Hidden populations: discovering the differences between the known and the unknown drug using populations in the Republic of Georgia

Background

The HIV epidemic in Georgia is increasing. Data shows that compared to previous years, Georgia has increasingly more HIV-infected individuals than previous assessments. Select client groups remain hard to reach by harm reduction programs. The need for innovative strategies to involve these individuals is imperative.

Methods

The following study examines demographics and risk factors of participants, previously known and not known to harm reduction services, for HIV and other infectious disease in towns across Georgia in 2015 and compares risk among different groups, while also assessing the rationale for implementing Peer-Driven Interventions in Georgian Harm Reduction activities. Important differences in demographics and risk profile are thought to exist between those exposed, and those unexposed, to harm reduction activity.

Results

Important and striking differences between previously known and unknown participants, including demographic background and risk profile and behaviours exist in the drug using community. These differences can potentially explain some of the rise of HIV prevalence in Georgia.

Conclusion

Significant differences exist between known and unknown drug users in Georgia, the differences between which are crucial for planning future and holistic harm reduction activities in Georgia, regionally and globally. The research advocates for smarter harm reduction activity, adds to the global evidence for the utility of Peer-Driven Intervention, and encourages sustained global effort for reduction of blood-borne disease burden globally.

Cardiorespiratory changes following chemical applications to gut serosa

Application of 0.2-0.3 ml of 1 M ammonium chloride, 100 mM citric acid, 100 mM hydrochloric acid, 1% potassium chloride, 1% ammonium oxalate, 1% oxalic acid, 0.5% sodium hydroxide, 200 micrograms% bradykinin or 20 mg% capsaicin to gastrointestinal serosa produced a fall in blood pressure and inhibition of respiration in hypertensive as well as normotensive rats. In 6 (8%) of the animals studied, a fall in heart rate was also seen which was blocked by atropine. The blood pressure changes were independent of changes in heart rate. After acute abdominal vagotomy, while the respiratory inhibition following chemical application on gut serosa was enhanced, the cardiovascular responses were the same as before. In animals subjected to sympathetic denervation by spinal section at T5, celiac ganglionectomy or splanchnicotomy, a similar application produced an augmented respiratory response while the cardiovascular parameters were unaffected. These results show that the above inhibitions were mediated through the sympathetic afferents and a minor stimulation of respiration, via vagal afferents. The efferent pathway for the cardiac changes seems to be via vagus and the vascular changes via the sympathetics. In chronic vagotomized animals, the same stimulation produced a response similar to that seen in animals with intact vagus. An adaptive response may be operating in chronic animals reverting the status back to normal.