sodium-hypochlorite and Substance-Related-Disorders

The social dynamics of prostitution render prostitutes unable at times to meet basic human needs, vulnerable to violence, and at risk for sexually transmitted disease. Since April 1989 a mobile van from a private foundation has been contacting prostitutes throughout the five boroughs of New York City to provide HIV testing and counseling and to distribute condoms, bleach kits for cleaning needles, and HIV prevention information. Data collected from 1,963 female prostitutes are discussed in this article. Information is provided on demographics, family and living arrangements, sex and drug practices, HIV status and risk reduction practices, and health history. Methods are discussed for social workers to develop creative ways to provide outreach and develop relationships with a vulnerable population that invests much effort in remaining concealed.

Topics: Adult; AIDS Serodiagnosis; Community-Institutional Relations; Condoms; Counseling; Disinfection; Family Characteristics; Female; HIV Infections; Humans; Needles; New York City; Risk Assessment; Risk Factors; Sex Work; Sexual Behavior; Sexually Transmitted Diseases; Social Environment; Social Work; Sodium Hypochlorite; Substance-Related Disorders; Violence

To examine the HIV seroconversion rate, risk factors for seroconversion, and changes in risk behavior over time in intravenous drug users (IVDU) in San Francisco, 1985-1990.. Observational study.. All methadone maintenance and 21-day methadone detoxification programs in San Francisco.. A total of 2351 heterosexual IVDU, of whom 681 were seronegative at first visit and seen at least twice ('repeaters').. HIV seroconversion rates, risk factors for seroconversion, and changes in behavior.. The HIV seroconversion rate in repeaters was 1.9% per person-year (ppy) of follow-up [2.1% in women versus 1.7% in men (not significant); 4% in African Americans versus 1% in whites (P = 0.006); 3.9% ppy in the first third of the study, 1.2% in the second (P = 0.007), and 1.9% in the last (not significant)]. Risk factors for seroconversion were five or more sexual partners per year [hazard ratio (HR) = 2.6; P = 0.02], use of shooting gallery ever (HR = 2.9; P = 0.02), and less than 1 year (lifetime) in methadone maintenance (HR = 2.7; P = 0.02). Self-reported intravenous cocaine use fell from 33 to 15% over 5 years, shooting gallery use fell from 19 to 6%, and the proportion with five or more sexual partners fell from 25 to 10%. Bleach use rose to 75% of needle-sharers.. The 1985-1990 HIV seroconversion rate in IVDU (1.9% ppy) was comparable to that in San Francisco cohorts of homosexual men (1.4% ppy). A decline in HIV seroconversion coincided with changes in risk behavior. Stable attendance of methadone maintenance was highly protective: the seroconversion rate in subjects with 1 year or more in methadone was 12% ppy.

Topics: Adult; Amphetamines; Bias; Cocaine; Cohort Studies; Comorbidity; Disinfection; Equipment Contamination; Ethnicity; Female; Heroin Dependence; HIV Infections; HIV Seropositivity; HIV Seroprevalence; Humans; Injections, Intravenous; Male; Needle Sharing; Risk Factors; San Francisco; Sexual Behavior; Sexual Partners; Sodium Hypochlorite; Substance Abuse Treatment Centers; Substance Abuse, Intravenous; Substance-Related Disorders; Urban Population

Topics: Cocaine; Decontamination; Disinfection; Humans; Needles; Sodium Hypochlorite; Substance-Related Disorders

Topics: Acquired Immunodeficiency Syndrome; Disinfection; Humans; Injections, Intravenous; Sodium Hypochlorite; Sterilization; Substance-Related Disorders; Syringes