The results are among the highest found in US inmates, and suggest that there were 12,500 seropositive individuals incarcerated in 1989. This represents approximately 10% of the estimated number of seropositive individuals in NYC. The NYC Correctional System should be viewed as a front-line institution in the fight against AIDS through provision of HIV-related prevention services and clinical care, and drug treatment.

Topics: Adult; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Female; Heroin; HIV Infections; HIV Seroprevalence; HIV-1; Humans; Male; New York City; Prevalence; Prisoners; Substance Abuse, Intravenous; Syphilis; Treponema Immobilization Test

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.

Topics: Black or African American; Cocaine; Endocarditis, Bacterial; Female; Heroin; Hispanic or Latino; HIV Seropositivity; Humans; Injections, Intravenous; Male; Methadone; San Francisco; Substance-Related Disorders; Syphilis; White People

Topics: Adolescent; Adult; Birth Weight; Female; Heroin; Humans; Infant, Newborn; Labor Presentation; Methadone; Pregnancy; Pregnancy Complications; Substance-Related Disorders; Syphilis