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Emerging Geographies of Opioids and HIV/HCV: Services, Responses, and Prevention

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (19 February 2019) | Viewed by 15556

Special Issue Editor

Institute for Infectious Disease Research, National Development and Research Institutes, Inc., New York, United States
Interests: infectious disease; political ecology of health and disease; health and place; health policy; risk environments

Special Issue Information

Dear Colleagues,

During the past decade, the opioid epidemic has fueled an increase in people who inject drugs (PWID), shaping new geographies of HIV/HCV-related risk in the U.S. and abroad. This Special Issue of the International Journal of Environmental Research and Public Health, on the “Emerging Geographies of Opioids and HIV/HCV: Services, Responses, and Prevention”, offers an opportunity for multi-disciplinary researchers to come together and bring new understanding to the evolving opioid crisis and its relationship to emerging geographies of HIV/HCV-related risk, health services research and response. To frame the development of effective policy interventions, it is critically important that the interconnected opioid and HIV/HCV epidemics be better understood, along with geographically-varying responses, services, and prevention activities. We are particularly interested in research related to increasing trends in HIV/HCV-related opioid risk and responses (both public policy and new research initiatives) within non-urban communities (i.e., suburban and rural areas). We welcome papers related to evidence of successful prevention/intervention strategies, governmental, harm reduction or otherwise; surveillance to monitor the spread of HIV/HCV-related opioid risk in non-traditional geographic areas; place factors as indicators of opioid-related risk; and analyses of spatial variation in services and response; and submissions on other topics related to this theme. This Special Issue aims to critically examine and advance geographic research and theory in this area by bringing together national and international contributors from geography, medical anthropology, sociology, health policy, epidemiology and public health.

Dr. Barbara Tempalski
Guest Editor

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Keywords

  • place
  • structural determinants
  • NIMBY
  • build environments
  • vulnerable populations
  • socio-spatial stigma
  • need
  • risk spaces
  • harm reduction
  • coverage

Published Papers (4 papers)

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Research

10 pages, 280 KiB  
Article
Factors Associated with Compliance among Methadone Maintenance Treatment Transfers: Evidence from Audit Records at Clinics in Guangdong, China
by Cheng Gong, Xia Zou, Wen Chen, Yin Liu, Qian Lu and Li Ling
Int. J. Environ. Res. Public Health 2019, 16(11), 2023; https://doi.org/10.3390/ijerph16112023 - 06 Jun 2019
Cited by 1 | Viewed by 2483
Abstract
Methadone maintenance treatment (MMT) requires patients to intake their daily dose in person at their clinic. Therefore, transfer services are vital for patients who need temporary leave from their primary MMT clinic. However, studies have shown that transfer patients might delay return after [...] Read more.
Methadone maintenance treatment (MMT) requires patients to intake their daily dose in person at their clinic. Therefore, transfer services are vital for patients who need temporary leave from their primary MMT clinic. However, studies have shown that transfer patients might delay return after temporary leave, leading to missed doses and putting them at risk of increased harm. In this study, we aimed to explore the transfer rates and factors associated with MMT patients who delayed return during a transfer period. In this retrospective analysis, we used audit records from the web-based management system from six MMT clinics in Guangdong, China. Multilevel logistic regression and multilevel Poisson regression analyses were used to examine the factors associated with patients who delayed return to their primary MMT clinic. A total of 459 people used the transfer system 2940 times between January 2006 and December 2016. Of those, patients delayed return to their primary MMT clinic 1199 times (40.78%). Patients who transferred regularly had poor compliance rates with MMT treatment. Those who once dropped out from and then re-enrolled in MMT were more likely to delay return. Most patients (82.71%) who used the transfer service for “work” were more likely to prolong their delay length. The findings highlight that a more flexible transfer system would minimize inconvenience to the patients. Full article
10 pages, 286 KiB  
Article
Gaps in HCV Knowledge and Risk Behaviors among Young Suburban People Who Inject Drugs
by John J. Jost, Barbara Tempalski, Tatiana Vera, Matthew J. Akiyama, Aprille P. Mangalonzo and Alain H. Litwin
Int. J. Environ. Res. Public Health 2019, 16(11), 1958; https://doi.org/10.3390/ijerph16111958 - 02 Jun 2019
Cited by 16 | Viewed by 3271
Abstract
Background: Hepatitis C virus (HCV) among young suburban people who inject drugs (PWID) is a growing epidemic in the United States, yet little is known about the factors contributing to increased exposure. The goal of this study was to explore and assess HCV [...] Read more.
Background: Hepatitis C virus (HCV) among young suburban people who inject drugs (PWID) is a growing epidemic in the United States, yet little is known about the factors contributing to increased exposure. The goal of this study was to explore and assess HCV knowledge and attitudes about treatment and identify risk behaviors among a cohort of young suburban PWID. Methods: We conducted interviews with New Jersey (NJ) service providers and staff from the state’s five syringe service programs to inform a semistructured survey addressing HCV knowledge, treatment, and risk factors among young suburban PWID. We then used this survey to conduct qualitative interviews with 14 young suburban PWID (median age 26 years) in NJ between April and May 2015. Data were analyzed using a modified grounded theory approach and coded to identify thematic relationships among respondents. Results: Most participants had substantial gaps in several aspects of HCV knowledge. These included: HCV transmission, HCV symptoms, and the availability of new direct-acting antiviral therapy. Participants also downplayed the risk of past and current risk behaviors, such as sharing drug paraphernalia and reusing needles, which also reflected incomplete knowledge regarding these practices. Conclusion: Young suburban PWID are not receiving or retaining accurate and current HCV information. Innovative outreach and prevention messages specifically tailored to young suburban PWID may help to disseminate HCV prevention and treatment information to this population. Full article
14 pages, 7934 KiB  
Article
Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois
by Colleen McLuckie, Mai T. Pho, Kaitlin Ellis, Livia Navon, Kelly Walblay, Wiley D. Jenkins, Christofer Rodriguez, Marynia A. Kolak, Yen-Tyng Chen, John A. Schneider and Whitney E. Zahnd
Int. J. Environ. Res. Public Health 2019, 16(6), 989; https://doi.org/10.3390/ijerph16060989 - 19 Mar 2019
Cited by 17 | Viewed by 6139
Abstract
Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role [...] Read more.
Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and disease burden to inform service prioritization in rural settings. Methods: We surveyed rural Illinois LHDs to assess their OUD-related services, and calculated county-level opioid overdose, HIV, and hepatitis C diagnosis rates. Bivariate choropleth maps were created to display LHD service provision relative to disease burden in rural Illinois counties. Results: Most rural LHDs provided limited OUD-related services, although many LHDs provided HIV and HCV testing. Bivariate mapping showed rural counties with limited OUD treatment and HIV services and with corresponding higher outcome/disease rates to be dispersed throughout Illinois. Additionally, rural counties with limited LHD-offered hepatitis C services and high hepatitis C diagnosis rates were geographically concentrated in southern Illinois. Conclusions: Bivariate mapping can enable geographic targeting of resources to address the opioid crisis and related infectious disease by identifying areas with low LHD services relative to high disease burden. Full article
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15 pages, 522 KiB  
Article
Evaluating the Integrated Methadone and Anti-Retroviral Therapy Strategy in Tanzania Using the RE-AIM Framework
by Saria Hassan, Alexis Cooke, Haneefa Saleem, Dorothy Mushi, Jessie Mbwambo and Barrot H. Lambdin
Int. J. Environ. Res. Public Health 2019, 16(5), 728; https://doi.org/10.3390/ijerph16050728 - 28 Feb 2019
Cited by 13 | Viewed by 3283
Abstract
There are an estimated 50,000 people who inject drugs in Tanzania, with an HIV prevalence in this population of 42%. The Integrated Methadone and Anti-Retroviral Therapy (IMAT) strategy was developed to integrate HIV services into an opioid treatment program (OTP) in sub-Saharan Africa [...] Read more.
There are an estimated 50,000 people who inject drugs in Tanzania, with an HIV prevalence in this population of 42%. The Integrated Methadone and Anti-Retroviral Therapy (IMAT) strategy was developed to integrate HIV services into an opioid treatment program (OTP) in sub-Saharan Africa and increase anti-retroviral therapy (ART) initiation rates. In this paper, we evaluate the IMAT strategy using an implementation science framework to inform future care integration efforts in the region. IMAT centralized HIV services into an OTP clinic in Dar Es Salaam, Tanzania: HIV diagnosis, ART initiation, monitoring and follow up. A mixed-methods, concurrent design, was used for evaluation: quantitative programmatic data and semi-structured interviews with providers and clients addressed 4 out of 5 components of the RE-AIM framework: reach, effectiveness, adoption, implementation. Results showed high reach: 98% of HIV-positive clients received HIV services; effectiveness: 90-day ART initiation rate doubled, from 41% pre-IMAT to 87% post-IMAT (p < 0.001); proportion of HIV-positive eligible clients on ART increased from 71% pre-IMAT to 98% post-IMAT (p < 0.001). There was high adoption and implementation protocol fidelity. Qualitative results informed barriers and facilitators of RE-AIM components. In conclusion, we successfully integrated HIV care into an OTP clinic in sub-Saharan Africa with increased rates of ART initiation. The IMAT strategy represents an effective care integration model to improve HIV care delivery for OTP clients. Full article
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