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Rudolph AE, Young AM. Privacy and Confidentiality Considerations for Collecting HIV Risk Network Data among Men who Have Sex with Men and Implications for Constructing Valid Risk Networks. SOCIAL NETWORKS 2021; 67:47-54. [PMID: 34712004 PMCID: PMC8547314 DOI: 10.1016/j.socnet.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Studies aiming to construct risk networks have historically collected network members' names, demographic characteristics and relational data (i.e., type, strength, duration, frequency of interaction, and HIV-related risk behaviors between the pair). Due to difficulties in constructing risk networks stemming from partner anonymity and the use of nicknames, some studies also collect network members' screen names, phone numbers, physical attributes, and scars/tattoos to assist with entity resolution. In-depth interviews with 20 men who have sex with men and transgender women in Kentucky assessed privacy/confidentiality concerns as well as accuracy/recall issues associated with providing these details. Most preferred providing alters' nicknames/first names only or a first name with the first letter of the last name. Many perceived screen names, phone numbers, and scars/tattoos to be too personal/identifying. Willingness to provide more detailed information varied by relationship type/strength, which could influence the validity of the resulting network.
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Affiliation(s)
- Abby E. Rudolph
- Department of Epidemiology, Boston University School of Public Health, Boston MA
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia PA
| | - April M. Young
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington KY
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington KY
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Guo L, Wang W, Du X, Guo Y, Li W, Zhao M, Wu R, Lu C. Associations of Substance Use Behaviors With Suicidal Ideation and Suicide Attempts Among US and Chinese Adolescents. Front Psychiatry 2020; 11:611579. [PMID: 33536951 PMCID: PMC7848020 DOI: 10.3389/fpsyt.2020.611579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Adolescence has been described as a period of increased health risk-taking behaviors. Given the variety of cultural contexts, healthcare systems, and public health policies in different regions, the present study aimed to determine whether there are similar or different associations of substance use behaviors with suicidal ideation and suicide attempts among US and Chinese adolescents. Methods: This study included a total of 14,765 US adolescents from the 2017 National Youth Risk Behavior Surveillance System (YRBSS) and 24,345 Chinese adolescents from the 2017 School-based Chinese Adolescents Health Survey (SCAHS). Results: The proportions of suicidal ideation and suicide attempts were 17.4 and 5.7% among US adolescents, which were higher than those among Chinese adolescents (suicidal ideation: 13.7% and suicide attempts: 2.7%). Among Chinese adolescents, the most common substance use behavior was "alcohol use (55.4%)," followed by "cigarette use (11.6%)." Among US adolescents, the most popular substance was alcohol (ever used: 55.9%), followed by marijuana (ever used: 34.6%). Moreover, alcohol use was significantly related to suicidal ideation/suicide attempts only in Chinese adolescents [suicidal ideation: Adjusted odds ratio (AOR) = 1.88, 95% CI = 1.71~2.06; suicide attempts: AOR = 2.12, 95% CI = 1.71~2.63], and marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group (suicidal ideation: AOR = 1.23, 95% CI = 1.06~1.44; suicide attempts: AOR = 1.51, 95% CI = 1.21~1.87). Moreover, although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were stronger in Chinese adolescents than in US adolescents (Chinese adolescents: AOR = 3.97, 95% CI = 2.76~5.72; US adolescents: AOR = 1.76, 95% CI = 1.43~2.16; P < 0.05). Conclusions: The associations of alcohol use with suicidal ideation and suicide attempts were only significant in Chinese adolescents. Marijuana use was associated with suicidal ideation and suicide attempts only in the US adolescent group. Although the associations of prescription pain medication use with suicide attempts were significant in both Chinese and US adolescent groups, the adjusted associations were significantly stronger for Chinese adolescents. These findings might be related to the differences in cultural contexts, healthcare systems, and public health policies in the two different countries.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Xueying Du
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Yangfeng Guo
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
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3
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Xiong H, Jia J. Situational Social Support and Relapse: An Exploration of Compulsory Drug Abuse Treatment Effect in China. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:1202-1219. [PMID: 30501427 DOI: 10.1177/0306624x18815243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The present study explores situational social support of drug abusers during compulsory rehabilitation and provides a preliminary estimation of relationship between social support and relapse. Links between social support and relapse are examined in a study of drug abusers accepting coercive detoxification and rehabilitation treatment, and self-reported relapse in the following 6 months ( N = 535). External and internal social support with abstinence-specific support inclusive are investigated. With certain demographic variables and risk-related variables controlled, greater special type of external social support (as measured by number of children) predicts a lower risk of relapse, which means better effect of compulsory rehabilitation. Participation into some of the institutional programs and experienced personal conflicts for abstinence show no statistically significant with relapse risk.
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Affiliation(s)
- Haiyan Xiong
- 1 Southwest University of Political Science and Law, Chongqing, China
| | - Jidong Jia
- 2 Huazhong University of Science & Technology, Wuhan, China
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Guo L, Li P, Pan S, Li M, Li W, Gao X, Huang G, Xu Y, Lu C. Associations of childhood maltreatment with subsequent illicit drug use among Chinese adolescents: The moderating role of the child's sex. Psychiatry Res 2018; 269:361-368. [PMID: 30173042 DOI: 10.1016/j.psychres.2018.08.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 06/27/2018] [Accepted: 08/24/2018] [Indexed: 01/23/2023]
Abstract
Adolescence is a critical period for the onset of illicit drug use. This study aimed to estimate the prevalence of illicit drug use among Chinese adolescents, to assess the associations between different forms of childhood maltreatment and subsequent illicit drug use and to test whether the child's sex plays a moderating role in the associations. A secondary analysis was made of cross-sectional data collected from 10th to 12th graders from China who were sampled in the 2015 School-based Chinese Adolescents Health Survey. A total of 59,518 questionnaires were included in the final analysis. The prevalence estimates and logistic regression analyses were weighted to account for the complex survey design. If the interaction term (between childhood maltreatment and sex) was significantly associated with illicit drug use, we would perform stratification analyses across sex. Of the total sample, 45.2% were boys, and the mean (SD) age was 17.0 (0.9) years. The results of stratification analyses demonstrated that among boys, physical abuse and sexual abuse were independently associated with an increased risk of use during their lifetime of MDMA, methamphetamine, ketamine, and mephedrone; among girls, only emotional abuse and sexual abuse were associated with MDMA use, methamphetamine use, ketamine use, and mephedrone use.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China
| | - Siyuan Pan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China
| | - Ming Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China
| | - Wuquan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China
| | - Xue Gao
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Yan Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China; Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China.
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Rudolph AE, Crawford ND, Latkin C, Lewis CF. Multiplex Relationships and HIV: Implications for Network-Based Interventions. AIDS Behav 2017; 21:1219-1227. [PMID: 27272657 DOI: 10.1007/s10461-016-1454-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The number of network members and the roles they play can influence risk behaviors and consequently intervention strategies to reduce HIV transmission. We recruited 652 people who use drugs (PWUD) from socially disadvantaged neighborhoods in New York City (07/2006-06/2009). Interviewer-administered surveys ascertained demographic, behavioral, and network data. We used logistic regression, stratified by exchange sex, to assess the relationship between HIV status and the number of network members with different roles, treated as independent and multiplex (i.e., drug + sex). Those with more multiplex risk ties were significantly more likely to be HIV positive, but only among those not reporting exchange sex (AOR = 3.2). Among those reporting exchange sex, men reporting recent male sex partners were more likely to report HIV positive status (AOR = 12.6). These data suggest that sex and drug relationships among PWUD are interrelated. Interventions that target multiplex rather than single-role relationships may be more effective in influencing behavior change.
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Affiliation(s)
- Abby E Rudolph
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, T418E, Boston, MA, 02118-2526, USA.
| | - Natalie D Crawford
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Carl Latkin
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Crystal Fuller Lewis
- Division of Social Solutions and Services Research, Nathan Kline Institute, Orangeburg, NY, USA
- Department of Psychiatry, New York University School of Medicine, New York City, NY, USA
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Sun Y, Meng S, Li J, Shi J, Lu L. Advances in genetic studies of substance abuse in China. SHANGHAI ARCHIVES OF PSYCHIATRY 2014; 25:199-211. [PMID: 24991158 PMCID: PMC4054556 DOI: 10.3969/j.issn.1002-0829.2013.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Summary The importance of genetic factors in substance addiction has long been established. The rationale for this work is that understanding of the function of addiction genes and delineation of the key molecular pathways of these genes would enhance the development of novel therapeutic targets and biomarkers that could be used in the prevention and management of substance abuse. Over the past few years, there has been a substantial increase in the number of genetic studies conducted on addiction in China; these studies have primarily focused on heroin, alcohol, and nicotine dependence. Most studies of candidate genes have concentrated on the dopamine, opioid, and serotonin systems. A number of genes associated with substance abuse in Caucasians are also risk factors in Chinese, but several novel genes and genetic risk factors associated with substance abuse in Chinese subjects have also been identified. This paper reviews the genetic studies of substance abuse performed by Chinese researchers. Genotypes and alleles related to addictive behavior in Chinese individuals are discussed and the contributions of Chinese researchers to the international corpus of knowledge about the genetic understanding of substance abuse are described.
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Affiliation(s)
- Yan Sun
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Shiqiu Meng
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Jiali Li
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Institute of Mental Health, Peking University, Beijing, China
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Abstract
The interrelationships of HIV/AIDS and drug use and misuse result in complex problems that have been addressed by a variety of sociolegal approaches that often are in contrast to evidence-based medical practices proven effective in reducing associated harms. Like other countries struggling to reduce the incidence and consequences of addiction and HIV/AIDS, China is working to improve systems of care and to revise policies toward drug use and misuse and HIV/AIDS. Greater interaction with researchers and clinicians from around the world can foster increased awareness of effective practices and help implement effective strategies to deal with the problems of HIV/AIDS, and addiction.
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Affiliation(s)
- Min Zhao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Walter Ling
- UCLA Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Pilot trial of a recovery management intervention for heroin addicts released from compulsory rehabilitation in China. J Subst Abuse Treat 2012; 44:78-83. [PMID: 22520276 DOI: 10.1016/j.jsat.2012.03.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 11/24/2022]
Abstract
China faces the challenge of dual epidemics of drug use and HIV/AIDS. Despite the high relapse rate among heroin addicts released from compulsory rehabilitation facilities, there are few programs available in China to assist these addicts in the community. We pilot-tested in China a Recovery Management Intervention (RMI) program designed to facilitate early detection of relapse and prompt linkage from compulsory rehabilitation to the community and, if participants relapse, to community-based methadone maintenance treatment (MMT) programs. One hundred heroin addicts were randomly assigned to either the Standard Care group (n = 50) or the RMI group (n = 50). At the end of the 3-month trial, participants in the RMI group, relative to the standard care group, demonstrated positive outcomes in recidivism due to relapse (0 vs. 6%, p = .08; d = 0.354), MMT participation (8% vs. 0, p = 0.06; d = 0.417), and employment (33% vs. 2%, p < .001; d = 0.876), although no difference was found in urine testing results (8.5% vs. 8.7%; d = 0.013) among interviewed participants. These pilot study results were based on a small sample size and short-term observation, suggesting the need for more research to further improve and test RMI effectiveness with larger samples over a longer period of time in order to provide evidence in support of RMI as an effective strategy for community reintegration among addicts released from rehabilitation facilities in China.
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Li J, Liu H, Li J, Luo J, Koram N, Detels R. Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China. Addiction 2011; 106:1780-7; discussion 1788-9. [PMID: 21457169 PMCID: PMC3142291 DOI: 10.1111/j.1360-0443.2011.03459.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To investigate the patterns of concurrent sexual partnerships among young opiate users and sexual transmissibility of human immunodeficiency virus (HIV) in concurrent sexual partnerships in drug-use and sexual networks. DESIGN Cross-sectional design. PARTICIPANTS A total of 426 young opiate users in Yunnan, China. SETTING Young opiate users recruited from their network ties. MEASUREMENT Respondent-driven sampling (RDS) was used to recruit participants. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with egocentric social network components, risky sexual behavior for HIV and drug-use practices. FINDINGS The RDS-adjusted prevalence of concurrent sexual partners was 42.9% among opiate users. Opiate users with concurrent sexual partnerships were more likely to engage in risky HIV-related sexual behavior, compared to those without. Specifically, they were more likely to report having had four or more sexual partners (26.3% versus 2.0%), having had a spouse or boy/girlfriends who also had concurrent sexual partnerships (28.1% versus 8.2%), having exchanged drug for sex (12.4% versus 3.8%), having had sexual partners who were non-injection drug users (22.6% versus 10.1%), having had sexual partners who were injection drug users (25.3% versus 13.5%) and having used club drugs (26.3% versus 13.5%). There were no significant differences in consistent condom use between opiate users with sexual concurrency and those without. The same proportion (25.8%) of opiate users in the two groups reported having consistently used condoms when having sex with regular partners, and 46.3% of opiate users with sexual concurrency and 36.4% of those without such concurrency consistently used condoms with non-regular partners. CONCLUSION The expansion of the human immunodeficiency virus epidemic from high-risk populations to the general population in China may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated into harm reduction programmes.
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Affiliation(s)
- Jian Li
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hongjie Liu
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jianhua Li
- Yunnan Institute for Drug Abuse, Kunming, Yunnan, China
| | - Jian Luo
- Yunnan Institute for Drug Abuse, Kunming, Yunnan, China
| | - Nana Koram
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Roger Detels
- Department of Epidemiology, University of California, Los Angeles, California, USA
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Rudolph AE, Latkin C, Crawford ND, Jones KC, Fuller CM. Does respondent driven sampling alter the social network composition and health-seeking behaviors of illicit drug users followed prospectively? PLoS One 2011; 6:e19615. [PMID: 21573122 PMCID: PMC3089627 DOI: 10.1371/journal.pone.0019615] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 04/12/2011] [Indexed: 11/28/2022] Open
Abstract
Respondent driven sampling (RDS) was originally developed to sample and provide peer education to injection drug users at risk for HIV. Based on the premise that drug users' social networks were maintained through sharing rituals, this peer-driven approach to disseminate educational information and reduce risk behaviors capitalizes and expands upon the norms that sustain these relationships. Compared with traditional outreach interventions, peer-driven interventions produce greater reductions in HIV risk behaviors and adoption of safer behaviors over time, however, control and intervention groups are not similarly recruited. As peer-recruitment may alter risk networks and individual risk behaviors over time, such comparison studies are unable to isolate the effect of a peer-delivered intervention. This analysis examines whether RDS recruitment (without an intervention) is associated with changes in health-seeking behaviors and network composition over 6 months. New York City drug users (N = 618) were recruited using targeted street outreach (TSO) and RDS (2006–2009). 329 non-injectors (RDS = 237; TSO = 92) completed baseline and 6-month surveys ascertaining demographic, drug use, and network characteristics. Chi-square and t-tests compared RDS- and TSO-recruited participants on changes in HIV testing and drug treatment utilization and in the proportion of drug using, sex, incarcerated and social support networks over the follow-up period. The sample was 66% male, 24% Hispanic, 69% black, 62% homeless, and the median age was 35. At baseline, the median network size was 3, 86% used crack, 70% used cocaine, 40% used heroin, and in the past 6 months 72% were tested for HIV and 46% were enrolled in drug treatment. There were no significant differences by recruitment strategy with respect to changes in health-seeking behaviors or network composition over 6 months. These findings suggest no association between RDS recruitment and changes in network composition or HIV risk, which supports prior findings from prospective HIV behavioral surveillance and intervention studies.
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Affiliation(s)
- Abby E Rudolph
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
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Wang X, Zhao D, Shi J, Zhao C, Liu Z, Lu L. Addiction research centres and the nurturing of creativity. The Chinese National Institute on Drug Dependence, Peking University: past, present and future. Addiction 2010; 105:1525-30. [PMID: 20491722 DOI: 10.1111/j.1360-0443.2010.02957.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the 25 years since drug abuse re-emerged in China in the 1980s, the National Institute of Drug Dependence (NIDD) has made many contributions to China's antidrug campaign. This present paper offers an account of the history, current status and future of drug dependence research at NIDD. NIDD was originally a research centre at Beijing Medical University, founded by the Chinese Ministry of Health to address the rapid spread of drug abuse in China. Originally, the main task of NIDD was to complete the commissions assigned by the government and university. Further developments transformed NIDD into a national research institute in the field of drug addiction that began to conduct its own research. NIDD has now created a professional team spread across several independent departments involved in neurobiological mechanisms, epidemiological surveys and monitoring, pre-clinical and clinical evaluation of new drugs (mainly analgesic drugs and detoxification drugs) and informatics and data analysis. As a university-based research institute, NIDD's funding derives mainly from grants provided by the government and financial support from international organizations. Its past and present research has a gained NIDD a reputation with both practitioners and policy makers in the field of drug addiction. In the future, NIDD will continue to engage in various aspects of drug addiction research and will enter the field of brain function.
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Affiliation(s)
- Xi Wang
- National Institute on Drug Dependence, Peking University, Beijing, China
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Li J, Ha TH, Zhang C, Liu H. The Chinese government's response to drug use and HIV/AIDS: a review of policies and programs. Harm Reduct J 2010; 7:4. [PMID: 20205729 PMCID: PMC2847555 DOI: 10.1186/1477-7517-7-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 03/05/2010] [Indexed: 12/03/2022] Open
Abstract
Illicit drug use has become popular in China. Acknowledging the challenge of illicit drug use, China has adopted several new policies on the management of illicit drug use in recent years. This study reviews the current policies on drug use and assesses the harm reduction interventions among drug users in China. The review documents that the new policies on drug use provide a variety of choices of detoxification treatment for drug users. The methadone maintenance treatment and needle exchange programs have been adopted as harm reduction models in China. Most of the reviewed harm reduction programs have been successfully implemented and yielded positive effects in reducing drug related risk behaviors among drug users. Although there remain barriers to the effective implementation of policies on drug use and harm reduction programs, Chinese government has shown their commitment to support the expansion of harm reduction interventions for drug users throughout the country.
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Affiliation(s)
- Jianhua Li
- Yunnan Institute for Drug Abuse, Yunnan, China.
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13
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Abstract
Drug addiction in China began with the importation of Indian opium by the British in the 16th century and brought severe social and health problems. While drug abuse abated following the establishment of People's Republic of China, modernization and Westernization in the 1980s led to the reemergence of this problem. Drug abuse in China became epidemic, facilitating the spread of HIV/AIDS. The Chinese government has made great efforts to address these problems, focusing both on treatments of drug addiction and on harm-reduction programs. Although the new trends of drug addiction in China pose great public health challenges, these government interventions are likely to successfully stem the problem of drug abuse in the future.
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Affiliation(s)
- Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, China.
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Genome-wide linkage analysis of heroin dependence in Han Chinese: results from Wave Two of a multi-stage study. Drug Alcohol Depend 2008; 98:30-4. [PMID: 18538955 PMCID: PMC2764288 DOI: 10.1016/j.drugalcdep.2008.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 04/06/2008] [Accepted: 04/13/2008] [Indexed: 11/21/2022]
Abstract
Previously we reported the results of Wave One of a genome-wide search for heroin dependence susceptibility loci in Han Chinese families from Yunnan Province, China, near Asia's "Golden Triangle". Our initial analysis of 194 independent affected sibling-pairs from 192 families identified two regions with nonparametric linkage (NPL) Z-scores greater than 2.0, which were suggestive of linkage. Presently we have supplemented our sample with additional individuals and families, bringing the total number of genotyped individuals to 1513 and the number of independent sibling-pairs to 397. Upon repeating our analyses with this larger sample, we found that the evidence for linkage at our most strongly implicated locus from Wave One (marker D17S1880; 53.4cM on 17q11.2; NPL Z=2.36; uncorrected p=0.009) was completely abolished (Z=-1.13; p=0.900). In contrast, the evidence for linkage at the second-most strongly implicated locus from Wave One (D4S1644; 143.3cM on 4q31.21; NPL Z=2.19; uncorrected p=0.014) increased in its magnitude and significance (Z=2.64; uncorrected p=0.004), becoming the most strongly implicated locus overall in our full sample. Other loci on chromosomes 1, 2, 4, 12, 16, and X also displayed nominally significant evidence for linkage (p< or =0.05). These loci appear to be entirely distinct from opioid-linked loci reported by other groups; however, meta-analyses of all available linkage data may reveal common sites of interest and promising candidate genes that can be further evaluated as risk factors for the illness.
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Peng JS, Wang X, Liu MQ, Zhou DJ, Gong J, Xu HM, Chen JP, Zhu HH, Zhou W, Ho WZ. Genetic variation of hepatitis C virus in a cohort of injection heroin users in Wuhan, China. Virus Res 2008; 135:191-6. [PMID: 18353479 PMCID: PMC2483840 DOI: 10.1016/j.virusres.2008.01.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 01/29/2008] [Accepted: 01/30/2008] [Indexed: 01/18/2023]
Abstract
Since the majority of heroin abusers use injection as the primary route of admission, heroin abuse contributes significantly to the transmission of hepatitis C virus (HCV). We determined HCV infection and its genotype distribution among injection heroin users in Wuhan, the largest city in the central China. Eight hundred seventy-eight (84%) out of 1046 serum specimens from the injection drug users were positive for HCV antibody. Out of randomly selected 122 specimens positive for HCV antibody, seventy-eight (64%) had detectable HCV RNA with genotype 6a as the predominant strain (50%), followed by 3b (32.2%), 1a (8.1%), 1b (6.5%), and 3a (3.2%). HCV RNA levels in male heroin users were significantly higher (P=0.013) than those in the female subjects. Although there was no significant difference in HCV RNA levels among the specimens positive for HCV 6a and 1a/1b, the samples with 6a or 1a/1b contained higher levels of HCV RNA than the specimens positive for HCV 3b (P=0.019, P=0.012, respectively). These findings indicate that there is a high prevalence of HCV infection with genotypes 6a and 3b as predominated strains among injection heroin users in Wuhan, China.
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Affiliation(s)
- Jin-Song Peng
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
- TongJi Medical College, HuaZhong University of Science & Technology, Wuhan, P.R. China
| | - Xu Wang
- Division of Allergy & Immunology, Joseph Stokes, Jr. Research Institute at The Children’s Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, U.S.A
| | - Man-Qing Liu
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
| | - Dun-Jin Zhou
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
| | - Jie Gong
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
| | - Han-Ming Xu
- Wuhan Psychiatric Health Center, Wuhan, P.R. China
| | | | - Hong-Hao Zhu
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
| | - Wang Zhou
- Wuhan Centers for Disease Control and Prevention, Wuhan, P.R. China
| | - Wen-Zhe Ho
- Division of Allergy & Immunology, Joseph Stokes, Jr. Research Institute at The Children’s Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, U.S.A
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Xia X, Luo J, Bai J, Yu R. Epidemiology of hepatitis C virus infection among injection drug users in China: systematic review and meta-analysis. Public Health 2008; 122:990-1003. [PMID: 18486955 DOI: 10.1016/j.puhe.2008.01.014] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 12/06/2007] [Accepted: 01/29/2008] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Injection drug use (IDU) is the predominant mode of hepatitis C virus (HCV) transmission in China. This paper aims to provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for HCV infection in injection drug users (IDUs) in China to help inform prevention programmes and guide future research. STUDY DESIGN Data from articles and reports according to pre-defined criteria on HCV infection rates among IDUs of different regions, genders, ethnic backgrounds and risk factors (injecting practice, needle sharing, long duration, sex behaviour and co-infection status) were abstracted and pooled by meta-analysis. A systematic review was constructed based on both pooled data and representative viewpoints. METHODS Ninety-five percent confidence intervals (CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios and 95% CI were calculated by fixed or random effects models. Publication bias was examined using Begg's test and Egger's test. Data manipulation and statistical analyses were undertaken using STATA 7.0 and RevMan 4.2. Epi Info 3.4.3 was used for map construction. RESULTS The pooled prevalence of HCV infection among IDUs in China was 61.4% (95% CI 55.7-67.2%), and the epidemic was most severe in Hubei, Yunnan, Guangxi, Hunan and Xinjiang. No significant difference was found in HCV infection rates between male and female IDUs. A significant association was found between HCV infection and ethnic-minority status. IDUs were 9.24 times more likely to be infected with HCV than non-IDUs, while non-IDUs were more likely to be infected with HCV than members of the general population and other risk populations. There was no significant difference in the risk of HCV infection for needle-sharing IDUs and non-needle-sharing IDUs. A longer duration of IDU was associated with increased HCV prevalence. High-risk sexual practices were strongly associated with drug injection behaviours. Co-infection with human immunodeficiency virus (HIV) greatly increased the probability of HCV infection among IDUs, while the probability of hepatitis B virus infection remained similar for HCV-positive and HCV-negative IDUs in China. CONCLUSIONS IDU continues to fuel the HCV/HIV epidemics spreading throughout China. Many pragmatic strategies are being implemented but need further evaluation.
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Affiliation(s)
- Xian Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, No. 140, Hanzhong Road, Nanjing, Jiangsu 210029, PR China
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Lu L, Fang Y, Wang X. Drug Abuse in China: Past, Present and Future. Cell Mol Neurobiol 2007; 28:479-90. [PMID: 17990098 DOI: 10.1007/s10571-007-9225-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 10/08/2007] [Indexed: 10/22/2022]
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Abstract
Drug abuse has a long, but also different history in Germany and China. The Opium War largely influenced the history of China in 19th century; however, China was once recognized as a drug-free nation for 3 decades from the 1950s to the 1980s. Drug abuse has spread quickly since re-emerging as a national problem in China in the late 1980s. The number of registered drug abusers increased from 70 000 in 1990 to more than 1 million by the end of 2005. In past decades, illicit drug trafficking and production have swept most provinces in China, and drug abuse has caused many problems for both abusers and the community. One major drug-related problem is the spread of HIV, which has caused major social and economic damage in China. Germany, the largest developed European country, also faces the drug and addiction problem. Germany has about 150 000 heroin addicts, for whom HIV/AIDS has become a serious threat since the mid 1980s. To control the drug problem, the German Government adopted the “Action Plan on Drugs and Addiction” in 2003; the China Central Government approved a similar regulation in the antidrug campaign in 2005. Germany has experience in reducing drug-related harm. The methadone maintenance treatment (MMT) program has run for more than 20 years and the public has become more tolerant of addicts. In 2003, China began the MMT program for controlling the spread of HIV/AIDS. It is necessary for China to learn from developed countries to acquire success in its antidrug campaign. In this review, we will go over the differences and similarities in drug abuse between Germany and China. The differences are related to history, population and economics, drug policy context, drug laws, HIV/hepatitis C virus infection, the MMT program and so on. These 2 nations have drug abuse problems with different histories and currently use different approaches to handle illicit drug marketing and use. The legal penalties for illicit drug offences reflect the social differences of these 2 nations with respect to the seriousness of particular types of crimes. The characteristics of the MMT program may also influence patterns of drug abuse in these 2 nations and China should improve the MMT program based on the successful model in Europe, the USA, and Australia. We recommend more dialogue and collaboration between Germany and China.
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Affiliation(s)
- Ingo Ilja Michels
- Office of the Federal Drug Commissioner, Federal Ministry of Health, Berlin, 10117 Germany
| | - Yu-xia Fang
- Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, 21224 Maryland USA
| | - Dong Zhao
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
| | - Li-yan Zhao
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
| | - Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
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19
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Abstract
AIMS To illustrate the current situation and problems of drug addiction in treatment China and propose suggestions. METHODS A descriptive study based on literature searched from Medline and the China National Knowledge Infrastructure database (1996-2007) and hand-picked references. RESULTS Since the re-emergence of drug addiction in China in the early 1990s, there has been tremendous progress in drug addiction treatments in China, especially treatments for opiate addiction. However, many problems and challenges remain for improvement, including widespread negative attitudes towards drug abuse and drug-dependent individuals, the lack of evidence-based data on the efficacy of Chinese traditional medicine and the lack of a comprehensive and integrated system to organize all treatment resources and monitor treatment progress. The authors discuss the challenges that impede effective treatments of drug addiction and some suggestions are proposed. Implementing these suggestions can improve the outcome of treatment of drug-dependent individuals and benefit the whole society. CONCLUSION China faces substantial drug addiction problems that appear to be worsening with time. Although much progress in drug addiction treatment has been made, improvement in many aspects is needed urgently.
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Affiliation(s)
- Yi-Lang Tang
- Beijing Anding Hospital, Capital University of Medical Sciences, Beijing, China.
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20
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Xiao Y, Kristensen S, Sun J, Lu L, Vermund SH. Expansion of HIV/AIDS in China: lessons from Yunnan Province. Soc Sci Med 2006; 64:665-75. [PMID: 17107739 PMCID: PMC2730760 DOI: 10.1016/j.socscimed.2006.09.019] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Indexed: 11/20/2022]
Abstract
In this article we systematically and critically review the Chinese and English language literature on human immunodeficiency virus (HIV)-related studies in Yunnan Province, Southwestern China. Yunnan Province had the first Chinese HIV outbreak and is still the worst affected area in the nation. Since 1989, HIV infection has extended from injecting drug users into the general population through sexual transmission. Since the economic reform of the 1980s, changed social norms and increased migration have spawned increases in HIV-related risk behaviors such as drug use and commercial sex work. A smaller size of "bridge" populations and lower sexual contact rates between persons in "bridge" and general populations may explain the slower expansion of the HIV epidemic in Yunnan compared to nearby Southeast Asian nations. In 2004, women in antenatal care had a 0.38% HIV prevalence province wide, although >1% infection rates are seen in those counties with high injection drug rates. Patterns of drug trafficking have spread the unusual recombinant HIV subtypes first seen in Yunnan to far-flung regions of China. Increased efforts of Yunnan's HIV control program are correlated with an improved general HIV awareness, but risk behaviors continue at worrisome rates. Future efforts should focus on changing risk behaviors, including harm reduction and condom promotion, especially among the "bridge" groups. The resurgence of commercial sex work in Yunnan, and the high frequency of workers migrating into provinces far from home and family are all sociocultural factors of considerable importance for future HIV and sexually transmitted disease control in China.
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Affiliation(s)
- Yan Xiao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Room 502, No. 42 Dongjing Road, Xuanwu District, Beijing 100050, China
- Corresponding author. Tel.: +8613911788993
| | | | - Jiangping Sun
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Room 502, No. 42 Dongjing Road, Xuanwu District, Beijing 100050, China
| | - Lin Lu
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Sten H. Vermund
- Vanderbilt University School of Medicine Institute for Global Health, Nashville, TN, USA
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Glatt SJ, Su JA, Zhu SC, Zhang R, Zhang B, Li J, Yuan X, Li J, Lyons MJ, Faraone SV, Tsuang MT. Genome-wide linkage analysis of heroin dependence in Han Chinese: results from wave one of a multi-stage study. Am J Med Genet B Neuropsychiatr Genet 2006; 141B:648-52. [PMID: 16856125 PMCID: PMC2562776 DOI: 10.1002/ajmg.b.30361] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The contribution of genes to the etiology of heroin dependence is greater than for any other illicit drug. The specific genes mediating this effect remain unknown, despite several candidate gene association studies of the condition. Here we report the results of a genome-wide search for heroin dependence susceptibility loci using multipoint linkage analysis. In phase I, we ascertained 207 independent affected sibling pairs from 202 Han Chinese families from Yunnan Province, China (near Asia's "Golden Triangle"). After data-cleaning, 194 fully independent sibling pairs (i.e., with no overlapping individuals) from 192 families were genotyped on 404 short tandem-repeat markers spaced at an average inter-marker distance of 9 cM. Although none of our findings achieved genome-wide significance, we found two regions with non-parametric linkage (NPL) Z-scores greater than 2.0. An NPL Z-score of 2.19 (uncorrected P-value = 0.014) was observed at D4S1644, located at 143.3 cM on chromosomal region 4q31.21. The highest NPL Z-score of 2.36 (uncorrected P-value = 0.009) was observed at 53.4 cM on chromosomal region 17q11.2 at marker D17S1880. This is among the first published reports of a genome-wide linkage analysis of heroin dependence. Forthcoming results from other groups and from two additional waves of ascertainment (one planned, one currently ongoing) for our own study should be able to support or refute the putative susceptibility loci we have identified, after which positional candidate genes can be further evaluated as risk factors for the illness.
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Affiliation(s)
- Stephen J Glatt
- Department of Psychiatry, Center for Behavioral Genomics, University of California, San Diego, Gilman Drive, La Jolla, California 92093-0603, USA.
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22
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Liu H, Grusky O, Zhu Y, Li X. Do drug users in China who frequently receive detoxification treatment change their risky drug use practices and sexual behavior? Drug Alcohol Depend 2006; 84:114-21. [PMID: 16443333 DOI: 10.1016/j.drugalcdep.2006.01.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Revised: 01/05/2006] [Accepted: 01/06/2006] [Indexed: 11/24/2022]
Abstract
BACKGROUND Relapse rates among treated drug users in China are high. We examined the associations between frequency of drug detoxification treatment and HIV-related risky drug practices and sexual behavior. METHODS A cross-sectional study was conducted among drug users in two Anhui province detoxification centers in 2003. RESULTS A total of 312 drug users were recruited. Seventy-seven percent of the subjects had ever received two or more detoxification treatments. The median number of detoxification treatments received was three, with an interquartile range of two to five treatments. More than 7 in 10 (72%) ever injected drugs; 19% shared needles and syringes in the past 30 days; 40% of drug users reported having both regular and commercial sex partners in the past year and 48% reported having only regular sex partners. Multiple Poisson regression analysis documented that the frequency of detoxification treatment was not associated with a decrease in drug practice (injection or sharing needles) and in unprotected sex. CONCLUSION Drug users who frequently received detoxification treatment did not change their risky drug use practices and sexual behavior. Effective behavioral interventions and substitution maintenance treatment should become an integral part of detoxification programs in China.
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Affiliation(s)
- Hongjie Liu
- Prevention Research Center, Wayne State University School of Medicine, 4201 St. Antoine Street, UHC-6D, Detroit, MI 48201, USA.
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23
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Abstract
BACKGROUND Historically, China has had extraordinarily high rates of opiate dependence. These rates declined drastically following the 1949 revolution; however, opiate abuse has re-emerged in the late 1980's and has spread quickly since then. AIMS To describe the current situation of opiate addiction and treatments in China and make some suggestions. DESIGN A descriptive study based on literature searched from Medline and the China National Knowledge Infrastructure database (1996 to 2004) and hand-picked references. FINDINGS The number of registered addicts in 2004 was 1.14 million (more than 75% of them heroin addicts), but the actual number is probably far higher. Opiate abuse contributes substantially to the spread of HIV/AIDS in China, with intravenous drug use the most prevalent route of transmission (51.2%). Currently, the main treatments for opiate dependence in China include short-term detoxification with opiate agonists or non-opiate agents, such as clonidine or lofexidine; Chinese herbal medicine and traditional non-medication treatments are also used. Methadone maintenance treatment (MMT) has not been officially approved by the Chinese government for widespread implementation, but some pilot studies are currently underway. CONCLUSION China faces substantial drug abuse problems that appear to be worsening with time. Opiate dependence is a major threat to the public health and social security of China because of its devastating medical effects, its impact on risk for HIV/AIDS and criminal behaviors, low rates of recovery and high rates of relapse. There is an urgent need to implement MMT and other modern treatments for opiate dependence more widely in China.
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Affiliation(s)
- Yi-Lang Tang
- Beijing Anding Hospital, Capital University of Medical Sciences, Beijing, China.
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24
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Chamla D, Chamla JH, Dabin W, Delin H, Rennes N. Transition to injection and sharing of needles/syringes: potential for HIV transmission among heroin users in Chengdu, China. Addict Behav 2006; 31:697-701. [PMID: 15982826 DOI: 10.1016/j.addbeh.2005.05.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Revised: 05/26/2005] [Accepted: 05/26/2005] [Indexed: 11/18/2022]
Abstract
This cross-sectional survey interviewed heroin injectors admitted in three detoxification centres from August 2003 to June 2004 in Chengdu City, China. Logistic regression and survival analysis were performed to identify factors associated with sharing of needles/syringes and time from initiation of heroin to adoption of injection, respectively. Out of 266 subjects studied, 206 (77.44%) were males, 103 (38.72%) never shared injecting materials, 113 (42.48%) were non-Chengdu residents and 9 (3.38%) belonged to ethnic minorities. Those with short history of heroin injection (P<0.05) and those belonged to ethnic minorities (P<0.05) were more likely to share injecting materials. Only age, ethnicity and duration of heroin use were associated with time to first injection. Median time to injection was 6 months for those who used heroin for the duration up to 1 year and 21 months for those who used heroin for 2-5 years. The study suggests that there is early initiation of injection and sharing of injecting materials is high among heroin users, a major risk for HIV transmission. Ethnic minorities have been identified to be the most risky group, which needs further attention.
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Affiliation(s)
- Dick Chamla
- World Health Organization, EIP/LMF/HLS Uganda country office, Cnr Kintu/Shimoni Road, P.O. Box 24578, Nakasero, Kampala, Uganda
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Qian HZ, Schumacher JE, Chen HT, Ruan YH. Injection drug use and HIV/AIDS in China: review of current situation, prevention and policy implications. Harm Reduct J 2006; 3:4. [PMID: 16451717 PMCID: PMC1402269 DOI: 10.1186/1477-7517-3-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Accepted: 02/01/2006] [Indexed: 11/10/2022] Open
Abstract
Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem.
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Affiliation(s)
- Han-Zhu Qian
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Joseph E Schumacher
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Huey T Chen
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Alabama, USA
| | - Yu-Hua Ruan
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Methods for assessing HIV and HIV risk among IDUs and for evaluating interventions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2005. [DOI: 10.1016/j.drugpo.2005.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
After nearly three decades of being virtually drug free, use of heroin and other illicit drugs has re-emerged in China as a major public health problem. One result is that drug abuse, particularly heroin injection, has come to play a predominant role in fueling China's AIDS epidemic. The first outbreak of HIV among China's IDUs was reported in the border area of Yunnan province between China and Myanmar where drug trafficking is heavy. Since then drug-related HIV has spread to all 31 provinces, autonomous regions and municipalities. This paper provides an overview to HIV/AIDS transmission through injection drug use in China. It begins with a brief history of the illicit drug trade in China, followed by a discussion of the emergence of drug related AIDS, and a profile of drug users and their sexual partners who have contracted the virus or who are vulnerable to infection. It ends by summarizing three national strategies being used by China to address both drug use and AIDS as major health threats.
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Affiliation(s)
- Tian Xin Chu
- Beijing Center for Disease Prevention and Control, 16 Hepingli Middle Street, Beijing 100013, China.
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Andersen HS. Mental health in prison populations. A review--with special emphasis on a study of Danish prisoners on remand. Acta Psychiatr Scand 2004:5-59. [PMID: 15447785 DOI: 10.1111/j.1600-0447.2004.00436_2.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To review the literature on mental health and psychiatric morbidity in prison populations and relate findings to a Danish study on remand prisoners. METHOD The literature is reviewed and subdivided in the following section: validity of psychometrics in prison populations, prevalence of psychiatric disorders prior to imprisonment, incidence of psychiatric disorders during imprisonment, psychopathy related to psychiatric comorbidity, dependence syndromes with special emphasis on different administrations of heroin use (smoke vs. injection). The results are compared with a longitudinal Danish study on remand prisoners in either solitary confinement (SC) or non-SC. RESULTS Many factors must be taken into consideration when dealing with prisoners and mental health, e.g. international differences, the prison setting, demographics and methodological issues. The prison populations in general are increasing worldwide. Psychometrics may perform differently in prison populations compared with general populations with the General Health Questionnaire-28 having a low validity in remand prisoners. Psychiatric morbidity including schizophrenia is higher and perhaps increasing in prison populations compared with general populations with dependence syndromes being the most frequent disorders. The early phase of imprisonment is a vulnerable period with a moderately high incidence of adjustment disorders and twice the incidence in SC compared with non-SC. Prevalence of psychopathy is lower in European than North American prisons. Medium to high scores of psychopathy is related to higher psychiatric comorbidity. Opioid dependence is the most frequent drug disorder with subjects using injection representing a more dysfunctional group than subjects using smoke administration. Many mentally ill prisoners remain undetected and undertreated. CONCLUSION There is a growing population of mentally ill prisoners being insufficiently detected and treated.
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Affiliation(s)
- H S Andersen
- Psychiatric Department, Bispebjerg University Hospital, Copenhagen Hospital Cooperation, Denmark.
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