High HIV prevalence and risk behaviors in men who have sex with men in Chennai, India.

Objective: To estimate HIV and sexually transmitted disease (STD) prevalence and behavioral risk characteristics of men who have sex with men (MSM) in Chennai, India.

Methods: A cross-sectional population-based random sample survey was conducted in 2001. Randomly selected residents of 30 slums in Chennai were interviewed for behavioral risk factors through face-to-face interviews.

Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States.

Using data from a multisite venue-based survey of male subjects aged 15 to 22 years, we examined racial/ethnic differences in demographics, partner type, partner type-specific condom use, drug use, and HIV prevalence in 3316 US black, multiethnic black, Latino, and white men who have sex with men (MSM). We further estimated associations of these factors with HIV infection and their influence on racial/ethnic disparities in HIV prevalence. HIV prevalences were 16% for both black and multiethnic black participants, 6.

High-risk behavior and potential transmission of drug-resistant HIV among injection drug users.

Evidence of increasing prevalence of drug resistance among recent HIV seroconverters indicates a growing public health concern and warrants an examination of the problem from a prevention perspective. Among 638 HIV-infected injection drug users (IDUs) completing 2731 visits between December 1996 and February 2000 in an ongoing cohort study in Baltimore, Maryland, factors associated with unprotected sex and needle sharing were determined. Participants were classified as being at higher or lower risk of HIV and of drug-resistant HIV transmission based on viral load, antiretroviral therapy use, and reported high-risk behavior.

Relation of coronary artery calcium to left ventricular mass in African-Americans.

Both coronary artery calcium (CAC) deposits and increased left ventricular (LV) mass are important risk factors for coronary heart disease, but the relation between these 2 factors has rarely been studied. We examined the correlation of CAC and LV mass in 159 young to middle-aged African-Americans, and found that the average LV mass indexes were bigger in the CAC-positive groups than in CAC-negative groups in both genders (p = 0.0004 in men; p = 0.

HIV prevention among drug users: an international perspective from Thailand.

All too often in reviews of HIV prevention needs, the role of drugs is summarily dismissed, especially in contexts where the heterosexual epidemic is the primary mode of transmission. Substance use and abuse, particularly injection drug use, play a paramount role in maintaining the heterosexual spread of HIV, as well as in maintaining epidemics where heterosexual spread of the infection has come under control due to prolonged and concerted HIV prevention activities. This article presents several themes to place in the developing country context what we have learned about substance use-related HIV prevention and the special problems of HIV interventions.

Regional patterns and correlates of substance use among young men who have sex with men in 7 US urban areas.

Objectives: We sought to characterize substance use patterns in young men who have sex with men (MSM) in 7 US urban areas and sociodemographic characteristics and history associated with such use.

Methods: We examined data collected from 1994 through 1998 in a venue-based, cross-sectional survey.

Results: Among the 3492 participants, 66% reported use of illicit drugs; 28%, use of 3 or more drugs; 29%, frequent drug use (once a week or more); and 4%, injection drug use.

Drug use, increasing incarceration rates, and prison-associated HIV risks in Thailand.

Background: Incarceration is a known risk for HIV infection in Thai drug users. Through the 1990s, incarceration rates for drug-related offenses rose sharply, whereas HIV prevention and drug treatment in prisons remained limited.

Methods: We assessed HIV and incarceration risks for injection drug users (IDU) and non-IDU in a large treatment center cohort in northern Thailand to investigate HIV and prison risks in this period.

When HIV-prevention messages and gender norms clash: the impact of domestic violence on women's HIV risk in slums of Chennai, India.

This paper examines how marital violence affects women's ability to protect themselves from HIV/AIDS. In-depth interviews (n = 48) and focus groups (n = 84, 3-7 per group) were conducted among men and women in two randomly selected slums of Chennai, India. The study showed that community gender norms tacitly sanction domestic violence that interferes with adopting HIV-preventive behaviors.

Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance.

Nonadherence to highly active antiretroviral therapy (HAART) is a major cause of human immunodeficiency virus (HIV) drug resistance; however the level of nonadherence associated with the greatest risk of resistance is unknown. Beginning in February 2000, 195 patients at the Johns Hopkins Outpatient Center (Baltimore, MD) who were receiving HAART and who had HIV loads of <500 copies/mL were recruited into a cohort study and observed for 1 year. At each visit, adherence to HAART was assessed and plasma samples were obtained and stored for resistance testing, if indicated.

Attitudes toward HIV treatments influence unsafe sexual and injection practices among injecting drug users.

Objective: To determine if HIV treatment-related attitudes are associated with unprotected sex and needle sharing among HIV-seropositive and -seronegative injecting drug users (IDU) in Baltimore, Maryland.

Design And Methods: IDU participating in a cohort study seen between December 2000 and July 2001 completed an interviewer-administered questionnaire on attitudes toward HIV treatment and risk behaviors (593 HIV-seronegative, 338 HIV-seropositive), including: perceived HIV transmissibility through unprotected sex and needle sharing, and safer sex and injection fatigue. Logistic regression was used to examine the role of attitudinal factors on needle sharing and unsafe sex.

Risk factors for HIV infection among drug injectors in southern Thailand.

Background: To determine HIV sero-prevalence and risk factors for HIV infection among injecting drug users (IDU) in southern Thailand.

Methods: Using a cross-sectional HIV sero-prevalence and behavioral survey, 272 active IDU were interviewed about background, life-style, drug use patterns, and sexual behaviors at six drug-treatment clinics in southern Thailand.

Results: Ninety-one percent reported lifetime needle sharing; 96% had tried HIV risk-reduction by either stopping/decreasing visits to sex workers and/or stopping/decreasing needle sharing.

A new circulating recombinant form, CRF15_01B, reinforces the linkage between IDU and heterosexual epidemics in Thailand.

HIV-1 subtype B and CRF01_AE have been in circulation in Thailand and Southeast Asia for more than a decade. Initially separated by risk group, the two strains are increasingly intermixed, and two recombinant strains of essentially reciprocal structure have been recently reported. Here we identify additional CRF_01B recombinants and provide the evidence that HIV-1 strains now pass freely between the two high-risk populations.

Association of hepatitis C virus infection with sexual exposure in southern India.

To determine the association between sexual exposure and hepatitis C virus (HCV) infection in urban Chennai, India, a random sample of adults who live in a slum community completed interviews and provided samples to test for HCV, herpes simplex virus type 2 (HSV-2), and other sexually transmitted infections (STIs). All analyses excluded recent and current injection drug users. HCV infection was not associated with the reported number of sex partners for men or women.

Needle sharing among southern Thai drug injectors.

Aim: To examine factors associated with needle sharing among injecting drug users (IDU) in southern Thailand.

Design: Using a cross-sectional survey, 272 active IDU were interviewed about their socio-economic background, needle sharing and drug use patterns at six drug-treatment clinics in southern Thailand.

Findings: Ninety-one per cent of IDU gave a past history of ever sharing injecting equipment: of these, 23% currently injected but did not share and 68% still shared.

Drug use patterns over time among HIV-seropositive and HIV-seronegative women: the HER study experience.

Background: Drug use, particularly among women, is a public health issue given its health effects and its impact on HIV transmission. Becoming HIV seropositive could lead to differing patterns of drug use over time. HIV infection may decrease drug use due to an increased access to health services.

Human papillomavirus type 16 and immune status in human immunodeficiency virus-seropositive women.

Background: Human papillomavirus (HPV) type 16 is etiologically associated with approximately half of all cervical cancers. It is important, therefore, to determine the characteristics that distinguish HPV16 from other HPV types. A preliminary result based on cross-sectional baseline data in the Women's Interagency Human Immunodeficiency Virus (HIV) Study (WIHS) suggested that the prevalence of HPV16 might have a weaker association with immune status in HIV-seropositive women than that of other HPV types.

Factors associated with accelerated atherosclerosis in HIV-1-infected persons treated with protease inhibitors.

Recent evidence suggests that as a group protease inhibitors (PIs) may accelerate certain factors associated with atherosclerosis. The objective of this study was to evaluate the effect of individual PIs (indinavir, lopinavir, nelfinavir, ritonavir, and saquinavir) on certain factors associated with atherosclerosis. Persons who took saquinavir and/or ritonavir were compared with those on other PIs.

HIV prevalence and risks among injection and noninjection drug users in northern Thailand: need for comprehensive HIV prevention programs.

The authors sought to determine sociodemographic and sexual and drug use risk factors for HIV infection among drug users in northern Thailand adjacent to the Golden Triangle. The authors enrolled patients admitted for inpatient drug detoxification at one treatment center in northern Thailand and studied HIV risks and prevalence using an interviewer-administered questionnaire and serum collection with HIV pretest and posttest counseling. Between February 1, 1999 and January 31, 2000, 1865 patients admitted for opiate and methamphetamine dependence completed study procedures.

Elevated C-reactive protein levels are associated with endothelial dysfunction in chronic cocaine users.

Objective: To examine the relationship of the serum C-reactive protein (CRP) and endothelial function and their associations with coronary artery calcification, lipid profile and cardiac changes.

Methods: The analyses for serum lipids and CRP, echocardiography, spiral computed tomography scans and endothelial function assay were performed in 53 participants with a history of chronic cocaine use.

Results: There were no statistically significant differences in demographic characteristics and drug use between CRP normal (<1.

The role of Medicaid HMO enrollment in the longitudinal utilization of medical care services in a cohort of injecting drug users in Baltimore, Maryland.

Although injecting drug users (IDUs) are highly dependent on Medicaid, the literature has not explored the effect of Medicaid HMO enrollment on medical care utilization. This longitudinal analysis compares 6-month utilization levels of IDUs in Medicaid HMOs with those of other Medicaid-enrolled IDUs and IDUs in other insurance arrangements. The analysis includes 1064 participants from the AIDS Link to Intravenous Experience (ALIVE) study, a natural history study of HIV infection in a community-based sample of IDUs in Baltimore, Maryland.

The association of health-care use and hepatitis C virus infection in a random sample of urban slum community residents in southern India.

To determine whether health-care use was associated with prevalent hepatitis C virus (HCV) infection in Chennai, India, 1,947 adults from 30 slum communities were randomly selected to be interviewed about parenteral and sexual risks for HCV infection and to provide biological specimens for HCV and sexually transmitted infection (STI) testing. Prevalent HCV infection was detected in 2.4% of non-injection drug using (IDU) participants.

Readiness for cessation of drug use among recent attenders and nonattenders of a needle exchange program.

Needle exchange programs (NEPs) represent a bridge to drug abuse treatment. NEP attenders tend to have more severe drug problems, however, and may be less ready to reduce their drug use than other drug users. This study investigated the relationship between NEP attendance and readiness for cessation of drug use.

Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic.

Objective: To examine the influence of environmental-structural factors in promoting consistent condom use (CCU) among female sex workers (FSW) and their regular paying partners in the Dominican Republic.

Methods: A cross-sectional survey was conducted with 288 FSW recruited from 41 sex establishments in Santo Domingo from March to June 1998. Sex workers were asked about their sexual behavior, self-efficacy at negotiating safe sex, perceived intimacy with their most recent regular paying partner, and the physical, social and policy environment of the establishment where they worked.

Social circumstances of initiation of injection drug use and early shooting gallery attendance: implications for HIV intervention among adolescent and young adult injection drug users.

To determine correlates of early shooting gallery (SG) attendance and HIV prevalence and incidence among new injection drug users (IDUs), baseline data from a prospective cohort study of street-recruited IDUs aged 15 to 30 years and injecting < or =5 years were used to identify early high-risk practices and salient social circumstances associated with early SG attendance to help in the design of innovative intervention strategies. Of 226 IDUs, 10.6% were HIV-seropositive, and HIV incidence was 6.