Moderating effect of illicit drug use on the relationship between sexual behaviours and prevalence of HIV or sexually transmitted infections

The influence of adverse childhood experiences and depression on addiction severity among methamphetamine users: exploring the role of perseveration

Aims

This investigation aimed to clarify the intricate relationship among depression, cognitive function, adverse childhood experiences (ACEs), and their combined influence on methamphetamine use disorder (MUD).

Methods

Utilizing a battery of psychological tests, this study ascertained the impact of ACEs on the condition of 76 people with MUD who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, aged 42.17 on average. The Iowa Gambling Task (IGT), Conners' Continuous Performance-II (CPT-II), the self-report Severity of Dependence Scale (SDS), and the Beck Depression Inventory-II (BDI-II) were used for these evaluations. Individuals involved in the study were categorized into two discrete cohorts, mild (ME) and severe (SE), based on the extent of their ACEs exposure. This study employed the PROCESS regression, the independent t-test andχ2 tests for the analysis.

Results

The findings revealed notable discrepancies in the psychological consequences between the two groups with different degrees of ACEs; however, no substantial differences were observed in the demographic parameters. The SE group exhibited elevated BDI-II scores, more evident indications of MUD, and a higher degree of CPT-II cognitive perseveration. The PROCESS model revealed that cognitive perseveration moderated the impact of depression on ACEs and subjective MUD severity, explaining 20.2% of the variance. The ACEs and depression predicted 28.6% of the variance in MUD symptoms. However, no statistically significant differences were detected between the two groups regarding the parameters in the IGT-2 assessment.

Conclusions

These results indicate that the interaction between cognitive and depressive factors mediates the effect of ACEs on subjective MUD severity but not on MUD symptoms. The ACEs significant impact on mental health severity perception is explained by cognitive and depressive factors. This implies that MUD treatment and rehabilitation should address cognitive dysfunction and developmental trauma.

Perceived Accuracy Around Undetectable = Untransmitable Among Sexual and Gender Minorities Using Smartphones in India

Sexual and gender minorities (SGM) using online venues in India are usually not reached by government HIV interventions, remaining an understudied yet important population. We investigated sociodemographic characteristics, sexual behaviours along with familiarity, knowledge, and correlated factors around perceived accuracy of the Undetectable = Untransmittable (U = U) slogan. Grindr users in India completed an online, cross-sectional survey in May-June 2022. We included individuals ≥ 18 years old who reported sex with men (excluding those who were born female and or identified as cis-gender female). Associations with perceived U = U accuracy were estimated using adjusted prevalence odds ratios (aPOR) with 95% confidence intervals (95% CI). The survey was completed by 3,126 eligible participants. The median age was 28 years and most participants lived in urban areas and had graduate or postgraduate education. HIV prevalence was 3.1%. Only 14% reported familiarity with the U = U slogan and after an explanation was provided, 25% perceived it as completely accurate. This was associated with knowing their HIV status (HIV Negative aPOR 1.37 [95%CI 1.1, 1.71], HIV Positive aPOR 3.39 [95%CI 2.11, 5.46]), having heard of PrEP (aPOR1.58 [95%CI 1.29,1.92]) or have used PrEP (aPOR1.56 [95%CI 1.15, 2.12]) along with use of party drugs (aPOR1.51 [95%CI 1.0 2.10]), being in touch with NGOs (aPOR 1.61 [95%CI 1.27, 2.02], p < .001) and having attended LGBTQIA + events (aPOR1.38 [95%CI 1.1, 1.73]). SGMs in India had low familiarity and low perceived accuracy around U = U. Education about U = U and innovating new strategies to reach this hidden population could reduce stigma around HIV in India.

Gender differences in clinical characteristics of emergency department patients involving illicit drugs use with analytical confirmation

BACKGROUND

To compare gender differences in socio-demographics, clinical manifestations, and laboratory test results of individuals who visited emergency departments (EDs) involving drug use.

METHODS

We retrospectively collected the data from 10 hospitals in Taiwan on drug-related ED visits from May 2017 to December 2020. We then examined the gender differences in their socio-demographics, clinical manifestations, urine toxicological results, and other laboratory tests results using chi-square or multivariable logistic regression.

RESULTS

Among individuals with drug-related ED visits, there were 546 (73.7%) men and 195 (26.3%) women. The most commonly used drugs were meth/amphetamine, followed by synthetic cathinones, and ketamine and its analogs. Compared to men, women were younger (32.03 ± 10.86 vs. 36.51 ± 10.84 years, p < 0.001) and more likely to use new psychoactive substances (NPS) (p = 0.011). Men were more likely to have human immunodeficiency virus infection (p < 0.001), whereas women were more likely to report psychiatric comorbidities (p = 0.003). Women were less likely to have aggressive behaviors (odds ratio (OR): 0.59, 95% CI: 0.39-0.88). After adjusting for socio-demographics and drug types, women were still less likely to have aggressive behaviors than men (adjusted OR: 0.59, 95% CI: 0.38-0.93). The likelihood of rhabdomyolysis and intensive care unit admission was higher in men (p < 0.001).

CONCLUSION

We found considerable gender differences in clinical characteristics among ED-visiting drug users, which could offer valuable information for the future development of more tailored gender-specific drug prevention and treatment strategies.